Cycle Up

Familiar Challenges. A New Way Forward.    From Jeff Nieman, CEO

Posted by Jeff Nieman on Nov 11, 2024 3:07:05 PM
photoWelcome to the third and final edition of Cycle Up for 2024. Since our July installment, healthcare revenue cycle management (RCM) has faced familiar challenges – a lack of experienced RCM employees, surging claim denials inspired by payer AI, and a continued emphasis on giving patients more options and conveniences throughout their payment journey.

In search of some inspiration for this article, I looked through previous editions of Cycle Up to explore how we got to this moment in the industry. This passage is from my intro to October 2022’s Cycle Up:

“After nearly three years of dealing with the unrelenting impact of COVID-19, hospitals, health systems, and physician groups across the nation are continuing to grapple with:
  • Financial instability
  • Staffing issues related to RCM and processing accounts
  • Patient satisfaction and retention
  • Missing revenues
Clearly, not much has changed in the past two years. Hospitals and health systems are still grappling with staffing shortfalls, enhancing the patient experience, and plenty of unclaimed revenue.

There has been one change, however, and it’s been monumental: the role of technology and how artificial intelligence (AI) and robotic process automation (RPA) have taken healthcare RCM by storm. In 2022, healthcare providers had a finite number of tools in the RCM toolbox and, therefore, limited strategies at their disposal. Today, thanks to the awesome capabilities of AI and RPA, there’s nothing but open field in front of us in terms of our capacity to exponentially increase and accelerate financial performance at scale for hospitals, health systems and larger provider groups.
 
We began to see the true potential of AI back in the late 20-teens, established a research and development team, and have been building and launching AI and RPA capabilities ever since. The benefits have been clear, measurable, and immense for both our clients and the patients they serve. 
  
Those advances are powering a new solution that combines our decades of healthcare-specific RCM expertise with cutting-edge AI, RPA, and data analytics. Essentially, we are harmonizing the critical thinking skills of experienced RCM specialists with the extraordinary capabilities of AI. It’s not a matter of choosing one or the other. RCM success hinges on a balanced approach that attacks the same old challenges from multiple new angles.

While we won’t unveil all the details about our new solution just yet, we’re confident that it will equip our clients with the new tools they need to thrive from both a patient-care and revenue cycle perspective – even in today’s challenging RCM environment. 

I hope you enjoy this issue of Cycle Up. As always, thank you for reading!

Regards,

Jeff Nieman
CEO
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