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IDC Makes the Case for Purpose-Built Revenue Cycle Management Solutions

November 6, 2019

In September, International Data Corporation (IDC) released a new white paper, “Making a Case for Purpose-Built RCM: How Actionable Data and Lab Visibility Benefits Health Systems.” In this paper, IDC research director, Mutaz Shegewi outlines the many reasons that a laboratory-specific revenue cycle management (RCM) system is the best choice for hospital and health system outreach laboratories.

In the paper, Shegewi states that:  

“Hospital ancillary laboratories, outreach lab programs, and specialty or proprietary testing labs hold the potential to positively impact a health system’s balance sheet through efficiencies, productivity, data sharing, and business intelligence — all of which are directly related to patient care.”

To do so successfully, however, the hospital laboratory likely requires sophisticated, lab-specific capabilities, including business intelligence and connectivity that are not available through the enterprise billing and RCM system used by the rest of the hospital or health system.

IDC analyzes and presents many of the ways that purpose-built laboratory RCM and business intelligence can enhance enterprise system investments and reduce the risk for hospital groups and health systems. Specifically, the paper highlights the following benefits achieved by hospital and health systems that incorporate purpose-built laboratory RCM capabilities:

  • Increase the ability to collect on claims regardless of volume, value, or complexity while minimizing labor costs.
  • Improve reimbursements through fewer denials and improved appeals success.
  • Better mitigation of risk and adherence to compliance requirements.
  • Minimize labor costs through intelligent workflow automation, configuration, and logic specialization.
  • Enhance financial visibility with machine learning-enabled business analytics and visualizations.
  • Facilitate delivery of lab-specific business intelligence to the health system to enable data-driven decision making based on data models with financial referential integrity.
  • Improve bidirectional data exchange that helps close gaps in care and drives better outcomes, richer engagements, and experiences between laboratories and their patients and their physician clients.
  • Mitigate compliance exposure by minimizing clerical decision making through intelligent workflow automation.

IDC also found that laboratories that adopt next-generation revenue cycle management capabilities can grow volume, while reducing costs, and providing a better experience for patients, physicians, and hospital administrators, alike. The paper also includes case studies from four XiFin clients to help bring to life how these benefits were accomplished across different types of organizations.

To learn more about the details of the IDC analysis and findings, including the considerations that lead to suboptimal laboratory financial performance and risk exposure, read the IDC white paper, “Making a Case for Purpose-Built RCM: How Actionable Data and Lab Visibility Benefits Health Systems.” 

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Business IntelligenceHospitalLaboratoryRevenue Cycle ManagementTechnology

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