The health system expects net revenue to improve by more than $40 million on an annualized basis.
Baylor Scott & White Health’s use of AI in the revenue cycle is expected to result in an annualized net revenue improvement of $40 million.
The sprawling Texas health system of 52 hospitals was able to achieve this through a partnership with Accuity, a physician-led technology company. BSWH started in February with a two-month pilot of Accuity’s Amplifi AI technology at its flagship hospital and achieved a strong return on investment, according to Sarah Knodel, senior vice president of revenue cycle.
In May, BSWH deployed Amplifi AI technology to 26 of its sites.
Six months later, in November, BSWH had an additional $20.6 million in revenue, according to Knodel. By 2026, that figure is expected to reach $45 million, she said.
In annualized terms, that represents a net revenue improvement of more than $40 million, she said.
The impact of the Case Mix Index showed an average improvement of 3.5%, leading to greater reimbursement.
“BSWH sees AI solutions as having great potential to improve its revenue cycle efforts,” Knodel said. “AI has added efficiencies that free up resources to focus more on quality capture and other key initiatives.”
WHY IT IS IMPORTANT
Accuity partners with hospitals and health systems for clinical documentation improvement (CDI) and coding review.
“The middle of the revenue cycle is where you find opportunities,” said Candice Daszewski, chief customer officer at Accuity.
The AI focuses on CDI and coding, highlighting inconsistencies in the patient’s record that may prompt questioning of the doctor. This results in improved clinical documentation in approximately 8-9% of cases.
Amplifi analyzes comprehensive data from patient records, Daszewski said, against the Diagnosis Related Group, or DRG, a classification system for medical conditions.
Leveraging AI in algorithms creates a more efficient process, Daszewski said.
“It gives partners an AI solution without having to own it, without concerns about accuracy,” she said.
Knodel said his team felt like they had a strong CDI program, but wanted to get confirmation of that and take it a step further to determine how much money they could leave on the table.
“Baylor Scott & White was looking to maximize net revenue and reduce collection costs,” Knodel said. Additionally, the health system wanted to know, “How can we improve the overall patient experience?” » she said.
The automation journey began over 10 years ago with Robotic Process Automation robots. This has evolved into machine learning, natural language processing and now agentic AI for more advanced capabilities, Knodel said.
“It was really exciting, they confirmed we had a strong program,” she said. “More broadly, how does this increase and improve our efficiency?
THE BIGGEST TREND
In June, the conversation about AI and the revenue cycle was part of an HFMA panel presentation between Daszewski and clinical and revenue cycle leaders from Prisma Health, Mass General Brigham and MultiCare Health.
According to Daszewski, one of the key takeaways is the influence of AI-driven automation on the revenue cycle.
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