Today, RCM company leaders all over the
world have realized the importance of embracing and leveraging, the
capabilities of information technology, to improve business outcomes for
themselves and their clients. The level of accuracy and precision that can
result from integrating Robotic Process Automation, Machine Learning, and
Artificial Intelligence into RCM is extraordinary and if done first and done
right will be revolutionary. This is the real-world truth and you cannot delay
accepting it and acknowledging that this is going to be the future of RCM and
your business. If you think otherwise, I advise you to start updating your CV
today.
The biggest challenge with integrating
technology into RCM is the lack of Subject Matter Experts (SMEs) who understand
the technology and the lack of Technology Experts (Techies) who under the
Subject Matter. And as a result, you guessed it, there is constant tension. The
tension between the two teams that result in poorly developed solutions that
replace a current problem with a new one. What a shame.
Did you know that the USA contributed to
37% of the world’s healthcare expenditure in 2017 but had only 4% of the
world’s population? Something is seriously backward about this country’s
healthcare system. Anyways, let’s come back to RCM. The USA spent approx. 8% –
12% of that expense towards the cost of collections, which includes RCM
Services, Software, collections agency fees, and related administrative costs
and overheads. As RCM leaders, we can do something about that, something
significant enough to change the lives of millions of people seeking affordable
and safe healthcare. (Now if the word ‘Affordable’ got you thinking about
‘Value’ based healthcare, trust me, you have more time to deal with that. So
stay with me on implementing ‘Technology’)
1. Reassurance
Your current staff needs reassurance
(repeatedly and consistently) that their jobs are not at stake as a result of
supporting the development and deployment of intelligent IT solutions.
Otherwise, they are never going to contribute their wealth of knowledge and
expertise towards building IT products that truly deliver the desired outcomes.
I strongly believe that it is not a fabricated story you tell your staff. It is
a fact. There is so much growth and opportunity to increase your client base
through competitive pricing and demoing your robust solutions. Your staff can
be reassigned to grow into a higher level of thinking and contribution as your
business grows.
Think through this again, your staff is
sure to lose their jobs eventually if they don’t contribute towards this
transformation today. That does not mean you use fear to drive the change, this
fact is just for you to find your motivation to ensure the longevity of your
employee’s jobs. Now if that does not motivate you, I really don’t know what
else to say (facepalm).
2. Selecting the Right People for the job
Your transformation team should contain the
right balance of attitude, knowledge, and skill. Attitude tops it all. Here is
why. It is far easier to train a Techy on RCM than it is to train an RCM expert
on IT solutions. You need to find an IT lead who understands the importance of
learning RCM and even going to the extent of doing some of the RCM functions
for a short time to gain a decent sense of the subject. Give your tech lead
examples of contrasting specialties, systems, and denials so that it gets
his/her thinking more and more in line with what the solution should entail.
3. Balance 'Short Term Gains' with 'Long
Term Sustainability'
Your tech team will be eager to use
off-the-shelf bots to eliminate small portions of manual labor. Everyone is
motivated to show quick wins, even the boss likes quick results and faster ROI.
Today there are off-the-shelf attended and unattended bots that can take away
manual processing of ERAs, Extract Claim Status from web portals and even
update large sets of data on multiple systems. It is easy to purchase these
bots and take away the obvious direct tasks, but don’t lose focus on the
ultimate goal of why you started down this path. Sustainable solutions are
critical to longevity than short-term patches. My advice, reinvest every saving
from the quick wins back into building a platform (foundation) that can over time
exponentiate your unique value proposition. What I mean by the platform is
creating a larger pool of talent that foresees the future of RCM and architects
a foundation on which you can build more solutions. This will over time replace
your quick win bots (patches) and build a sustainable flow of information,
intelligence, and rules.
4. Start today
Do not waste time pondering upon whether
you must invest in technology. The opportunity cost is immense. Make the move.
Start by asking your team to look at what the competition is doing and how you
can be competitive 5 years from now. When they come to you with their findings
(which will have technology on the top of their list), it will be easier for
you to get them on board with the mission
5. Enjoy the Change
Keep your Eye on the Price and keep your
teams focused on the enormity of benefits. The promise of a technology-enabled
RCM is badly needed for the Healthcare industry. Think of all the resources you
will have freed up and the savings you can use to invest in growth and
sustainability.
