Healthcarercm

  Providing excellent patient service is the primary goal of any healthcare organization. To this end, key performance indicators (KPIs) measure well-defined, quantifiable goals that healthcare providers can strive for. According to the Institute for Healthcare Improvement, vital KPIs measure the Triple Aim: Improving the overall patient experience of care – with a focus on quality and patient satisfaction Improving the health of populations Reducing healthcare costs per capita Key Performance Indicators There are a variety of metrics that can be used to assess the performance of healthcare organizations. Clearly defined KPIs help organizations more quickly improve performance because they allow for better focus. Some primary KPIs that organizations should focus on to improve revenue cycle performance include: Case Mix Index (CMI) -  CMI is the average value assigned to a group of people with the same diagnosis based on their personal details and treatment. This enables health...

  Automation and artificial intelligence (AI) in revenue cycle management (RCM) have numerous real-world applications as healthcare organizations seek to implement advanced technology and tools. This first article in our three-part RCM automation series explores the automation continuum and the various forms of automation that are reshaping the healthcare industry. Discovering the Automation Continuum The automation continuum can be categorized across four progressive stages of increasing complexity and capability: basic automation, advanced automation, intelligent automation, and generative AI. Basic Automation  emphasizes rules-based processes designed for repetitive tasks, which operate under predefined instructions. This foundational level of automation performs simple, routine operations, reducing manual workload and minimizing errors. An illustrative example in healthcare is the automated claim status query process, where a standard transaction prompts a predetermined re...