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AI to Improve Revenue Cycle Management in Healthcare

The presence of artificial intelligence (AI) has been increasing in the healthcare sector, and with the technology maturing and becoming more viable, the opportunities for it to make administrative and process improvements have been rising — and income cycle management is one space wherein this is particularly manifest.

AI to Improve Revenue Cycle Management in Healthcare

The problem with many present revenue cycle processes is that it can result in quite a lot of friction and waste. In a HIMSS20 digital presentation, Mark Morsch, VP of technology at Optum360, cited data indicating that there might be up to $200 billion in the administrative waste in the healthcare system due to inefficient revenue cycle practices.

Hiring data provided by Optum360 illustrates the extent to which administrative spending has increased. Hiring for physicians has increased since 1970, but nearly to the extent of administrative hires, which have grown 3,000% throughout that time.

The potential to alleviate waste with AI is joined by an overall positive sentiment toward the expertise among healthcare professionals. In accordance with Optum’s data, 97% of those in the sector trust AI to deal with administrative or clinical applications, while 85% are at present implementing or developing some type of AI technique. Over half, 55%, expect AI to realize positive ROI in fewer than three years.

On average, organizations are investing $39.7 million in AI implementation over the next five years. Already, nearly one-third of health plans, suppliers and employers are automating processes similar to administrative tasks or customer service, and 56% of health plans are utilizing the technology to fraud, waste, and abuse. 39% of providers are employing it to personalize care recommendations.

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