Adapt To Shrinking Margins: The True Cost Of Automation

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2 Min

Not to sound “Big Brother-y”

Source: Wakefield
May 26, 2024

Our Right Touch, Right Time Philosophy

By 2024, it’s predicted that 25% of employee-facing app development will be replaced by the codeless development of just-in-time tasks. Your team can work smarter, not harder, with purpose-built automation that removes unproductive touches and gives you a head start on claim rejections and denials.  

Our technology allows us to scrape payor websites and EDI feeds to work up to 70% of accounts within minutes. This improves collections, drives efficiency, and reduces the time to collect, we call this our, “right time, right touch,” approach.

But automation in revenue cycle isn’t just nice to have. It’s necessary.

The Great Resignation

Wakefield

Amid inflation and rising costs related to workforce shortages and supply chain disruptions, health system finance leaders can’t afford to overlook potential for meaningful cost savings.

A whopping 3.6% of healthcare workers resigned between March 2020 and March 2021.

The latest group of workers to quit their jobs are older, more tenured employees.  With this trend, organizations may feel the loss of their most knowledgeable employees even more.  

The trend raises questions about how organizations will cope with losing their most experienced and knowledgeable staff and how they can hold onto them, especially if pay and benefits are less important to this group.

Cost of Maintaining Your Practice

According to the American Medical Association (AMA), clinical spending grew by an average of 8.3% per year between 2009 and 2019, while overall healthcare spending grew by an average of 4.6%.

In 2021, the cost of qualified clinical workers increased by $24 billion a year over pre-pandemic levels, translating into an 8% hike per patient day compared with 2019.

52% of workers who stayed with their companies have taken on more responsibilities, with 30% of remaining employees stating they struggle to complete necessary tasks. Many workers are questioning whether their pay is high enough, and 27% feel less loyalty to their company all while  Healthcare administrator growth astronomically outpaces physician growth.

Lack of Technological Advancements

An estimated 80% of medical bills contain errors due to human mistakes according to a 2016 Becker’s article.

Lack of automation, combined with the loss of tenured employees, and overworked staff can result in costly mistakes and slow revenue.

Automation is the Future

Wakefield

With automation on-site, there are some things to consider. About 64% of IT and AI practitioners say It takes at least a month to implement a new AI model  

 And unfortunately, 1/5 have 90% of their AI models going unused.

That said, it’s estimated that within the next 5 years, hybrid human-digital workforces will be the new normal. About 78% of hospitals and health systems plan to leverage automation within the revenue cycle over the next year to increase productivity, reduce cost-to-collect, and elevate staff.

How do we even begin?

Limitless options and tight budgets make the decisions around leveraging automation complex.

Most of us are not in a position to spend unlimited amounts of money and automate beginning to end, so we must make some very important decisions on where and how we implement automation within the revenue cycle

Over the last decade, Revenue Cycle leaders have looked at ways to decrease their expenses, whether that came from a new technology that allowed us to send claims faster, an integration that allowed us to complete benefit checks within our systems, or a tool to reduce the time your staff spent sifting through pdf rejection reports.

Ongoing overhauls, continuous process improvements, and strategic redesigns have truly been a way of life,  and based on the market changes, these decisions are now even more critical.

The key difference between now, and let’s say 10 years ago is that technology is advancing at such a high rate of speed, that Revenue Cycle Leaders are faced with a new problem, what seems like an exhausting list of options… now, the market is just jam-packed things ‘must’ automate.

So, with an ever-growing list of options, you can automate & integrate something at nearly any point in the revenue cycle. It can be overwhelming to know where to start with so much to choose from, and we must ask ourselves:   What will give us the most significant impact for our investment?

And how do we even begin?

It's all in the data

Wakefield

Data tells a clear story of the problems within our revenue cycle.  With the marketing around the latest and greatest tech available, it is hard not to make decisions based on a feeling rather than data.   But we must stay grounded.  With what seems like an ever-expanding sea of options, it is more important than ever to start with the data.

So what KPIs is your organization struggling to meet or exceed benchmarks on? Do you know?  Do you track KPIs?

assuming you do, what is the root cause of those difficulties? 

For example, if an organization struggles with a high denial rate that can be a long list of things that could be impacting performance.  The first step in examining the root cause of that struggle would be to understand what types of denials or payer delays you face.

One of the reports we provide is Payer Delay and Denial Trending. We use this report to track over time the types of denials a practice is experiencing. For example, things like Timely Filing, Failure to Respond to Requests for Records, No Authorization, Medical Necessity, and Coverage Issues are readily displayed and tracked. But perhaps most importantly trended over time. Giving you insight into performance changes within your receivable.  Making it easier to see what is improving and what is not.

As a leader with visibility into the reasons for denials, we can analyze other processes within our revenue cycle to see if automation can improve our outcomes, leading you to identify the areas that stand to have the greatest benefits from process enhancement or replacement Automation. 

The True Cost of Automation

Now you can argue that this could easily be the very first item you consider, comparing the costs both in the initial implementation of the automation as well as the ongoing fees must be considered before making a final decision. And it very well may be for many of us. However I would make the case that you would not even know what you needed to spend the money on until you have completed your assessment.

Typically we take into consideration the upfront or capital costs as well as our ongoing costs or budgeted expenses of the automation. Those are rather fixed, we see those numbers in black and white when we get an estimate or review an agreement with a vendor however when we are talking technology there are also hidden costs that we must account for.  Let’s say we want to build our automation inhouse, we contract with a company to build this out for us, and now we are 8 months into using it and it stops functioning.   Who fixes that?  Do you have a maintenance agreement with a that contractor?   For those of us that jumped on the payer screen scraping train, or even scripting data back into systems, we quickly learned that technology does not stand still for anyone, and that website you programmed to scrape or that system you built scripting for, it will change too.  There will be an update, an enhancement, something, and it will need to be addressed in your solution. 

Often times when we get to this step of our options become more narrowed and we can find a solution that meats our needs, will improve our outcomes, and that will do so within our budgets.

 

We’re the experts in all things revenue cycle. Give us a call today to learn more!