Technology in industries, including financial services and manufacturing, has evolved rapidly over the past 20 years, with offices becoming more and more automated and digitized. Consider the leading companies in market capitalization in the early years of this century: Hard-asset companies (think GE and Walmart). Today’s leaders in market cap? Digital companies (think Apple, Amazon, and Facebook).1
Today’s market might be digitally driven. But where does healthcare stand amid this evolution?
While the healthcare industry in general might lag behind others in the move to automation, this digital world of the future eventually will attach itself to healthcare – and it won’t let go. The future of the healthcare business office will be an autonomous environment.
What is an autonomous business office?
Many people hear “autonomous” and imagine a completely automated environment with robots or “bots” taking over. In reality, an autonomous business environment likely will be a combination of human workers and digital tools. In other words, it will be a digital world in which autonomous tasks are executed by technology but designed and managed by humans.
The healthcare business office in particular is well positioned for automation. It is the area of healthcare finance that features the greatest number of redundant tasks. And these redundant, yet complex, tasks, which often require human ingenuity and decision-making, are ideal candidates for automation. They typically have the most revenue attached to them and, therefore, can make a big impact within a healthcare revenue cycle. Denials and credit balances are two examples of such tasks.
Benefits of an autonomous business office
An autonomous business office can allow health systems to achieve the following goals:
- Highest revenue realization
- Least amount of operational variability
- Lowest costs for redundant tasks
How does an autonomous business office help organizations achieve these three goals? Think of a triangle, with “analytics” at the top, “process” at the bottom left, and “automation” at the bottom right. Often, organizations tend to look at analytics, process, and automation in isolation. They might work with predictive analytics and hope it leads to a better process. Or, they might look at a process and wonder how it can be automated – without understanding whether it’s a correct or best process. If organizations can get all three of the components of the triangle – precise analytics, correct process, and targeted automation – to work in concert, the benefit to the organization will be significantly greater.
Consider this example of a health system that wanted to use robotic process automation (RPA)/bots to resolve credit balances. An RPA vendor said, “Just tell us what your processes are, and we will program a bot to do them.”
The vendor and the organization, however, didn’t take the time to analyze the business office’s credit balance processes. They didn't realize that each year the health system was refunding $2 million inappropriately. In fact, some of those credit balances were actually double contractuals (discounts) the organization had been refunding to patients. The process the health system was using was incorrect. So why automate that process?
By using analytics to correct the process, the organization could achieve the three goals mentioned earlier: higher revenue realization from better credit balance resolution, reduced operational variability by introducing automation into the credit balance resolution process, and lower cost of redundant tasks. In addition, automating redundant tasks freed up staff to work on higher-touch revenue cycle work and reduce the number of staff members needed to work on redundant tasks.
The journey to automation
As the example illustrates, simply adopting bots for the sake of automation isn’t effective. To achieve an autonomous business office – and realize the goals of higher revenue realization, reduced variability, and lowest costs for redundant tasks – an organization must consider taking a journey to automation. This journey is a six-step process:
Step 1: Agree. Make sure the healthcare organization’s board, CFO, revenue cycle leaders, and operations directors and managers are on the same page and fully support adopting automation within the organization.
Step 2: Plan. Develop a plan for how and when the organization will adopt automation.
Step 3: Craft. Identify the best, most accurate processes within the revenue cycle – the ones that yield the best results. Reviewing best practices from other healthcare organizations brings additional value to this process.
Step 4: Standardize. Implement the identified best processes into the business office’s workflows, conduct staff training, and monitor performance.
Step 5: Systematize. Make sure that the technology (for example, the patient accounting system) is aligned with this best process.
Step 6: Automate. Apply automation. This can be done through existing, but previously unused, automation tools such as those found in the organization’s own patient accounting system; automation available for purchase in the marketplace, such as bots or bolt-on systems; or a third-party automation service.
Following these steps on the journey to automation helps an organization determine where it is on the way to achieving an autonomous business office and how far it needs to go.
Tips for success
The autonomous business office and the interconnection of all things digital are the future of the healthcare industry. The market, industry, and current economics all point to a more autonomous business environment. Organizations must be ready to move from human-driven services supplemented by digital technologies to business environments that lead with autonomous services and are managed by humans.
Healthcare organizations may be behind the early adopters and innovators in other industries that already have embraced automation, but it’s not too late. Consider the following tips for a successful journey toward an autonomous business office:
- Avoid a “just apply a bot” mentality. Follow the journey to automation, considering the organization’s – and the industry’s – best practices.
- Remember that the success an organization will have with the move to automation is a function of its commitment to adoption and its ability to manage change.
The journey to the autonomous business office, while exciting, will be challenging at times. However, the return on investment for today’s healthcare organizations could be substantial, including significant improvements to financial metrics such as cost to collect and net revenue realization. Healthcare organizations that choose not to adopt a more autonomous business environment likely will be at a competitive disadvantage in the years to come.
Even so, the journey to automation cannot be rushed. The idea of hurrying to apply a bot to every process might sound appealing. But “random acts of automation” can wind up costing an organization dearly down the line. A thoughtfully planned, well-paved journey to automation, incorporating accurate data about industry best practices, will be the optimal path forward to the autonomous business office.