How to successfully navigate the roadblocks in the revenue cycle
Where are mistakes happening & what are the proven strategies to fix them? View the infographic and take product tours of Ei Suite.
Matt Seefeld, Executive Vice President & Chief Commercial Officer at MedEvolve, brings over 24 years of management consulting experience in the healthcare industry. He has extensive expertise in the assessment, design and implementation of process improvement programs and technology development across the entire revenue cycle. Matt began his career with Stockamp & Associates, Inc. and worked for both PricewaterhouseCoopers LLP and Deloitte Consulting LLP in their healthcare and life sciences practice lines. In 2007, he developed a business intelligence solution and founded Interpoint Partners, LLC, where he served as Chairman and Chief Executive Officer. In 2011, he sold his business to Streamline Health Solutions where he then served as Chief Strategist of Revenue Cycle followed by Senior Vice President of Solutions Strategy until 2014. Matt ran global sales for NantHealth and provided consulting services for healthcare technology and service businesses nationwide, prior to joining MedEvolve full-time.
Everyone is aware of the fears and uncertainties in the industry. But beyond discussing that, I want to dive into my favorite topic: how we can apply revolutionary manufacturing principles from the early 1900s developed by Henry Ford to revenue cycle management. These principles focus on minimizing unnecessary touches, optimizing processes, and achieving better financial outcomes.
A study we conducted recently highlighted the squeeze on operating expenses in healthcare. Over the past 25 years, costs were reasonable compared to revenue, and operating margins were not under the pressure they are today. However, as we analyze the administrative costs associated with claims management, the reality becomes alarming. That’s where our focus is today—administrative inefficiencies.
Operating margins over time have been significantly impacted. The COVID-19 pandemic temporarily bumped margins, but the outlook for 2023, 2024, and beyond suggests continued declines. One of the main focuses of my career has been simplifying margin concepts.
When we think about margin, we can break it down into three components:
Insurance companies invest heavily in AI to find ways to avoid timely payments. Reimbursements are flat or declining, while labor and administrative costs continue to rise. Employee turnover is increasing, along with training costs. Additionally, consumer behavior is shifting—high-deductible plans force patients to consider whether they can afford care or need a payment plan.
I started drawing parallels between revenue cycle management and early industrial manufacturing principles last year while speaking at industry conferences. Henry Ford’s assembly line revolutionized efficiency by reducing unnecessary steps, minimizing errors, and properly incentivizing workers. The same logic can be applied to healthcare revenue cycles.
A study I read early in my career, while working on a patient experience project for a major health system, shaped my perspective on revenue cycle management. The CEO wanted a seamless experience—like the Ritz-Carlton approach—from parking lot arrival to claim resolution.
Through discussions with industry leaders, I learned that employee satisfaction directly impacts customer satisfaction. When employees feel valued, equipped with the right tools, and incentivized properly, they perform better. The result is an improved patient experience—not just in clinical care but in financial interactions as well.
Billions of dollars are lost annually due to inefficiencies in claims management. While healthcare costs—drugs, procedures, and innovation—rise, administrative waste remains a major problem. We must measure the number of touches involved in claims processing and identify where breakdowns occur to improve efficiency.
Many outside the industry ask why healthcare is so complex. The reality is that the journey from patient intake to a zero-balance claim involves numerous processes, people, and technologies—many of which introduce inefficiencies. Autonomous coding, AI-driven solutions, and process automation promise improvements, but many fall short because they fail to address fundamental human-driven inefficiencies.
Our clients can now track every human touch and task associated with claims adjudication. This allows them to answer key questions such as:
In one study, we found that nearly 50% of all claim touches were wasted—meaning there was no necessary action taken, yet time and resources were spent. This cost the organization millions in administrative expenses.
The key to improving efficiency is eliminating unnecessary touches. Our analysis reveals that:
Based on analyzing millions of data points, the following benchmarks are critical for revenue cycle efficiency:
Atlas Healthcare Partners implemented these solutions and saw:
AI and automation will play a major role in the future of revenue cycle management. However, technology alone is not a silver bullet. Organizations must first diagnose why human intervention is needed before investing in tech solutions. Generative AI will only be effective if combined with structured people-data insights.
The business of healthcare must evolve. Rising costs and misaligned incentives continue to challenge margins. Organizations must measure and optimize human involvement in revenue cycle processes. By focusing on efficiency, accountability, and strategic automation, we can improve financial outcomes while maintaining quality patient experiences.
Effective Intelligence combines Patient Financial Clearance Automation, Medical Billing Workflow Automation, and Real-Time RCM Analytics in a cloud-based platform designed to integration with your current EMR/PM technology to measure the effectiveness of your RCM staff.
Review and assess your practice’s financial status in 5 min or less and know exact where you are losing money and why. Measure the work effort of every revenue cycle employee, incentivize and retain your top performers, and help employees that need improvement.
You can prevent most common denials, rejections and write-offs during the scheduling and pre-registration process in advance of the appointment. Configure checkpoints and use central task management to quickly clear patients and keep your front office staffing needs at a minimum.
As team members log in to the web-based application and record each “touch” of a claim, outcome, and next task, key data points are recorded like who completed the task and when, outcome, task notes, internal / external messages sent, collection success and other data points that feed into our real-time analytics.
Reduce RCM labor dependence with financial clearance, coding, insurance A/R, & patient A/R automation modules with real-time analytics.
Increase productivity and simplify front & back office processes while keeping your staff focused with our flagship PM system.
Where are mistakes happening & what are the proven strategies to fix them? View the infographic and take product tours of Ei Suite.
Matt Seefeld discusses the role that measuring claim touches & calculating the cost to collect will have on AI-powered revenue cycles.
The reality is that current stats related to U.S. administrative waste in healthcare are abysmal, equating to about 30% of total spending waste. In response, healthcare organizations are prioritizing adoption
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