In a roundtable discussion hosted during our second annual AGS Health Partner Summit, our customers discussed industry transformations driven by rapid technology adoption and increased collaboration with global workforces. These revenue cycle management (RCM) leaders shared priorities related to change management, generational workforce differences, denial management, and strategic technology integrations, including generative artificial intelligence (AI), automation, and analytics.
Change Management Strategies for Revenue Cycle Success
Leaders emphasized that a successful change management strategy includes an embedded project management approach that ensures teams are supported through transitions. A structure that assigns dedicated resources alongside operational managers helps ensure smooth transitions without disrupting day-to-day operations. By fostering open communication, clearly articulating the "why" behind changes, and involving team members directly in decision-making processes, leaders can significantly increase employee support.
Building a Future-Ready Workforce
In a discussion about workforce management, leaders recognize the urgency of preparing for a future shift to maintain long-term organizational stability. This includes investing in automation education, mentorship programs, and professional development through certifications with organizations such as the Healthcare Financial Management Association (HFMA). Currently, Gen Z represents only about 3% of revenue cycle roles and preparing for a workforce that is in the early stages of their career means rethinking talent acquisition through a comprehensive engagement and development strategy to attract and retain top talent. Research shows that Gen Z employees look for opportunities that align with their beliefs and ability to make an impact, underscoring the importance of creating a purpose-driven workplace at our hospitals and health systems as well as at AGS Health.
Proactive Denial Management
Tackling rising denial rates stands out as an industry-wide priority. Revenue cycle leaders are shifting from reactive denial management strategies towards proactive prevention. Many healthcare organizations are establishing denial prevention task forces comprised of interdisciplinary teams that analyze root causes, improve documentation processes, and collaborate with clinicians and payer contracting teams.
AI Integration in Revenue Cycle Management
Another critical trend shaping revenue cycle management is the integration of technology and AI, from large language models to generative AI. AI tools, natural language processing -enhanced coding systems, and robotic process automation (RPA) are playing a role in reducing administrative burdens and improving operational efficiencies for claim status updates, prior authorizations, and appeals. AI-enabled clinical documentation improvement (CDI) tools prioritize work for specialists, improving coding accuracy and reimbursement rates. Many healthcare organizations have begun to establish AI governance frameworks to responsibly manage emerging technologies, ensuring both technological advancement and compliance with privacy standards. Revenue cycle leaders are also recognizing the importance of integrating IT teams within the revenue cycle functions to accelerate technological adoption and maximize benefits from system enhancements.
Leveraging Analytics and Predictive Modeling
Analytics plays a critical role in identifying denial patterns and root causes, driving targeted interventions, and ultimately safeguarding revenue integrity. Many healthcare organizations have dedicated revenue cycle analytics teams and are partnering to drive integrated data-driven decision-making. Big data and predictive analytics can help healthcare organizations identify patterns and trends, identifying potential denials before they happen to enable real-time adjustments that target interventions and create a more efficient appeals process.
This enlightening session, like many opportunities during our Partner Summit, connected our valued customers and partners with industry leaders and peers to achieve results. We are grateful for our partnerships and sharing challenges that equip us to provide and prioritize the best solutions for long-term success. Contact us for more insights and guidance on the importance of strategic collaboration, advanced technology solutions, and proactive approaches to challenges.
Cheryl Cruver
