Focus on patient care and access transcends hospital-centric model

Healthcare is undergoing a fundamental shift. The feedback highlighted in this report confirms that the physical, hospital-centric model is no longer the industry’s foundation. In its place, a more distributed, digital and financially disciplined care platform is emerging.  

For revenue cycle leaders, this transformation is deeply operational. As care expands across ambulatory, virtual and home-based settings, the revenue cycle must evolve into an enterprise capability that supports the entire patient financial experience.  

 Health systems are rapidly shifting care and revenue opportunities outside the hospital. This introduces complexity and new opportunities. The anecdote from Matthew Cox about the patient who gets a flat tire on the way to their appointment — and receives a ride to the appointment and help fixing their tire — illustrates what’s possible.  There are opportunities to use revenue cycle data — whether from eligibility, authorization or social determinants of health (SDOH) — to help reduce friction and guide patients to the right care at the right time.  

 Forward-thinking organizations are already doing this. By identifying barriers, they can intervene earlier and help patients keep appointments, access care and avoid delays. For instance, if SDOH indicators show a patient has transportation challenges, providers can target interventions such as home health services or reimbursing ride-share fares for necessary in-person visits. What was once administrative data is now a powerful tool to improve both access and outcomes.  

 At the same time, AI is becoming foundational for revenue cycle management. Beyond enhancing documentation, coding accuracy and charge capture, it enables more effective orchestration and prioritization through predictive modeling, automation and next-best-action insights. These capabilities direct resources to the highest-impact activities, lowering cost to collect while improving financial outcomes and supporting a more seamless, transparent financial experience.    

These changes come amid mounting financial pressure. Reimbursement shifts, rising patient responsibility and payer complexity are tightening margins across the industry. In response, health leaders are reevaluating strategies to strengthen financial resilience.   

In this environment, revenue cycle management goes beyond collecting dollars to removing barriers to care and driving growth. Organizations that harness revenue cycle data and technology to simplify access and anticipate patient needs will be best positioned to succeed.   

The hospital-centric model may be waning, but the revenue cycle role is only expanding. 

Learn more about leveraging AI, automation and revenue cycle data in HFMA’s The Hospital of the Future Part I report.