Revenue Cycle Management (RCM) is an essential component of healthcare operations, ensuring medical service providers receive timely payments from patients. Despite its importance, the RCM process can be complex, often involving manual-intensive checks and data processing to track revenue from the initial delivery of healthcare services to the patient’s recovery phase.
The healthcare sector is on the cusp of significant enhancements in its revenue cycle management (RCM) practices and operations, fueled by the rapid evolution of technologies like artificial intelligence, automation, and outsourcing. These emerging trends and statistics hold the potential to carve a brighter path for the future of healthcare RCM.
A recently published market report on Revenue Cycle Management offers an extensive 100-page analysis of the industry. The report covers various aspects of the market, such as product specifications, manufacturing processes, cost structures, industry chain structure, and market overview. Additionally, it presents qualitative and quantitative information on the market size and revenue forecast for Revenue Cycle Management, categorized by product types (Integrated, Standalone) and applications (Physician Back Office, Hospitals, Diagnostic Laboratories). The report also includes an evaluation of the historical and baseline economic conditions, industry trends, the financial performance of market participants, and significant developments in the Revenue Cycle Management market. Overall, the report serves as a valuable resource for stakeholders and investors seeking valuable insights into the industry.
As per market research, the global Revenue Cycle Management market experienced a notable surge, reaching a valuation of USD 63451.49 million in 2022, and is projected to grow at a substantial CAGR of 14.54% during the forecast period. By 2028, the market is expected to reach a staggering USD 143306.4 million. The report not only evaluates the market’s current state but also outlines key opportunities and growth-driving factors. In light of the ongoing Russia-Ukraine War and the COVID-19 pandemic, these external factors are anticipated to significantly impact the Revenue Cycle Management market.
Even though the COVID-19 pandemic has been ongoing for nearly three years, telehealth continues to be a significant revenue cycle management trend, with no signs of slowing down anytime soon. If your practice provides telehealth services, it’s crucial to stay up-to-date on the latest developments in 2023.
For 2023, the Centers for Medicare and Medicaid Services (CMS) have expanded the Medicare Telehealth Service List, adding 54 new services under Category III. This category comprises current procedural terminology (CPT) codes for emerging and innovative technologies. These codes will be temporarily placed in Category III to monitor usage and gather data before being made permanent. You can submit claims for these Category III telehealth codes until at least December 31, 2023.
Healthcare providers are expected to broaden their outsourcing coverage in the future, resulting in enhanced operational efficiency.
With proven competency in RCM activities, providers are now directing their attention toward healthcare support programs such as CDI, Virtual Nursing, and Virtual Scribing.
Wearable technology has primarily been used for lifestyle purposes rather than healthcare and disease management. However, experts predict that this will change in the future as wearables such as Remote Patient Monitoring devices become more clinically relevant and capable of collecting accurate clinical data that can be used for insights and better care delivery. With the aid of AI, the analysis of this data will become more in-depth, leading to faster and more preventative care.
The healthcare industry is also becoming more consumer-oriented, driven by RPM Services and other technologies. As a result, design, function, and user experience are becoming crucial factors in healthcare development. This shift is driving a patient-first approach, with providers focusing on improving the patient experience to increase efficiency and realign incentives to outcomes, ultimately leading to the adoption of value-based care through RPM Services.
Before the COVID-19 pandemic, Mental Health America reported that nearly 19% of Americans, or over 50 million individuals, were affected by a mental health disorder. Furthermore, almost 4.5% of people experienced severe suicidal thoughts, while approximately 15% of adolescents suffered from a significant depressive episode.
As a result, the demand for specialized revenue cycle solutions dedicated to psychological and behavioral care is on the rise. It is predicted that revenue cycle management for psychological and psychosocial clinics will require specialized software and experienced RCM personnel in the future.
Artificial Intelligence is gradually but permanently transforming the Revenue Cycle Management industry. The pace of change is rapid, and service providers are keeping up with the times.
By improving the payer interface, implementing smart payment processing, and automating updates, employees are able to handle claim denials more effectively. The role of SaaS-based systems is also evolving to accommodate the increasing demand for automation, which can be accessed from anywhere at any time.
As we enter 2023, industries across the board are bracing themselves for a potential recession, and healthcare is no exception. Hospitals and health systems are already grappling with financial difficulties, and there’s a concern that this could become a trend in revenue cycle management.
Although we hope that this trend doesn’t come to fruition, we advise private practices to establish a robust financial foundation to help them endure any economic turbulence.
In the event of an economic downturn, having a strong revenue cycle is particularly important for specialties that provide elective procedures and care. As patients lose insurance coverage, they may opt not to seek routine, non-urgent treatment. Additionally, health expenses may be pushed down the priority list without sufficient insurance coverage or disposable income.
If we look at the latest revenue cycle management trends in healthcare, we can anticipate an interesting year ahead in 2023. While there may be some uncertainty, private practices can take proactive steps to start the year strong:
Keep themselves updated on industry developments, especially regarding the changes in reimbursement and the Medicare Telehealth Services List.
Develop a robust revenue cycle, with an efficient insurance verification process and upfront patient collections, to strengthen your bottom line.
Integrate automation in their RCM to mitigate costly errors, minimize staff shortages and burnout, and enhance the patient experience.
"This story illustrates the power of remote patient monitoring. Our doctors can’t monitor us all the time, and the limited snapshot they get from office visits often doesn’t paint the whole picture."
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