Healthcare’s Imperative to Reduce Administrative Waste Starts with Revenue Cycle - 2025 Fall Conference - HBMA Store

Healthcare’s Imperative to Reduce Administrative Waste Starts with Revenue Cycle Presented by Cindy Groux and Matt Seefeld

As presented at HBMA's 2025 Fall Conference October 6th-8th, 2025.

Operational margin will continue to be a primary concern in 2025 for healthcare organizations, and provider organizations will look to their RCM service providers to help them stay financially viable. As the cost to collect continues to increase in tandem with declining reimbursements, financial leaders must consider one of the few remaining options in their control for improving the outlook: reducing administrative waste, especially in revenue cycle.

The reality is that current stats related to healthcare administrative waste are abysmal, equating to about 30% of total healthcare spending waste. While healthcare organizations are AI and automation to improve the outlook in revenue cycle, many are leaving money on the table because they lack visibility into a critical area: human generated data.

In session, presenters will demonstrate how Healthcare Practice Management, a Delaware based RCM services consultant, implemented an infrastructure to support regular analysis of human-generated data to identify opportunities for controlling administrative waste and improving staff performance. The presentation will include metrics on how the organization drove operational efficiencies and improved the capacity of existing staff.

In contrast to the limitations of common data—basic data housed in EHRs and practice management systems such as denials and claims status—human-generated data allows revenue cycle leaders to drill down into the number of “human touches” it takes to get a claim paid along with the effectiveness of staff. It also provides answers to some seemingly basic questions such as: Am I staffed correctly in accounts receivable? How many human touches does it take to get a claim paid? What is the cost of “wasted touches?” Presenters will also discuss a recent analysis across millions of human touches related to collecting on insurance claims that reveal upwards of 50% of touches are wasted on a consistent basis in today’s healthcare RCM processes.

Learning Objectives
Course participants will be able to:

• Analyze converging macro-economic challenges impacting healthcare organizations and why controlling administrative waste is one of the few areas left for impacting positive change.
• Explore the real-life experience of one RCM services provider implementing advanced technology infrastructures to support visibility into human-generated data.
• Evaluate the data limitations of practice management systems and EHRs and how workflow automation, AI and analytics solutions can help holistically address and improve reimbursement lifecycles.