A recent poll of 200 health system revenue cycle management (RCM) executives that we conducted reveals a unanimous belief that healthcare’s ongoing staffing shortages have critically impacted RCM and patient engagement. In fact:
- 69% believe these staffing issues will be a long-term challenge.
- 96% stated that payer reimbursements, patient collections, or both, have been compromised by staffing gaps.
- 92% of respondents say new staff members make errors.
The message is clear: when staff is in short supply, both patient experience and revenue suffer. Indeed, 82% acknowledged a decline in patient experience. The major affected areas are:
- Scheduled intake (patient arrival/registration) – 55%
- Appointment scheduling – 50%
- Prior authorization approval – 44%
- Confirmation of insurance coverage – 43%
- Patient estimates – 40%
Yet, a silver lining emerges: technology, particularly automation and AI, presents a robust solution. They can bridge the staffing gap, helping providers not only maintain, but also enhance, their engagement and revenue cycle, potentially saving the industry billions of dollars.
Ripple effects: Turnover and staff wellbeing
Burnout, a byproduct of these shortages, is also influencing turnover rates. Forty-six percent indicated a turnover rate of 11-25% for roles related to patient access, RCM, and patient experience. Astonishingly, over one-third highlighted turnover rates between 26-40%. According to the Bureau of Labor Statistics, the average turnover rate this year in the U.S. is 3.8%.
To make matters worse, the cost of healthcare staff turnover is massive, significantly impacting hospital margins. For staff RNs, the average turnover cost is $52,350 per individual, leading to millions in losses for the average hospital. In fact, this report says, even though there was a decrease in turnover from 2021 to 2022, the rate in 2022 (22.5%) was still higher than the five-year average rate of 20.28%.
The cumulative effect of these elevated turnover rates means that hospitals have effectively had to replace their entire RN workforce over the last five years. Addressing the turnover rate within administration and operation departments with technology offers a quicker and more streamlined approach, allowing resources to be allocated to the more complex issue of clinical turnover, which poses greater challenges for providers.
Bridging the shortage gap
In the key areas where staff shortages are hurting hospitals’ RCM and bottom line, we see huge productivity enhancements via technology, specifically through automation and AI, offering a remedy for shrinking productivity and decreased efficiency, helping providers meet their revenue goals.
Scheduled intake:
- Problem: Manual paperwork by patients strains staff and risks data transfer errors.
- Solution: With a front-end system in place, patients can complete registration forms anytime, anywhere, from their phones.
Appointment scheduling:
- Problem: Manual appointment scheduling is inefficient and may not meet patient expectations for accessibility.
- Solution: Providers can enhance the patient experience and staff retention rates by offering 24/7 online patient scheduling and automated IVR, SMS, or email reminders. This digital front door approach can increase patient satisfaction, staff efficiency, and open up more revenue opportunities.
Prior authorization approval:
- Problem: The recent survey highlighted that 92% of respondents noted new employees are making mistakes that adversely affect claims. This has resulted in increased claim errors and denials.
- Solution: Automated systems for verifying coverage at the point of service can enhance staff efficiency, decreasing payment setbacks and claim denials.
Confirmation of insurance coverage:
- Problem: Manual insurance verification is tedious and time-consuming.
- Solution: Automation facilitates real-time insurance checks, which can reduce denials, speed up payments, and alleviate staff workload.
Patient estimates:
- Problem: Manually updating price lists and providing estimates can be inaccurate and strain staff resources.
- Solution: Automation ensures timely price list updates and delivers real-time cost estimates pre-care. This empowers patients to make informed decisions, leading to increased upfront payments and reducing the post-care collection burden on staff.
AI: A path to efficient claims processing
With enhancements in AI comes the ability to reduce the time and resources required for manual claims processing, ensuring that claims are paid faster and with greater accuracy.
Providers can harness this power to proactively identify claims with a high likelihood of denial, based on undocumented payer adjudication practices, before submission. For claims that do slip past, AI tools can pinpoint and segment those denials with the highest likelihood of being approved, so organizations can focus on the ones that will most impact their bottom line.
While staffing shortages are a daunting reality, technology—especially AI and automation—stands out as a game-changer. By streamlining front-end processes, reducing errors, and ensuring prompt service delivery, AI and automation not only boost the patient experience but also optimize revenue streams. Embracing these tools today will ensure a more resilient, efficient, and patient-centered healthcare system for tomorrow.
Photo: Andranik Hakobyan, Getty Images
