With profit margins shrinking and the cost of health care going nowhere but up, operational leaders and consultants throughout the healthcare industry are looking in every nook and cranny to either find ways to cut costs or generate more revenue. With the ongoing need for costly equipment, an expert workforce and the state-of-the-art facilities needed to deliver high-quality healthcare – the opportunities often seem limited.
That’s where advanced technology *might* finally be here to save the day. Recent advancements like natural language processing and artificial intelligence (AI) have proven very powerful in helping healthcare organizations harness the incredible power of data to streamline operations, improve processes and enhance the quality and value of care delivered.
According to a recent Accenture report, AI is healthcare’s “new nervous system,” forecasted to help create $150 billion in annual savings for the US healthcare economy by 2026. In an era where even the most effective politicians, brilliant scientific minds, successful business experts and devoted clinicians have tried limitless strategies to reduce healthcare costs – the incredible potential AI brings to the table is very promising.
AI in Healthcare – A Growing Market
The AI market is growing in all industries and health care is no exception. Specifically, the health AI market is expected to grow ten times over the next five years – predicted to become a $6.6 billion industry by 2021. While AI in healthcare is gaining national attention for its ability to help save lives through AI robotic-assisted surgery, aiding in diagnostics and early disease detection, one of AI’s most likely (and most heroic) initiatives may actually be its ability to help lower costs and improve the value of healthcare.
AI and the Revenue Cycle
Accuracy and efficiency in healthcare billing are of critical importance, but back-office functions such as these remain highly manual processes. They require a sizable and ongoing investment in staffing, training and double-checking (auditing) the work being done to comply with health care’s highly complex policies and regulations. From the patient registration process through to billing and collections, the incredible amount of administrative resources required just to submit a claim are a prime opportunity for AI to offer much-needed support for revenue cycle management teams.
And some really smart healthcare organizations and physician practices are already reaping the benefits of AI by focusing first on the accounts receivable (A/R) process. Physician groups that want to bring a consistent approach to critical workflows are implementing AI-supported revenue cycle management (RCM) systems to use data-driven decision-making to improve key performance indicators throughout the revenue cycle. In these cases, AI and complex algorithms are helping back-office staff determine which unpaid claims to follow up on or which accounts really need follow-up first. After just a few months of using AI-backed technologies, a group of Neurosurgeons in New Jersey has already seen a 15% decrease in overall accounts receivable as well as higher cash collections – giving good reason to consider how big data and AI can support revenue cycle management and other back-office functions in healthcare.
The power of AI is also being used to support complex back-office functions such as risk adjustment and HCC coding – saving time and reducing the incidence of human error. Virtually anywhere there’s a great deal of data to help drive decision-making, AI provides a great opportunity to optimize performance. Enhancing the health care industry’s revenue cycle may just be AI’s next big job.