CHAPTER 8

Future Trends in Mid-Cycle Revenue Cycle Management

CHAPTER 8

Future Trends in Mid-Cycle Revenue Cycle Management

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Looking to the future, provider organizations are beginning to put much more emphasis on mid-cycle processes due to complex value-based care models and the need for more effective data management. According to industry experts, the mid-cycle market will be worth $4.55 billion within the next four years (by 2027).1 This is understandable considering mid-cycle processes impact everything from cash flow to denials to timely and accurate reimbursement.

Outsourcing all or a portion of mid-cycle processes helps improve productivity, optimize revenue, and reduce costs.

Another trend impacting the mid-cycle is the ongoing shortage of revenue cycle experts. Organizations can find it increasingly challenging to find seasoned professionals with the insight to manage ever-changing payer requirements and increased healthcare regulation. This is why many providers are turning to outsourcing.

“The convergence of clinical care, documentation, and coding processes is vital to appropriate reimbursement, accurate quality scores, and informed decision-making to support high-quality patient care.”2

Benefits of Outsourcing in the Mid-Cycle

Outsourcers provide all the benefits of automation technology, eliminating the need for large
IT investments

Gain access to highly skilled, multi-shore talent pools at lower costs, reducing the expense of recruitment and hiring incentives

Enhanced payer expertise, enabling more timely intervention to reduce denials, delays in care,
and lagging reimbursement

Less stress on billing staff, helping to reduce turnover and knowledge gaps

eBook: Navigating the Heart of Healthcare Revenue

A Comprehensive Guide to the Mid-Cycle and Revenue Maximization

This eBook offers an extensive overview of mid-cycle operations within healthcare provider organizations. It emphasizes the critical importance of coding, clinical documentation integrity, revenue integrity, and health information management. The guide underscores that these processes are not isolated but are integral to both the front-end and back-end of the revenue cycle, affecting overall financial health and compliance.

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