In every edition of Cycle Up, we speak with one of Meduit’s leading voices. In this issue, Eric Coats, Vice President of Operations, shares his perspective on the changing realities of healthcare RCM, from evolving patient expectations to the shift toward more holistic partnerships, and how adaptability can give hospitals an RCM advantage.
Q. What’s changed the most in healthcare RCM over the last few years?
A. I think it’s the whole world that’s changing so fast, and I think the medical space and RCM are going along with it – maybe slower than other industries, but it’s definitely moving.
Of course, AI is at the center. It’s driving a dramatic shift in how we operate. It wasn’t that long ago that communicating with patients was all about calls and letters. Now the hit rate on a letter is microscopic, and nobody really answers the phone anymore unless they recognize the number – I know I don’t.
So, I think the pace of change is probably the thing that’s changed the most. If you built an advanced dialer and integrated letter system a few years ago, it’s obsolete now, which is pretty incredible.
Q. Healthcare isn’t known to be the fastest-moving industry, so how can hospitals keep up?
A. Well, it’s a challenge for sure. Especially when you consider that hospitals, particularly smaller or rural facilities, aren’t built to respond quickly to things, they’re built for service. But the business side has become so prominent that it’s forced their hand to start thinking like a company.
I think because of that, a lot of hospitals are realizing that their ability to use AI, attract enough expert people, and maintain good relationships with their patients, things that are all pretty mandatory these days, is limited. They’re there to help people, and even when they can tackle RCM internally, they discover how expensive it can be.
I think that’s where we step in to fill the void. We let doctors be doctors. We let hospitals focus on patients. We take care of the business side, so they don’t have to. And because the business side is all we do, we’ve got systems and technology that let us scale quickly without adding a lot of expense.
Q. Is relieving that pressure the key to an effective partnership?
A. It’s definitely one of them. Hospitals are under constant duress, whether it’s financial, operational, dealing with compliance issues, you name it. As a partner, we’re there to walk alongside them. If they have a problem, we have a problem.
I think we’re fortunate to be large enough and capable enough to meet the big asks but small enough to stay nimble. That combination matters because every hospital’s challenge is a little different. Being versatile enough to meet those needs is what our partnerships look like day to day.
Q. What role do you see AI and automation playing right now?
A. For the hospitals that have fully embraced it, it’s huge. But I still think overall adoption has been slow. And I get it, people are cautious. They’re like, “What can it do?” “How does it share data?” “Can we control it?” I think there’s still an Arnold Schwarzenegger as the Terminator image out there, like will AI wake up and take over one day? And honestly, I think it’s right to be cautious and to ask questions. AI is complex. You have to know how you’ll use it, what problems you’re trying to solve, and who will manage it. You can’t just buy an AI agent off the shelf, plug it in and let it go. But all that said, the benefits are just too great for people to wait on the sidelines forever.
Q. How do people fit into the technology equation?
A. The technology is only as good as the people overseeing it. That’s why I love talking to my agents. They’re such a critical piece of the process. They’re the bridge between the technology and our patients. We can build the best process in the world with the most powerful iteration of AI, but all it takes is one bad customer interaction, and it’s all over. That’s why we invest in our people the way we do.
Q. Since bad debt is your area of expertise, what impact do you think legislation like the OBBB will have on the industry?
A. I think there’s going to be a fundamental shift in how hospitals do business over the next couple of years. Things are already changing. There will be more uninsured patients, and more high-deductible plans. People who used to pay $1,000 before insurance kicked in will likely have to pay more, and that will impact both patients’ ability to pay and hospitals’ ability to collect. I think that will change who hospitals partner with, and how they partner with them to maximize every single dollar.
Q. What do you mean by “how they partner?”
A. In the past, revenue cycle management has always been like ordering off an a la carte menu. Hospitals would have one vendor here, another over there, and another doing something else way over there. The problem with doing that is that everything is disconnected, and not only do you usually end up paying more, but you also get less value.
When we consolidate services for a client, let’s say insurance, early out, and bad debt, we’re not just collecting more efficiently, we’re putting together a complete RCM picture that makes the entire process more efficient from top to bottom.
Since we’re involved in multiple areas, we get to know the payer, how the patient prefers to be contacted, when they’re most likely to respond, and what their payment habits look like. When you have that full picture, everything becomes better connected.
I think these kinds of holistic, integrated partnerships are where the industry is headed. The more connected the revenue cycle is, the easier it becomes to collect what you’re owed, and easier is always a good thing when it comes to revenue cycle management.