The People Aspect of Automation

July 4, 2020


Change management for revenue cycle teams when implementing robotic process automation

Revenue cycle leaders face an increasingly complex set of issues converging to deliver repeated financial blows that have health systems reeling. According to Kaufmann Hall, US health systems have started off the year 2022 with four straight months of negative operating margins. Many are opting to mitigate the impact by using automation to redeploy staff to more valuable work and to accelerate revenue by streamlining processes for more efficient workflows and shorter cycle times. The challenges that have providers turning to automation are thorny and complex:

Revenue cycle challenges

  • Unsustainable staffing constraints experts predict the healthcare staffing shortage will be extended and serious for both clinical and administrative roles.
  • Competing IT priorities with limited resources, healthcare IT departments can only support so many systems, and automation projects must compete with others for priority.
  • Eroding revenue commercial payers and third-party administrators contracted by CMS have become more aggressive and strategic about challenging claims to deny or delay reimbursement.
  • Pandemic hangover hospitals incurred huge debt during the coronavirus pandemic that for some is truly an existential threat and will take years to reconcile.

Automation as strategy


Industry studies show that most hospitals and health systems have started an automation journey. A recent HFMA report showed as many as 82% are implementing automation, but only 19% reported significant success so far. What does seem clear is that health systems using robotic process automation (RPA) in the revenue cycle are automating their biggest pain points first. According to a recent survey of revenue cycle leaders that R1 conducted with Becker’s Healthcare, the top five processes being automated are focused on eligibility, authorization, claims and follow-up, payments and collections, and charge capture.

While revenue cycle leaders may appear to be just gathering the low-hanging fruit, ultimately, they want automation to help them make their workforce more effective. In our survey, 58% of respondents ranked labor efficiency gains as the first- or second-most important benefit of automation, with 32% ranking decreased labor costs first or second. Also of note, 68% of revenue cycle leaders we surveyed said they plan to leverage automation to deploy staff to more strategic work with higher returns. Only 3% said they would use automation to immediately cut their workforce.

Change management obstacles and risks

It’s only natural for any project involving major changes to organizational structure, job scope or workflows to draw skepticism from staff. They have legitimate concerns that need to be heard and addressed because change can be hard to accept, and even the most positive change can come as a shock. People will need time to adapt and process the changes to their routines. Like major life changes, they will go through a process that begins with denial and frustration, but with the right change management can ultimately result in positive impact on employee satisfaction and retention in addition to improvements in providers’ revenue and margins.

While successful automation programs deliver considerable benefits, failure to manage change effectively can lead to a failure to successfully automate processes. An EY study on RPA adoption and success rates showed 3050% of projects fail to achieve intended results due to failures in change leadership. Poor change management can lead to low employee morale, productivity losses, higher staff attrition and failed implementation.

Strategies for leading change

R1 automation experts recommend designing a game plan that ensures organizational buy-in throughout the process before, during and after implementation.

Assume the best.
Your people care about the work they do and the results they deliver for the health system. Trust that they will understand the need for change if you make a compelling case. Automation can really improve people’s work experience if they let it.

Make the case.
Business cases are not just for the CFO. Lead with the “why” when briefing staff on new automation projects. How does this help the health system, the patients, the staff? Explain the human elements of the job you want them to have more time to focus on. Describe the plan, timeline and feedback mechanisms.

Involve the team.
Give staff meaningful roles in design, testing and error reporting. The more they know about the project and the more input they have, the more comfortable your team will be with change. You will get better results and your team will take more ownership. They are also more likely to speak up if something looks wrong when they know what right is supposed to look like.

Make it fun.
Try to think of some creative ways to make the process enjoyable for your team. A little gamification can go a long way. Perhaps sponsor a contest to name the bots or hold a robot-building competition using Legos. Use a toy robot as a traveling trophy for the most productive and engaged staff members.

Model good behavior.
You will likely experience your own change curve. Talk about your feelings honestly and show the team how you get back to a positive mindset. Automating tasks that you would normally handle can set a very powerful example and let your team see you going through the same change they are.

Reinforce the change.
Make automation the new normal. Adjust productivity expectations to reflect the new reality; automation often means the harder work is what’s left for staff to do, so be sure to set realistic expectations accordingly. Spotlight the success stories of automation. Make it hard to do things the old way and reward those who are engaged.

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