By 2030, the landscape of revenue cycle management in healthcare will undergo a significant transformation, becoming a digital-first operation. Healthcare provider organizations are increasingly relying on artificial intelligence, automation, and analytics to streamline processes, reduce costs, and enhance billing accuracy. These insights are derived from a recent report by Everest Group, in collaboration with Omega Healthcare, titled “Realizing the Promise of Tech-Enabled, AI-Driven Revenue Cycle Management: Outsourcing in the New Era.”
Key Findings from the Report:
– 85% of senior healthcare executives believe that AI will enhance efficiencies in RCM operations over the next five years.
– The outsourcing model in RCM is evolving from basic revenue management services to AI-powered, outcome-based partnerships.
– The future of RCM will be shaped by genAI use cases, key barriers to adoption, and investment priorities in the coming years.
Anurag Mehta, CEO, and cofounder of Omega Healthcare, a technology vendor specializing in RCM, care coordination, and workflow, sheds light on the survey results and the evolving RCM landscape in an exclusive interview with Healthcare IT News.
Q. Is the optimism around AI improving efficiencies in RCM operations informed by experience or blind optimism?
A. The confidence in AI’s potential to enhance RCM operations stems from real-world challenges faced by healthcare providers. AI offers practical solutions to address billing complexities, staffing shortages, and outdated technology systems, leading to tangible improvements in operational efficiency and accuracy.
Q. How do you explain the anticipated increase in RCM outsourcing budgets by 2030 and its connection to generative AI?
A. The rise in RCM outsourcing budgets is closely linked to the integration of generative AI into revenue cycle processes. Healthcare organizations are partnering with third-party vendors to leverage advanced AI technologies, operational support, and compliance expertise to deploy generative AI at scale.
Q. What are the key findings from providers actively exploring genAI in RCM, and how are they overcoming challenges?
A. Providers implementing generative AI in RCM are experiencing benefits such as operational efficiency, improved patient interactions, and reduced denials. Challenges include a lack of in-house expertise, integration with legacy systems, and data privacy concerns, which are being addressed through proof-of-concept projects, human-in-the-loop validation, and strategic partnerships.
Q. What other insights from the survey are crucial for the future of AI in RCM?
A. The survey highlights a strategic investment priority in AI, with AI/machine learning projected to become the top investment area for RCM leaders by 2030. The rise of agentic AI, capable of decision-making and optimizing workflows, represents the next frontier in automation, shaping the future of healthcare financial strategies.
In conclusion, the integration of AI, automation, and analytics in RCM operations is paving the way for a more efficient, cost-effective, and accurate revenue cycle management system in healthcare. As organizations embrace these technologies, they are poised to drive innovation, improve patient outcomes, and enhance financial performance.
