Hospitals and healthcare providers world over are constantly pressurized to augment the quality of patient care while concurrently reducing the cost. In the face of dwindling revenue and declining profit margin, it becomes imperative for them to optimize revenue cycle management in order to meet this twin objective. Technology spending on revenue cycle management (RCM) facilitates healthcare organizations in better managing claims, processing, and streamlining medical billing and payments, thereby helping them attain a steady generation of revenue.
Spiraling investment in healthcare IT initiatives has helped healthcare providers tap into incremental reimbursement opportunities and maintain a hassle-free regulatory compliance with various industry norms. In the past few years, several credit card programs have gained traction in revenue cycle management. This has enabled providers to expand the coverage of healthcare delivery across a large part of population while helping them access all their medical billing data faster. Propelled by these promising developments, the global market for technology spending on revenue cycle management is anticipated to reach US$51.56 bn by the end of 2024. The global market is projected to rise at a healthy CAGR of 6.9% during 2016–2024.
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What are the major platforms of revenue cycle management (RCM)?
The main platforms of revenue cycle management are integrated and stand-alone. The integrated RCM platform is characterized by the presence of a combined system consisting of end-to-end solutions for managing financial performance, patient’s electronic health records (EHR), and a host of business intelligence tools. These elements are integrated under a unified revenue cycle solution. Providers offering integrated systems often rely on a modular approach, which is suitable for healthcare organizations looking for the benefits of agility and scalability by their RCM with EHR. An integrated approach strategically enables them to overcome a siloed approach of revenue management due to disparate financial operations and boost patient satisfaction. A stand-alone RCM platform can be made up independently of any other solutions or software implemented. Furthermore, it does not require patient health records and medical records integration.
What are the major deployment models and what drives the adoption of a cloud-based model?
The main deployment models in revenue cycle management are cloud-based and on-premises. Over the past few years, the cloud-based deployment model has gained popularity, driven by lower up-front costs, increasing accessibility, and the launch of innovative solutions.
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For instance, Med Inc., a global cloud-based revenue cycle software provider based in the U.S., announced in April, 2017 that it launched Coverage Detection solution, an innovative business intelligence RCM solution, which can help healthcare providers recoup revenue from self-pay patients. The upsurge in self-pay population, coupled with high-deductible health plans, has been one of the most significant contributors to bad debt, which has stifled the revenue earnings of several hospitals. The next-generation technology solution is expected to help healthcare providers maximize return on investment—to the tune of 5%–15%, which may translate into tens of thousands of revenue earning ultimately. Such substantial benefits are expected to stimulate technology spending on revenue cycle management in various regions.
The successful implementation of RCM solutions helps healthcare organizations become a patient-centric. Eventually, all the stakeholders can achieve the key objectives of various healthcare reforms faster and with ease.
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