What's Happening?
Health systems across the U.S. are increasingly adopting generative artificial intelligence (AI) solutions for revenue cycle management (RCM), with 80% of systems exploring, piloting, or implementing these
tools in 2025. This marks a significant increase from 58% in 2023, according to a survey by the Healthcare Financial Management Association and AKASA. The technology promises to improve coding and revenue capture, but many systems face operational barriers such as cost, budget constraints, and integration challenges. Smaller health systems, in particular, struggle with limited IT capacity and competing priorities, slowing their adoption of AI solutions.
Why It's Important?
The adoption of AI in healthcare RCM is crucial as it can significantly enhance the accuracy and completeness of documentation and coding, directly impacting revenue integrity and compliance. With healthcare systems operating under tight financial margins, the ability to improve revenue capture is vital. However, the cost of implementing AI solutions remains a significant hurdle, especially for smaller systems. The potential for AI to streamline operations and reduce manual tasks could lead to substantial savings and efficiency gains, making it a critical tool for healthcare providers aiming to maintain financial stability and improve patient care.
What's Next?
As health systems continue to explore AI solutions, the focus will likely shift towards overcoming integration and cost barriers. Health tech vendors are expected to play a key role in facilitating this transition by providing standards-based integrations and minimizing the IT burden on health systems. The ongoing development of AI tools that can seamlessly integrate with existing electronic health records will be essential. Additionally, as more systems demonstrate the financial benefits of AI adoption, it may encourage wider implementation across the industry.
