“If you’re looking at a potentially shrinking workforce, it behooves you to look at how to optimize productivity through automation,” he said.
Stanford, for example, has already automated various RCM functions, and it soon plans to apply unified automation technology and machine learning to its key selected processes for patient financial clearance and hospital billing.
“We want to further automate functions over time to become much more efficient and to take on volume growth without adding additional staff,” Buathier said.
Her hope is that staff can address accounts that have a higher level of complexity while technology handles tasks that are transactional and predictive.
The first place to look in terms of automation is within your own EHR, Ormand said.
“It only takes delays in upgrading one module here or there to quickly get behind the eight ball,” he added. “Before looking at new solutions, you should be looking at how you can maximize your existing solution.”
“Robotic process automation (RPA) has been exceptionally helpful during the pandemic because it allows us to be pretty nimble,” Assenmacher said. For example, during the pandemic, a new CPT code for specimen collection was created, she noted.
“We used RPA to quickly add those charges to accounts in a very efficient way to get claims out the door and get paid,” Assenmacher said. “We’ve tried to be really creative about putting together use cases to plug holes that we sometimes have with our processes.”
Spectrum executives also used functionality within their EHR to automate the coding of simple cases, which has also helped maintain business continuity during times of staffing fluctuations. They’ve also implemented automated insurance eligibility checks and claim status checks and will soon be adding coverage detection and prior authorization to their automation portfolio.
“This has really allowed our team members to work at the top of their license while the more repetitive tasks can be completed by the software,” Assenmacher said.
The outsourcing option
Outsourcing is another consideration in terms of reducing labor costs while addressing a labor shortage.
“We’re in unprecedented times, and organizations are showing an openness to new ways of doing things,” Ormand said. “It’s not 100% across the board, but more progressive organizations are trying to stay ahead of these changes and not become consumed by them.”
Cari agreed: “Strategically leveraging partners to reduce labor spend can then help you afford to pay your internal resources at a higher rate, ask more from them and ultimately have fewer of them because they have critical thinking skills to drive the outcomes you seek.”
As patient volumes increased, Spectrum needed to engage an outsource partner for pre-registration due to rapidly expanding COVID-19 services.
“It was helpful because we could quickly insert that support ... to ensure business continuity,” Assenmacher said. They also hire outsource coding vendors when needed.
Another consideration is shared service models between hospital and physician services, Ormand said. For example, organizations may be able to drive efficiencies and economies of scale by consolidating leadership, teams, technologies and vendors across the functional areas supporting the physician and hospital revenue cycle in areas like coding and pre-arrival services.
“These opportunities should be embraced as imperatives to drive competitive advantage in the market,” Ormand said. “A unified revenue cycle can mean the difference between progress and stagnation and ultimately make your revenue cycle a strategic enabler for your organization.”