Is Innovation in Revenue Cycle Dead?
RCM Leaders Forum
May 17, 2018
Charlotte, NC
At the RCM Leaders Forum in May, I suggested we are practicing the same techniques and processes from 10 years ago. No one in the group disagreed. I really thought I would get some optimists arguing with me. There was no dissent. If a collection of the best leaders in the industry (a collective $150B+ in net revenue between them) would agree, is innovation dead? If so, what do we do about it?
In 2008, we were doing everything new and pushing the boundaries of what was possible at Accretive. One could argue that we collectively pushed too far (and ran people over in the process), but you could not argue with the results. At the time when the market was ready for something to change, we put some smart people in a room with PE-backed pockets, and it was a recipe for opportunity. Today, more vendors are pouring more VC and PE money into RC then ever and it seems we are still sitting in the same place.
I have a couple of good friends that have created a real automation technology for billing follow up. Without going into too much detail, it is flat out a game-changing technology. People are using and selling AI and automation, but few have actually executed it. These guys have actually created it and proven its effectiveness. They hit the market selling…and what they’ve gotten is very few takers. Their biggest challenge is that there isn’t a comparable product for leaders to reference. And I think that’s partially true. Leaders are less likely to embark on something unknown and risky when they don’t fully understand it. That has definitely been a barrier, but not the biggest one. It would seem that every health system’s IT department is struggling. Basically, they are refusing to do anything but Epic/Cerner (pick your poison) implementations or upgrades. Either they are going to go through an implementation (2 years at a minimum) or have been through one and now need to upgrade; essentially killing any other innovative technology because they don’t have the bandwidth.
One of the leaders at the Forum argued this:
“Epic has actually taken us a step back. At least in my old system, I knew exactly what was going on and where everything was. I could work with that. Now Epic promises that it will do everything, which may be true. However, it doesn’t do any of it well.”
We could debate the last part, but I fully agree with the first part. The single biggest thing killing innovation right now is the same products that were supposed to change the industry. For the record, I’m not bashing either Epic or Cerner on this. What they are trying to do in creating a full EHR/Billing system is admirable. It’s just rare that companies are going to be great at everything and this is a classic case.
How do we overcome these barriers and change RC for the future? Getting paid for services in healthcare isn’t going to get less complex over time. It will continue to get more complicated as every politician implements change. How do we move past the EHR Implementation dilemma plaguing RCM right now? Looking forward to discussing this over the next few months leading up to our November RCM Leaders Forum.