Growth in clinical documentation market is expected to reach US$5.3B by 2022 from $3.2B 2018 with a 10.3% CAGR driven by mid-RCM artificial intelligence supported solutions to reduce costs, manage unstructured data and check for billing and coding losses.
Black Book Research surveyed 540 health information management executives and revealed that 47% of healthcare organizations are using AI in one form or another, and 90% of them expect widespread implementation in the next five years, despite the operational constraints and financial priorities caused by the COVID-19 pandemic.
In a 2020 survey conducted through Q4 by Black Book, 95% of hospital respondents are optimistic that AI technology can streamline document creation and enable clinicians to capture a holistic patient history to boost outcomes but also improve revenue integrity.
An additional 391 provider respondents that have not yet fully implemented or optimally using AI-enhanced coding, CDI, speech recognition or transcription technology provided insight on budgeting, adoption plans, factors driving coding and transcription decisions and vendor awareness.
The collective results were culled from the current healthcare industry users of artificial intelligence tools and future AI users that participated in Black Book coding and HIM surveys in the current year:
- Both commercial and public payers are now denying about one in every 12 (8%) of submitted claims, costing health systems nearly 2.5% of net patient revenue.
- Health system coder productivity measured in Q3 2020 as compared to Q3 2017 has increased 68% in respondent hospitals over 250 beds.
- Ninety-four percent of providers polled are eager to implement more sophisticated clinical documentation improvement tools that use artificial intelligence to boost the speed, accuracy and efficiency of coders. Sixty-eight percent have retained committed funds to AI coding improvements in FY 2021.
- New platforms embed AI-powered clinical intelligence in both standard clinician and CDI workflows, analyzing EHR notes and clinical data to find gaps and deficiencies before notes are saved to the EHR, a 2021 acquisition priority in 87% of respondents.
“AI-enhanced CDI allows providers to explore new opportunities with payers because hospitals have the data to show where quality outcomes are performing best,” said Doug Brown, President of Black Book.
The average case mix overall improvement in 145 hospitals surveyed between 150-450 beds accomplished an average $2.3 million in financial improvements from AI-enhanced CDI initiatives from Q3 2019 to Q3 2020 as reported by the survey respondents, an increase of 27% from the same period the previous year.
“Improvement of clinical documentation provides the opportunity to maximize reimbursement and CDI is the process of enhancing medical data collection, improving quality of care while maximizing payer reimbursement income. It definitely maximized the revenue cycle efficiency,” said Brown.
An impressive 97% of hospitals confirm documented quality improvements and increases in case mix index within six months of AI-enhanced CDI implementation.
Eighty-six percent of health systems’ chief financial officers claim that the biggest motivator for adopting artificial intelligence coding support tools is to provide improvements in case mix index, resulting in increased revenues and the best possible utilization of high-value specialists in 2021 and beyond.