Nearly Half of Suppliers Are Behind Revenue Targets Due to RCM Department Labor Shortages, Report Says


As inflation soars and pandemic-era aid draws to a close, many industries and Americans are struggling to thrive in the post-pandemic economic landscape. The U.S. healthcare system is no stranger to this victimization – some of the nation’s largest healthcare systems saw substantial net losses in the first quarter of 2022. For example, Permanent Kaiser recorded a net loss of $961 million in the first trimester, and Ascentthe net loss was $884.7 million.

It doesn’t look like these revenue issues will stop anytime soon. Nearly half of U.S. health systems and physician groups are behind their 2022 revenue targets, according to a new report from the healthcare revenue cycle management (RCM) company. R1 CRM shared by email. For the report, R1 RCM commissioned Censuswide to conduct an online survey of 205 chief financial officers and vice presidents of revenue cycle at major health systems and physician groups in the United States. Responses were collected in June.

When respondents were asked to select their top concern with the financial health of their organization, the top three choices were rising costs, risk of recession, and shrinking margins.

Clinical and operational deficiencies due to healthcare workforce shortages were cited as the top issues affecting the bottom line of healthcare organizations. Other issues that respondents said were among their organizations’ most pressing issues included data security threats, pricing transparency compliance issues, declining patient volumes due to surges in Covid-19, navigating value-based payments, increased spending due to increased patient acuity and supply chain delays.

Not only do labor shortages affect clinical staffing levels, but they also impact administrative services. Forty-eight percent of executives surveyed said their organization’s RCM or billing department was experiencing a severe shortage, 34% said it was a moderate shortage, and 10% said it’s not. was a slight shortage. Only 8% of respondents said their organization has adequate staff for their RCM or billing department.

“As deferred care rebounds from two years of the pandemic, hospitals are still seeing less overall activity than three years ago,” said Gary Long, chief commercial officer of R1 RCM. “Additionally, as patients return for elective services they have postponed, the labor shortage – particularly in the revenue cycle – is impacting financial operations. The ongoing recruitment, hiring, and training of workers with the skills necessary to manage a health system revenue cycle is costly in ways it cannot afford at this time.

Long said one of the most poignant findings of the report is that all respondents said pressures on the RCM service were negatively impacting the patient experience. Respondents said they saw these tensions lead to delays in care, long wait times for scheduling and customer service calls, and patient billing errors due to lack of experienced staff.

“A bad financial experience can leave patients frustrated and disappointed regardless of the care they received,” Long pointed out.

To address the labor shortage affecting healthcare billing and RCM services, respondents said their organizations would make improvements in the following ways: adopting automation technologies (56%), expand employee benefits and/or compensation (51%) and partner with RCM optimization. company (44%).

A key action healthcare organizations need to take is to implement automation technology into their RCM processes to free up staff from manual tasks, Long said. He said this would help mitigate the negative effects of labor shortages on the patient experience, at least as it relates to billing.

“The revenue cycle may require substantial data entry, resubmission of claims assessment and restatement of appeals,” he said. “Artificial intelligence, machine learning, automation and rules engines can drive revenue and reduce costs and are examples of technologies that improve your operations, allowing suppliers and staff to focus on a job of greater value.”

Photo: Baris-Ozer, Getty Images


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