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Growth Expected for Revenue Cycle Management Outsourcing

by: Sarah Joson

Wednesday, November 26, 2014 | Outsourcing News |

ICD-10 and Revenue Cycle Management

A large number of organizations are seen making the necessary improvements in infrastructure in accordance with the ICD-10 code. Although the AMA initially predicted that changes needed to match the code will not be as costly as expected, it still presents several challenges to health organizations that do not have enough resources.

Some healthcare firms are said to be tapping external providers for clinical documentation improvement (CDI), revenue cycle management (RCM), and even coding consultancy. A Black Book estimate forecasts that the RCM outsourcing market will grow from $7.7 billion to $9.9 billion by the second half of 2016. However, some are still unsure whether these processes will help healthcare organizations to mitigate the changes brought on by ICD-10.

Some companies are positive when it comes to the new codes, but others are doing their best to recover from the delayed application of the ICD-10 to October 1, 2015.

In a recent survey conducted by AHIMA and eHealth Initiative, it was found that 14 percent of providers expect that they will break even during and after the switch. On the other hand, six percent anticipate their revenues to increase due to polished billing processes.

Black Book added that RCM outsourcing activities have already displayed gains in revenue. In fact, 80 percent of hospitals that outsourced RCM activities have posted six percent increase in revenues this year. This then may help in addressing the losses from the slowdown in productivity and timely billing operations.

However, 20 percent of hospitals that outsourced RCM processes are still fearful that they are more exposed to filing for closure or bankruptcy in the next four years if their RCM technology, in-house or outsourced, is not the best in the market. Ninety percent of hospitals said they opted to outsource RCM work because it is a more economical option.


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