Smarter Technologies is a new automation platform developed for hospitals and health systems. It brings together three companies: income cycle management service companies (RCM) access an income cycle automation platform supplied by AI reflected.
The CEO of Smarter Technologies, Jeremy Delinsky, the former CTO of Athenahealth and founding COO of Devoted Health, who will make a cat by the fire in Medcity Invest on May 20 in Chicago with the editor -in -chief Arundati Parmar, offered an overview of the newly formed company and factors of its launch.
Could you give an overview of the functioning of the smarter technology platform and why do this movement that industry has not seen before?
First of all, thank you and Medcity News for taking the time to cover our launch. It is a really exciting day for smarter technologies and our newly combined company when we introduce the first automation and industry insistence platform for health care efficiency.
This investment in Smarter Technologies represents the greatest investment of the health care platform by New Mountain Capital to date, inaugurating a new technological platform through the continuum of health care management. We define a new way of providing these types of technologies fueled by AI and how supplier organizations use services as software. It has never been done before.
We consider AI as the next big unlocking of Healthcare’s productivity for hospitals and health systems. That said, AI alone is not magic. It is not a miracle solution. Enter smarter technologies. We bring together the team, talents and innovations of Smarterdx, Pensimemel.ai and Access Healthcare to take advantage of the power of the AI to considerably unlock better results of the income cycle for providers with a minimum disturbance, a high degree of flexibility and predictability, at a radically lower cost.
Under a unified brand and leadership team, Smarter Technologies Combins The Leading, Lowest-Cost-To-Deliver Revenue Cycle Operations and Services Company (Access Healthcare) with the leading Provider of Propietary Clinical Ai for Revenue Integrity (Smarterdx), and the leading ai-Powed Business and Revenue Cycle Automation Platform (Thoughtful.ai) – All in a single platform to automate hospital ‘existing income cycle management workflows and deliver king, from the first day.
Unlike traditional models, Smarter Technologies focuses on the activation of source teams in supplier organizations and our industrial partners with modular solutions that are agnostic of the DSE and give them the lever effect they need. Providers do not need to change anything in their current technological environments. They do not rewrite anything and they do not have to train their staff on AI tools. We provide offers that complete hospitals and health systems in which they are, so that they maintain strategic control and choose from a menu of offers that help them fight against administrative charges, increase in operational costs, increase in complaint refusals, pressure to improve cash flows and the need to follow the pace of technological and regulatory changes.
Providers are 2 to 5 years behind payers when it comes to taking advantage of the power of the AI. We will change this and we can do it in relatively short time.
As a combined force, Smarter Technologies brings a unique scale to this challenge, because we now have more than 27,000 employees serving more than 200 customers, more than 60 hospitals and care organizations, supporting more than 500,000 suppliers, more than 70 RCMs and DSE systems and industry partners, and we are dealing with more than 400 million transactions each year, with more than $ 200 billion account.
The efforts of providers to be paid and better work are long -standing and fundamental challenges. Smarter Technologies wants to provide a new Automation platform led by AI to support suppliers. Why was it so difficult?
It is not a hyperbola to say that AI is the greatest disruptor of health care payments, because the transition to automation began more than 20 years ago. At the time, technological activity payers considerably increased the complexity of technological batteries for arbitration of complaints as well as rapid acquisitions of other insurers. These developments have slowed down the payment cycle and have led suppliers to radically accelerate their ability to process complaints, considerably reducing the total number of AR days – the average number of days in which a business needs to collect species with customers who have paid using credit. Like all technological breeds, payers and providers have finally found a balance, where denial rates and the AR days were both stabilized. Counter -intuitively, all the automation deployed in the mid -2000s did not drop the overall costs of the income cycle – it has released species so that providers increase their expenses as administrative staff. Paradoxically, the technology designed to stimulate efficiency and accelerate cash collection has also increased overall costs, which were finally transmitted to buyers, including health plans, government, employers and patients.
For some observers of recent history, the deployment of AI will appear on the surface as a new technological arms race, in which health plans invest first, health systems and hospitals catch up, there is a certain level of disturbance, and ultimately a new balance emerges. But it would be an error to assume that the disturbance led by today’s AI will take place in a similar way to the changes formed by automation, and it is for some key reasons.
A large part of the investment by AI payers was deployed during the pandemic years, when the use of high costs was low and the health plans have seen relative manifies, while providers had to obtain government living lines to maintain cash flows. Although these lines of life have helped maintain high cash levels, the capabilities of providers are now well behind the payers. Health insurers generally conduct the deployment of new technologies, but the capacity difference is much wider than normal.
Payers therefore have more sophisticated tools designed to increase refusals and slow down operations of the income cycle, resulting in a modest increase in supplier days – for the first time in two decades.
In the past, health systems would respond to new technological capacities with a simple game book: invest in new technologies to counter payers, hire more administrative staff to manage complaints and transmit prices to buyers over time. However, the problem is that buyers have already had to absorb massive price increases to take into account the unprecedented increase in clinical labor costs resulting from the pandemic (generally north of 20 increases in percentage points).
Health systems have a limited lever effect to increase staff and almost no capacity to pass along higher price increases. In fact, the price increases they were able to achieve (generally 10% to 12%) were unable to take full account of the increases in clinical labor costs; They relied on increased use to pay the difference. We believe that smarter technologies and our new automation and insistence platform and modular offers can help health systems and hospitals faced with growing administrative and operational challenges. They need a new type of flexible income cycle management platform which brings together the best technologies focused on man, AI of the owner agent (a form of AI that can take in a independent manner and perform tasks with minimum human surveillance), global operations and large -scale strategic ideas.
What is the current standard of the health care industry for how much the hospitals is to receive payment? Industry studies indicate that hospitals and health systems spending conservative about $ 40 billion per year on the costs associated with invoicing and collections. To what extent do smarter technologies provide an impact on this number?
The standard of the health care industry for the cost of hospital payment collection is generally a percentage of the revenues generated. This generally varies from 4% to 10% of total income. This percentage covers all costs related to billing, including technology, staff and general costs. Health systems and hospitals also manage dozens of computer systems. It is essential to give them technologies and scale to automate their administrative workflows because they focus on their main mission to offer an incredible patient experience. Our goal is that the smarter technology platform is the catalyst for a large unlocking health care, both technologically and financially.
Hospitals always update DSE to facilitate interoperability and other initiatives to support interoperability and data security, invest in new medical equipment, etc. How can they expect to invest in AI as aggressively as payers, who do not have these expenses?
Big question. Your observation highlights a key structural difference between suppliers and payers when it comes to investing in AI and emerging technologies. Here is how this dynamic often takes place because hospitals are high -intensity organizations with continuous and non -discriminated infrastructure costs linked to things such as DSE upgrades to comply with interoperability standards, hardening of cybersecurity to protect patient data, compliance with HIPAA and CMS rules, and the replacement of clinical and diagnostic equipment. These priorities can divert both the capital and human resources from experimental or high level areas like AI.
The payers, on the other hand, operate mainly in the digital field, without facing the same physical infrastructure burden, and their fundamental commercial model is rich in data and is intrinsically lends to AI requests in the processing of complaints, risk prediction and fraud detection. For this reason, they were able to move faster and more aggressively on AI initiatives.
