Finding senior-level revenue cycle talent is the most challenging for healthcare organizations, but even entry-level roles take an average of 84 days to fill.

The Great Resignation and other employment challenges are hitting revenue cycle management, a new survey of hospital and health system leaders indicates.

The survey commissioned by healthcare operations company AKASA surveyed 514 chief financial officers and revenue cycle leaders at hospitals and health system across the US using the Healthcare Financial Management Association’s (HFMA’s) Pulse Survey program. The survey was fielded between Sept. 30, 2021, and Oct. 17, 2021.

Survey results revealed that the cost of recruiting revenue cycle talent is significant and the timelines to fill open positions is long.

An open entry-level revenue cycle position cost hospitals and health systems $2,167 for recruitment, on average, according to the survey. Additionally, finance leaders said it takes an average of 84 days to fill the role despite applicants needing no experience.

Revenue cycle talent recruitment also costs more and takes longer to accomplish as hospitals and health systems seek more experienced professionals.

Finance leaders reported that mid-level revenue cycle positions, which require six to ten years of experience, cost an average of $3,581 for recruitment and take about 153 days to fill. For senior-level revenue cycle positions (ten or more years of experience), hospitals spent an average of $5,699 on recruitment and it took 207 days to fill, on average.

Researchers attributed the difficulty with revenue cycle talent recruitment to the larger Great Resignation trend.

The Great Resignation is resulting in higher staff turnover across nearly all industries, but healthcare seems to be getting hit the hardest by the current economic climate. A recent survey by Jackson Physician Search and Medical Group Management Association (MGMA) found higher-than-normal rates of turnover among nurses, physicians, and other healthcare providers. Many of the respondents reported high levels of burnout and nearly half said they are considering retirement.

This trend could last years, too. A new study published in Mayo Clinic Proceedings found that one in five physicians plan to leave their practice in the next two years. Many clerical staff and administrators also said they were planning to reduce their hours over the next year, although they were less likely to do so compared to patient care providers.

However, the trend appears to be hitting revenue cycle management pretty significantly. The AKASA survey did not poll finance leaders on why they are experiencing so many challenges with recruiting staff across levels. However, researchers hypothesized that skilled workers are leaving healthcare for higher-paying jobs in other industries, including retail and logistics.

Additionally, they said that hospital costs for completing revenue cycle talent recruitment are likely higher than finance leaders believe, which may be adding to the stress of filling vacant positions.

“Of note, the complete cost to recruit is likely higher as healthcare leaders often don’t have a full line of sight into the total cost of recruitment managed by marketing and HR as well as the costs associated with training and onboarding new staff,” the survey stated.

Longer hours, increased pressure to be more productive, and an industry-wide focus on improving the patient financial experience are also straining revenue cycle management teams, researchers stated.

“This combination increases the likelihood of morale issues and burnout while preventing teams from adapting quickly in the face of a rapidly shifting work environment,” they wrote.

Automation within revenue cycle management may help to alleviate workforce troubles, the survey suggests.

“Health systems simply can’t get the staff they need to get all the work done. So we have to change the way we work,” Malinka Walaliyadde, co-founder and CEO of AKASA, said in the survey. “We need to eliminate repetitive tasks and leverage our minimal staff to work on only the most cognitively complex activities. This pandemic is the crucible from which healthcare leaders can define their legacy and establish an AI foundation to set their health systems up for success for decades to come.”

Revenue cycle automation is on the rise as healthcare organizations not only address workforce challenges but also higher claim volumes, revenue losses, and increasing complexity of healthcare administration. But in a more remote work environment, some hospitals and health systems are also turning to outsourcing vendors to fill gaps in their revenue cycle workforce. One of those companies noticing increased interest is NextGen.

“Many of our clients are experiencing labor shortages and higher staff turnover,” David Sides, CEO of revenue cycle management company NextGen, said in an earnings call last week. “We are seeing customers who in the past would not have discussed outsourcing activities like revenue cycle management to now actively evaluating and engaging us for these services.”

With both automation and outsourcing trending up, hospitals and health systems are rethinking their revenue cycle talent recruitment strategies and leaning more on trusted vendor partners to fill workforce gaps as they focus on patient care.

 By Jacqueline LaPointe