Dive Brief:
- Driven by pressure from changing value-based payment models, providers are increasingly outsourcing revenue cycle management services, according to industry research house Black Book.
- Black Book has found that over the past two years, hundreds of providers have outsourced their RCM function, and that the number continues to grow. This should result in the outsourced RCM market hitting $10 billion by 2016, the firm projects.
- In-house RCM operations cost providers $252 billion this year, with reimbursements costing $30 to $90 per transaction, Black Book estimates.
Dive Insight:
Outsourcing RCM makes a lot of sense in today's world, given not only changes in reimbursement but also the need to collect from patients with high-deductible health plans. What's more, using RCM outsourcers can help providers complete the ICD-10 transition, as they typically have specialized staff and expertise that providers lack, Black Book notes.
Early results suggest that providers are benefiting from such outsourcing. After surveying 2,250 CEOs, CIOs, business office managers, technology and financial services staff across 445 hospitals, Black Book found that outsourcing RCM largely led to higher revenue. Specifically, more than 80% of hospitals with more than 200 beds saw revenue gains of about 5% when the contracted for RCM services. Meanwhile, 78% of hospitals with less than 200 beds saw revenue go up almost 7%.