Healthcare Providers Still Strongly Favor RCM Outsourcing

by | Published on Nov 30, 2015 | Medical Billing

RCM Outsourcing
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Early this year, we talked about the Black Book Market Research survey, revealing the sharp rise of revenue cycle management (RCM) outsourcing among healthcare providers. Now, a new Black Book survey reveals that RCM outsourcing is still going strong in the healthcare field. The survey found that the $9.7billion outsourced revenue cycle management market would grow at a CAGR of 26.5% through 2018. As per the Managing Partner of Black Book, RCM outsourcing has emerged as a great solution to address the challenges when hospitals and physicians are under intense pressure to optimize revenue cycle management processes, thanks to ICD-10.

Though the advisors and consultants coordinate RCM transition processes at 17% of hospitals surveyed, 78% of providers have not chosen technology vendors to move towards value-based reimbursements, which contribute to the rise of outsourcing as a provisional solution. Around 73% of medical group practices having consultants on accountable care reimbursement strategies are mulling over outsourcing RCM in 2016 as they evaluate technology vendors.

While 79% of health organization CFOs said that they need to eliminate financial and coding technology vendors that are not producing return on investment in 2016, 54% believe that RCM outsourcing will help them to become more efficient and have a positive impact on the financial health of their organization. When 80% of CFOs consider outsourcing as the best stop-gap measure until the selection, purchase and installation of new software, more than two-thirds of CFOs look for new outsourcing agreements extending minimum 18 to 36 months.

While contending with alternative payment models in the current scenario, there is an increase in the pace of some of RCM among the providers. The following are significant survey results that reveal it.

  • Around 83% of hospitals outsource some accounts receivable and collections
  • While 58% outsource contract management, 55% outsource denial management
  • Around 68% of physician groups having more than ten practitioners outsource some combination of collections and claims management

Black Book managing partner makes it clear that claims management would be the next for vendor opportunity as ICD-10 medical coding begins to affect cash flow. This is followed by eligibility and benefits management. In short, we can say as more value-based reimbursement opportunities are presented with the fall out of ICD-10, most healthcare providers rely upon medical billing and coding outsourcing to improve their financial health.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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