The emergence of expensive biologic therapies in the early 2000s led to the creation of patient support services primarily aimed at financial assistance.
Hospitals and health systems have been at the forefront of a major transformation while at a crossroads of increasing demand for higher acuity care and deepening financial instability.
Private employer costs for employee health plans have increased 4.2% each year since 2010,1,2 and 6.5% more in 2024.3 This has left employers desperate to control costs.
Artificial Intelligence (AI) has the potential to bring about a revolution in the field of healthcare, offering advancements in diagnosing illnesses, customizing treatments based on individual genetic profiles, and improving patient outcomes.
During recent years, outsourcing by health system administrators has evolved as a practical strategy to enhance profitability and enrich financial performance margins. Offshore sourcing engagements also play a critical role in easing the strain these same executives face due to the shortage of skilled workers here in the U.S.
As the healthcare industry grows increasingly competitive, more is expected of professional service providers. While the vendors of the past survived by delivering standardized, one-size-fits-all solutions, today’s service providers must adapt to a more complex and demanding environment.
Executive Summary: We’ve been hearing the same message for years now, that the United States has an aging population and workers aren’t being replaced fast enough. This is hitting hard, particularly in healthcare, and anybody working in one of our large health systems knows the far-reaching impact of the shortage.
The objective of this paper is to spotlight four developments that impact the face of revenue cycle management as we know it and, by extension, construct a different future for the back-office processes in healthcare.
Everyone acknowledges that the US healthcare system has many inefficiencies that drive costs up and impede the delivery of care. The current prior authorization (PA) process is a perfect example of this as it is fraught with issues that create higher costs, frustration for care providers, and more importantly can lead to adverse outcomes when patients are not treated timely and judiciously.
