As telehealth services become more widespread, behavioral health institutions are changing in terms of their geographic reach. The specifics of revenue cycle management (RCM) have grown increasingly complex with the addition of different payer types to the revenue stream.
Although paying for services privately is still a common option, it can be challenging to understand the unique regulations of private insurers, Medicaid, and Medicare. Demands and regulations that need to be closely monitored and followed increase along with the volume of services provided.
As a result of the great resignation, RCM leaders’ main priorities in the current environment are safeguarding income and optimizing efficiency. For leaders in RCM, the lack of administrative and clinical staff is a major obstacle that exacerbates staffing issues.
The healthcare sector is expected to experience significant innovation, consolidation, and change shortly. The adoption of innovative techniques and strategies is anticipated to characterize this transition, which will have a substantial effect on the revenue cycle. So, what are the major RCM trends in behavioral health that we are to look out for?
The need for quick access to information regarding services, costs, insurance coverage, and out-of-pocket payments is growing among patients. It is anticipated that healthcare professionals will experience significant changes in patient engagement in response to this trend. Better scheduling, increased pricing transparency, and the addition of more flexible payment alternatives are all part of this. Expect a boom in commercialism inside healthcare chains, especially in urgent care, mental health, behavioral health, and dental services, as well as the emergence of creative solutions and businesses centered on enhancing patient access and experience.
The automation of coding and billing operations in healthcare systems is being revolutionized by innovative technologies such as AI, ML, RPA, and autonomous coding. To maximize the revenue cycle management process, leaders need to evaluate their alternatives for developing or acquiring automation technology. According to Erin, the focus of Hansei Solutions has been to: “keep innovations at the forefront of our mind, and trying new things, and to anticipate the needs of the market,” thereby “building solutions to solve those problems.”
Value-based care is centered on the transition from quantity to quality, with preventive care being essential. The rise of wellness chains in the US is changing people’s lifestyles, extending life expectancies, and changing the need for healthcare. In the coming years, these changes are anticipated to have a major impact on the delivery of healthcare services.
The COVID-19 pandemic’s aftermath has burned medical personnel more, increasing the need for creative clinical documentation solutions and outsourcing. To free up physicians’ time, virtual clinical assistants and medical scribes are being used more and more for documentation. It is expected that competition for clinical and administrative expertise will grow, necessitating cooperation between clinical teams, finance, and human resources to maintain appropriate staffing levels.
Within the healthcare revenue cycle workforce, administrative teams have disappeared as a result of the extensive adoption of remote working technology during the pandemic. After COVID, a sizable percentage of the workforce chose gig economy work or moved closer to family, indicating a continuous and worsening labor shortage in the healthcare industry. Healthcare executives need to respond to this by implementing outsourcing techniques and safe remote technology to guarantee the availability of resources for clinical and administrative tasks.
Leaders in healthcare finance must contend with issues including inflation, growing supply prices, and diminishing reimbursements. Providers must focus on denial avoidance, stop income leakage through efficient clinical documentation, investigate workflow functions in software for more revenue with less effort, and invest in novel technology to achieve profitability.
Healthcare companies should expect to devote more resources to cybersecurity as cyber threats increase. The industry is especially vulnerable because of the shift toward remote work, patient monitoring, telehealth, and telemedicine. Healthcare RCM service companies that are progressive are already investing in certifications to guarantee strong information security management.
Apple, Microsoft, Google, Amazon, Oracle, and other big IT corporations are among those making significant investments in healthcare. Over the next ten years, it is anticipated that their contributions—which range from cloud platforms to wearable technology and telemedicine solutions—will increase and significantly influence the direction of healthcare.
A paradigm shift in revenue cycle management (RCM) is being heralded in the rapidly changing behavioral health sector by the convergence of labor dynamics, technological improvements, and developing patient expectations. Healthcare administrators are faced with several decisions, from promoting financial openness and adopting value-based treatment to addressing labor shortages through creative means.
The incorporation of remote work tactics, automation technology, and enhanced cybersecurity protocols highlights the industry’s adaptability in the face of difficulties. The need for strategic financial planning is increasing as large Internet companies are changing the landscape of healthcare.
The route map for this dynamic journey necessitates a proactive attitude. Utilizing new trends, streamlining RCM procedures, and getting ready for a future in healthcare where patient-centeredness and technological innovation go hand in hand are all important tasks at hand. Accept the change and steer the RCM for behavioral healthcare into the future with resiliency and insight.
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