Healthcare RCM

The buzz at HFMA RCC

Illustration of pills, medical syringe, and stethoscope.
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We love an excuse to go to Phoenix in the spring - tacos, Cactus League spring training, and healthcare rev cycle conversations at the HFMA Revenue Cycle Conference 2023.

As always, we had our ears to the ground, and the conversations were coming in hard on three important topics: consumerism, big tech in healthcare, and AI.

Here’s what HFMA RCC attendees had to say.

Consumerism

It’s interesting to listen to lots of conversations at a healthcare conference and hear who still says “patients” and who says “customers” or “consumers.” The RCM community is still a mix, but patients themselves are definitely still thinking of themselves as consumers, no matter what term they use.

Consumerism has always been an easier shift for rev cycle teams than for providers. The control and independence of self-payment and self-financing that consumers want is much more beneficial to and easier to implement for RCM teams than, say, self-scheduling is for providers.

But when healthcare consumers encounter resistance at any part of the process, it rains down on RCM. So conversations are on two tracks with consumerism:

  1. How can rev cycle management continue to meet and plan ahead for patient expectations?
  2. How can rev cycle management encourage other areas of healthcare to get on board with the shift (since it’s happening no matter what)?

Big tech disruption

HFMA says, “Only the unprepared call it disruption.” 

Given that Amazon and Apple have been telegraphing their moves into healthcare for years, that’s a fair statement, but there’s no other way to describe the potential shift those two 700-pound tech gorillas can have on healthcare.

There was some skepticism at HFMA RCC regarding Amazon’s previous healthcare ventures - Amazon Care, Haven, and Amazon Pharmacy - that haven’t worked out. But every failure means a learning opportunity, and their acquisition of One Medical could benefit from all those lessons, as well as what it knows about providing exactly what consumers want.

We also heard talk about where Apple is continuing to impact healthcare. While much of their focus has seemingly been on hardware, that hardware has enabled them to accumulate enormous amounts of data.

That data, we heard some folks point out, could have a huge impact on insurance companies.

Artificial intelligence

With HFMA RCC 2023 focusing on the future, we heard conversations about AI in self-diagnosis, clinical care, and insurance intervention.

But AI shines in work that is:

  • Repetitive
  • High volume
  • Rules-based

That means AI has particularly powerful applications in rev cycle management, including:

  • Payment and coding accuracy
  • Cost savings
  • Fraud and waste detection
  • Personalized payment and financing automation

At Prodigal, we use AI to make consumer finance conversations easier, including interactions between consumers and patient financial service representatives when discussing payment.

RCM conversations with patients aren’t exactly the same as other consumer finance conversations. So we use AI to help revenue cycle management teams focus on the person behind the transaction - by assisting reps as they talk to customers, automating notes so they can focus on the conversation, and supporting QA and compliance work.

It was great hearing how AI is impacting other parts of the revenue cycle as well as other parts of healthcare, and we’re looking forward to talking cost-effective healthcare at HFMA’s Annual Conference.