Monthly Archives: January 2023

In a recent poll, over half of CFOs and revenue cycle VPs reported their firms are falling short of their 2022 healthcare revenue targets.

According to a recent poll of health system and physician group finance chiefs, most provider organisations are falling short of their 2022 healthcare revenue targets.

Censuswide, a London-based survey consulting business, has been commissioned by R1 RCM to poll chief financial officers (CFOs) and revenue cycle vice presidents (VPs) from significant health systems and physician groups in the United States. In early June, 205 CFOs and VPs of revenue cycle responded to the poll. RevCycleIntelligence received the survey results by email.

In 2022, hospitals and health systems saw some improvement in terms of income and patient volume. However, provider organisations throughout the care continuum continue to face escalating costs and workforce constraints, resulting in poor financial performance despite the promise of brighter days following record losses at the outset of the COVID-19 epidemic.

Healthcare CFOs and revenue cycle VPs both expressed anxiety about rising expenses. When asked what their greatest concern is about their businesses’ financial health, 25 – 28% said rising expenses, making it the top issue.

More than a fifth of respondents indicated the prospect of a recession was a big issue for their organization’s financial health, while 21- 23% cited declining margins. Financial executives questioned were also concerned about claims reimbursement from both public and private payers and unexplained revenue loss.

According to the report, labour shortages have an influence on both care quality and healthcare revenue performance. A third of finance leaders reported that clinical shortcomings are now occurring in their firms owing to labour constraints.

A third of those polled indicated they are also concerned about data and cybersecurity concerns. Other top replies include operational difficulties owing to labour shortages, pricing transparency compliance concerns, reduced patient numbers because to COVID-19 spikes, and value-based payment navigation.

According to the report, labour shortages are also harming revenue cycle management. Over a fifth of respondents stated acquiring and keeping revenue cycle management expertise was a current revenue cycle difficulty for which they were looking for a solution. Almost half also reported a significant deficit in their revenue cycle management or billing department. Another third thought the deficit was moderate.

Most CFOs and revenue cycle VPs are looking to automation and technology to alleviate the consequences of the staffing crisis, particularly technologies that allow patients to self-serve. Half of finance executives are increasing staff perks or salary.

Healthcare revenue cycle management (RCM) refers to the process of managing the financial aspects of a healthcare organization, including patient billing, insurance claims processing, and revenue collection. It’s a complex and multi-step process that involves many different stakeholders, including patients, healthcare providers, insurance companies, and government agencies.

One of the main challenges of healthcare RCM is the complexity and constant change in the healthcare system. This includes changes in government regulations and reimbursement policies, as well as the increasing use of electronic medical records and other technological advancements. These changes can make it difficult for healthcare organizations to keep up with the latest requirements and best practices, which can lead to errors and delays in the revenue cycle.

Another challenge is the high cost of healthcare in the U.S. and lack of price transparency this make the patients not to be able to pay the bills, causing a strain on the revenue cycle.

Another challenge is the high amount of denied claims that can occur in the revenue cycle. This can be due to a variety of factors, such as incorrect coding, lack of pre-authorization, or a failure to meet other requirements set by insurance companies. Denied claims can be time-consuming and expensive to resolve, and can also negatively impact the financial performance of the healthcare organization.

In order to effectively manage the healthcare revenue cycle, it is important for organizations to have robust systems and processes in place to track and analyze data, identify and resolve issues, and improve overall performance. Additionally, it is important for organizations to have a strong team in place with the necessary knowledge and expertise to navigate the complex healthcare system and stay up-to-date with the latest regulations and requirements.