EHRs and Consumer Self-Pay Remain Top Revenue Cycle Challenges for Hospital and Health System Executives: Navigant

More than 60% of providers struggle to derive optimal value from their electronic health records (EHRs), and 85% believe the increase in consumer self-pay will continue to impact their organizations, a Navigant analysis has found. The analysis is based on an executive survey of 108 hospital and health system chief financial officers and revenue cycle executives conducted by Healthcare Financial Management Association (HFMA).

The survey revealed that 62% of the executives found EHR adoption challenges have been equal to or outweighed benefits specific to their organization’s revenue cycle performance, up from 56% in 2018. In addition, more than half of executives say their organizations can’t keep up with EHR upgrades or underuse available EHR functions.


Consumer self-pay concerns also persist for provider executives. Eighty-five percent of respondents – including all large hospital executives – believe the increase in consumer responsibility for healthcare costs will continue to affect their organizations, up from 81% last year but down from 92% in 2017.

IT, Collaboration Seen as Mitigating Challenges

In an ongoing effort to better manage these challenges, 69% of executives predict their organization’s IT budgets will increase over the next year, up from 68% last year but below 74% in 2017.

When asked which strategies they’ve already implemented to successfully decrease revenue cycle costs and increase economies of scale, 46% of executives selected collaboration with external entities, including outsourcing and vendor partnerships. In addition, one-in-four of both health system and large provider executives cited advanced health IT, including robotic process automation (RPA).

“It was anticipated that EHRs would be the main driver of broad performance improvement, but that has not occurred in many cases,” said Timothy Kinney, managing director at Navigant. “Instead, providers are now taking other steps, including looking outside their organizations to collaborate with external entities and leveraging advanced technology solutions, and they’re seeing successes.”

Moving forward, the majority of executives (87%) again suggest they’re most focused on technology-related capabilities to drive future revenue cycle improvements. Revenue integrity was the top area of focus for the third straight year, cited by 28% of executives, a 21% increase from 2017. Furthermore, RPA saw a major jump among health system executives – 15% cited the capability, which wasn’t selected by any health system executive in 2018.

“New technologies leveraging RPA, artificial intelligence, and machine learning have unlocked significant opportunities to reach previously unattainable levels of revenue cycle performance,” said Navigant Director Kent Ritter. “As we’ve learned with EHR implementations, there are no silver bullets. These tools are not ‘plug and play,’ and the ability to integrate operational and technical expertise remains key to provider success.”

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