How to handle the revenue cycle skills gap

Revenue cycle management is becoming less about managing transactions and more about technology, as hospital finance departments shift toward AI-enabled workflows.

Increasingly, skills valued by hospital and health system employers are aligning around automation and analytics.

As Heather Dunn, chief revenue officer at Novant Health, said in “The Revenue Cycle of the Future,” a recently published HFMA report, “Revenue cycle is becoming less about finance and more about technology.”

“It used to be about diligence: coming into the office every day, knowing payer rules, knowing how to get a claim out the door. That is completely changing,” said Dunn, who also is a senior vice president for Novant, which operates hospitals in North and South Carolina.

“Revenue cycle teams will increasingly need staff who are driven by outcomes and know how to use technology and analytics to achieve them,” she saisd.

Yet, many hospitals and health systems don’t feel their workforce is ready, and it’s unclear what that workforce should look like.

About 30% of revenue cycle executives report their teams are “unprepared” or “very unprepared” for the skills required over the next five years, according to a survey conducted for “The Revenue Cycle of the Future.” The survey of 95 revenue cycle vice presidents and directors found that increased use of AI and automation will shift work away from repetitive, transactional claims-management tasks and toward exception-based work and analytics.

One of the survey respondents, Sarah Hartwig, vice president of revenue cycle at Avera Health, based in Sioux Falls, South Dakota, predicted the next few years will be an “operating model reset” in which technology will have to inform processes and workflows.

“AI is quickly becoming foundational revenue cycle infrastructure, changing how performance is measured and pushing work from back-office tasks toward proactive, judgment-heavy exception management,” Hartwig said.

Taken together, these shifts point to a fundamental rethinking of how revenue cycle teams are trained, structured and sourced. For organizations looking to stay ahead, the question is no longer whether change is coming, but how to prepare for it.

3 workforce strategies for a tech-forward revenue cycle

As organizations position for success over the next five years, leaders can take several steps to prepare their revenue cycle workforce.

1. Review training needs and competencies. . With hospitals and systems preparing for greater automation and AI, workforce training is likely to focus on:

• Training staff for exception-based roles and patient-facing tasks in need of high empathy
• Strengthening competencies around vendor management and strategic partnering
• Supporting process redesign, data analytics and change management

“Start thinking about ways that you can transition or upskill the staff that you currently have into these new roles, and ways that you can help through education to get them there,” Dunn said in an interview.

Leadership will also need to evolve. Focus will be on leaders who have strategic systems thinking and technology savvy and can identify how to adapt tools to drive desired results.

“Be thinking about people who can be tenacious and adaptive and who are highly technology focused,” she said.

2. Assess opportunities for structural collaboration with technology teams. HFMA survey data suggest that some role restructuring is likely as technology becomes a greater focus for the revenue cycle. Most notably, expectations are for an increase in hybrid roles spanning clinical, financial and technology domains.

Cross-department leadership collaboration will also be integral.

“It kind of stands to reason your relationships with your CIO may start to look very different over these next three years,” Dunn said. “When I think about tech projects of the past, a lot of them have been very limited to the financial side of the house. Now, we’re hitting more interconnected initiatives and bigger projects.”

Dunn believes the pace and scale of technology change in the revenue cycle may result in a shift at some organizations in which technology and the revenue cycle are tied together as a single entity at the executive level, or even where the revenue cycle is absorbed into the IT department.

“One of the most important relationships a revenue cycle leader can have is the one with their IT team,” she said, noting that she has a weekly meeting with IT to stay aligned around performance and priorities. “If you don’t have that very strong connection with them, where you’re aligned on the ‘why and how and what the results are going to be,’ then I don’t know how you can be successful.”

3. Don’t be afraid to look beyond typical sources for talent. “Start hiring people who can meet the needs of what things are going to look like in three to five years: bold transformational leaders who are technology focused and who are catalysts for change,” Dunn said. “Maybe they don’t know healthcare, maybe they don’t know revenue cycle, but those are things that can be taught.