Has Robotic Process Automation (RPA) in Healthcare Revenue Cycle Management (RCM) Hit a Tipping Point?

According to some recent studies, there are now more health systems and hospitals in the U.S. using robotic process automation to streamline revenue cycle workflows than not – but just barely. Cloudmed’s own market research conducted by Becker’s Healthcare validates this adoption trend. In December 2021, Becker’s surveyed revenue cycle leaders at U.S. health systems and hospitals* to determine recent trends in consideration and adoption of automation in revenue cycle management.

Becker’s Healthcare asked revenue cycle leaders ten survey questions and from their answers gleaned eight key insights into what and how healthcare revenue cycle leaders are thinking about RPA. Those perceptions and the data behind them are detailed in a new white paper from Becker’s, The State of RPA in the Revenue Cycle: Insights from a 2021 Survey of U.S. Health System Leaders. While the survey results show an almost even split between adopters and delayers, the benefits of automating revenue cycle workflows appear to be resonating and driving faster, deeper adoption.

The survey showed that while 51% of health systems have adopted RPA to some degree, only 7% of those classified their adoption as “mature”, while 33% of revenue cycle leaders defined their utilization of RPA as “robust.” Larger health systems are more likely to adopt RPA, with 66% currently using automation in the revenue cycle, 15 points higher than the overall trend, according to the survey findings.

Considerations for Selecting an Automation Vendor

Infographic: RPA Adoption in 2022

One of the clearest insights from the survey is that revenue cycle leaders have very specific ideas about what is most important to them in selecting an automation product or vendor. When asked about their top criteria for vendors, an overwhelming 89% say they want deep healthcare revenue cycle management expertise. When it comes to selecting a product, there is a clear preference for solutions that integrate with existing revenue cycle and electronic health records systems; respondents chose that as their number one purchase consideration by a wide margin, more than four times that of their next key criterion.

Expected Benefits of Adopting Automation

There is also a wide divergence on expectations of the benefits that healthcare revenue leaders expect to reap from automation. While some revenue cycle pros expect a significant return on investment in the form of improved staff efficiency and increased revenue, others just want to make problems go away. Surprisingly, 20% of respondents said that there’s no real requirement for a financial return on their automation investment. However, most revenue cycle leaders do expect some level of return, although not necessarily purely financial. A full 58% say they expect to see improved labor efficiency, 45% expect increased revenue, and a full 80% say they would expect a financial return at least equal to, but as much as three times higher than, their automation spend. With a continuing labor shortage that may get worse before it gets better, driving revenue cycle efficiencies through automation becomes even more important for maintaining financial health.

Top Uses for Automation in the Revenue Cycle

One of the great advantages of RPA, and automation in general, is it can be used to streamline and simplify virtually any aspect of the revenue cycle that is manual, repetitive, or rules based. The survey clearly shows hospitals are using automation across all areas of RCM. However, many organizations are using automation more prominently to drive front-end revenue cycle efficiency. Here’s a rundown of the top five RCM processes being automated:

  • Eligibility – 59%
  • Authorization – 57%
  • Claims/Follow-up – 43%
  • Charge Capture – 39%
  • Payments/Collections – 39%
Top RPA Use Cases in RCM

Our next blog will dig into how hospitals and health systems are using RPA in the revenue cycle with a deep dive into automating insurance eligibility.

To read the full white paper with survey details and insights, click here.

*The survey polled 101 revenue cycle professionals with 73% representing senior leadership positions. 94% of respondents were from health systems, hospitals, or academic medical centers. 52% were from systems or facilities with 400+ beds, 21% with 200-399 beds, and 27% with fewer than 200 beds.

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