Many large payer organizations are beginning to embrace and promote analytics. However, soiled data and lack of incentives among the stakeholders are the major barriers that hold back the promotion of analytics for better RCM. Interoperability is the main barrier of data liquidation that prevents a practice from harnessing the true potential of analytics. A lot of research is under process to solve this issue in particular. Radiology RCM Account Receivable Service
Future and Growth
A number of fields in the healthcare value chain are well-suited for analytics and will likely offer an impressive return on investment. Some others are already experiencing quick uptake.
There is a great upsurge in imaging at the moment. The providers and vendors need to prepare for the opportunities that the imaging technology can bring to them in the near future. The advancement of imaging technology with several modalities will prove useful for various medical areas. There is an expected increase of 13.6% in medical imaging procedures.
Counting in the number of Americans who will enroll in the healthcare system in the next couple of years, this percentage is expected to see a further explosion of data. Furthermore, the sharing of images amidst different healthcare IT systems, with the help of electronic health record systems will increase too. PACS is the system used traditionally to store images. They are shared through vendor-neutral archive (VNA) systems.
Homecare is another area that lacks in the growth of images but holds a promise for the future. Many fields like dermatology and diabetics have made use of images captured remotely at home since long to provide wound care for making intervention decisions.
As of today, no established practice makes strict use of images captured at a patient’s home that are transferred to the electronic medical record system to support clinical follow-up or preventive intervention. However, changing trends of imaging explosion will add to the popularity of telemedicine.
Radiology and RCM
Today, Radiologists are not an isolated service provider. Instead, they are an integral part of the care collaboration that they make with multiple medical specialties. Images help the radiologists develop a better understanding of a patient’s medical history. Radiologists have a lot of scope for improvement in the care they provide the patient if the data on what treatment is rendered by the physician becomes available.
Accumulation and study of data gathered over a period of time can help Radiologists recognize patterns to review and improve the care delivery and service they provide.
Big Data -Automated Residents
Not all Radiologists have access to residents and fellows like the ones in medical centers. With the era of image explosion coming up, radiologists will require assistance in reviewing old images and in preparing synopsis before they are scheduled to see a patient.
This will allow them to spare more time for the patients to explain to them the medical conditions and answer their questions. This can be done with the help of smart analytical tools caller “automated residents”.
Smarter Revenue Cycle Management
The affordable care act has put Radiologists in a place prone to risks due to the pay-for-performance payment model as compared to fee-for-service models. This makes it necessary for care providers to invest in analytics to grasp a better understanding of both the operational and financial aspects of the business.
By applying different algorithmic tools and converting raw data to transformed data in such large datasets, there is a possibility of understanding and using Radiology data for gaining new knowledge and insights. By using big data, the planning and implementation of radiological procedures in radiology departments can be given a great boost.
FAQs
Analytics enhances RCM by identifying inefficiencies, reducing claim denials, and improving financial performance, ultimately leading to better patient care and operational efficiency.
Major barriers include poor data quality, lack of interoperability among healthcare systems, and insufficient incentives for stakeholders to adopt analytics.
The increasing volume of imaging procedures—expected to rise by 13.6%—will generate more data, necessitating advanced analytics to optimize revenue cycles and improve patient outcomes.
Automated residents assist radiologists in reviewing and summarizing previous images, allowing them to focus more on patient interaction and care while enhancing the efficiency of the RCM process.
By analyzing large datasets with algorithmic tools, radiology practices can gain valuable insights, improve care delivery, and optimize financial performance within the framework of the Affordable Care Act’s pay-for-performance model.
