The survey found that: 1) Hospital executives predict more moderate growth in revenue cycle IT budgets and continue focusing technology investments on improving revenue integrity and addressing issues with EHRs and consumer self-pay. 2) Many providers struggle to optimize revenue cycle functions in their EHRs and are still challenged by the impact of EHR adoption on revenue cycle performance. 3) While providers have gotten better at managing consumer financial responsibility, it remains a significant issue, especially for health systems and large hospitals.

1. REVENUE CYCLE
TECHNOLOGY
TRENDS
A survey of provider executives about revenue cycle
IT budgets, EHRs, and consumer self-pay
November 2018
Lead. Solve. Grow.

2. 2 Revenue Cycle Technology Trends | November 2018
HFMA/Navigant Survey At-a-Glance
According to an annual HFMA/Navigant survey of 107 hospital and health system
CFOs and revenue cycle management (RCM) executives, their organizations:
Predict more
moderate IT
investments to
improve revenue cycle
performance
Continue to focus
on IT – revenue
integrity in particular –
to drive revenue cycle
improvements
Still struggle to
optimize revenue
cycle-related EHR
functions and address
consumer self-pay

3. Executives Project More Moderate Revenue Cycle
IT Budget Growth
How is your organization's revenue cycle technology budget projected to change in the next 12 months?
0%
3%
29%
45%
23%
0%
7%
19%
42%
32%
Decrease >5% Decrease 0-5% No Change Increase 0-5% Increase >5%
Executives predicting
revenue cycle IT
budget growth over
next year:
68%
2018
74%
2017
More smaller hospital
executives predict
RCM IT budget growth
over next year:
75%
SMALLER HOSPITALS
(< 300 BEDS)
59%
LARGER HOSPITALS
(> 500 BEDS)
2018
2017

4. Providers Still Struggling to Optimize EHR Functions
To what extent is your organization able to implement/utilize new functional releases from your EHR
(workflow, reporting, functional enhancements)?
39%
UNDERUTILIZE
available EHR functions
44%
QUICKLY ADAPT
to EHR functional releases
17%
CAN’T KEEP UP
with EHR functional releases
* Percentages exceed 100% because respondents were asked to select all responses that apply.
56%
can’t keep up with
EHR upgrades or underuse
EHR functions, up from
51% last year

5. of execs say EHR RCM
adoption challenges equal to
or outweigh benefits
More benefits
than challenges
Benefits
and challenges
are equal
More challenges
than benefits
EHR Revenue Cycle Adoption Challenges Equal to
or Outweigh Benefits
How has your organization's EHR adoption impacted revenue cycle performance?
22%
34%
44% 56%
More hospital-based and smaller hospital
executives cite more challenges than benefits:
vs. vs.
24%
Hospital-
Based
16%
Health
System
27%
Smaller
Hospital
16%
Larger
Hospital

6. Providers Better at Addressing Consumer Self-Pay,
But Issues Persist
What impact does increased consumer responsibility for healthcare costs have on your organization?
NO OR LITTLE
IMPACT
2018 2017
8%19%
MODERATE
IMPACT
SIGNIFICANT
IMPACT
2018 2017
59% 52%
2018 2017
40%22%
81%
2018
92%
2017
Execs believing consumer
self-pay will impact their
organizations:
More health system and
larger hospital executives expect
significant consumer self-pay impact:
vs. vs.
33%
Health
System
18%
Hospital-
Based
18%
Smaller
Hospital
29%
Larger
Hospital

7. of these areas
involve or are
enabled by
technology
Execs Continue to Focus on IT, Revenue Integrity to
Drive RCM Improvements
Which RCM capability or tactic is your organization most focused on for improvement over the next 12 months?
2%
6%
7%
8%
9%
11%
12%
21%
24%
0%
4%
5%
18%
6%
13%
18%
15%
22%
Robotic
process
automation
Staff
training &
incentives
Labor
utilization
Business
intelligence/
analytics
Coding Self-pay
management
Physician/
clinician
documentation
EHR
optimization
Revenue
integrity
2018
2017
76%

8. “Hospitals and health systems have invested a significant amount of
time and money into their EHRs, but the technology’s complexity is
preventing them from realizing an immediate return on their
investments. When optimized correctly, a good portion of the ROI can
come from EHR-related revenue cycle process improvements.”
— Timothy Kinney, Managing Director, Navigant

9. “The impact of consumer self-pay on providers will only increase
with the popularity of high-deductible health plans and negative
changes to the economy. Providers must take advantage of
opportunities to more holistically educate patients on out-of-pocket
costs, predict their propensity to pay as early as possible, and
secure alternative payers or financing when needed.”
— James McHugh, Managing Director, Navigant

10. About Navigant
Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm focused on
markets and clients facing transformational change and significant regulatory or legal pressures,
primarily in the energy, financial services, and healthcare industries. Navigant’s Healthcare practice
is composed of more than 500 consultants, former provider administrators, clinicians, and other
experts with decades of strategy, operational/clinical consulting, managed services, revenue cycle
management, and outsourcing experience. Experts collaborate with hospitals and health systems,
physician enterprises, payers, and government entities, providing enterprisewide strategic
development and performance-improvement solutions. More information about Navigant can be
found at navigant.com.

11. 11 Revenue Cycle Technology Trends | November 2018