The medical billing industry is projected to see significant growth in the coming years. Spherical Insights predicts a compound annual growth rate (CAGR) of 13.23 percent for the global medical billing outsourcing market through 2032. Spherical Insights data also shows that the market will reach a total value of $41.9 billion by 2032. This puts numbers to the notion that medical practices of all sizes are increasingly outsourcing their revenue cycle management. Doing so eliminates tedious, repetitive tasks for a medical practice and frees up more time for other needs.
Improvements in automation technology have been a significant driver of the outsourced medical billing market’s expansion. This automation can expedite in-house and outsourced billing procedures while minimizing errors. It is increasingly part and parcel of cloud-based medical billing software.
Artificial intelligence is a significant driver of automation technology – a recent example worth watching is Outbound AI’s generative AI. Through this tool, which leverages ChatGPT and other AI technologies, billing teams minimize the manual labor of EOB processing, denial management and prior authorizations.
At every step of the way, AI software will remain vital to medical billing in 2024. Its importance is only expected to grow as healthcare IT vendors introduce machine learning algorithms into their products. More automation – and more accurate billing – should result.
Medical billing software data security is expected to be a paramount concern in 2024. This is especially true in light of the medical billing service Arietis Health informing patients of a data breach in October 2023. Due to this breach, personal medical information and key identifiers such as Social Security Numbers may be for sale among bad actors. Medical billing services – and the practices that use them – will likely prioritize security improvements to avoid similar breaches.
Additionally, according to study data published in December 2023, only 38 percent of U.S. hospital systems met three key medical billing quality standards. These standards were hospital legal action to collect outstanding patient payments, timely delivery of itemized patient statements and patient access to qualified billing staffers. Given that 62 percent of hospitals did not meet at least one of these standards, expect a focus on these medical billing areas in 2024. Hospitals and smaller practices alike may need to prioritize these measures.
Present-day medical billing options also come with personalization tools so patients can receive statements and use customized payment collection tools. Patient payment plans are also becoming more common. Outsourced medical billing providers may thus be expected to prioritize a personalized patient billing experience in 2024.
There will likely be a focus on medical billing transparency as well in 2024. State legislation reflects this, such as a 2023 Texas law that requires clear written invoices before sending patients to collections. So too do consumer concerns such as those out of Colorado, where one patient reported a billing error affecting tens of thousands of people. This patient filed a complaint directly with the state government, leading to national reporting on the issue. This suggests a renewed interest in medical billing transparency throughout the country.
Attention on medical billing has also emerged in Minnesota. There, the state Attorney General’s Office is investigating the health systems Mayo Clinic and Allina Health. In particular, Minnesota Attorney General Keith Ellison has been hosting listening sessions to get public input on negative medical billing experiences. As government focus on medical billing expands, prioritizing a highly positive patient experience will become increasingly important in 2024.
Additionally, in 2024, medical practices can expect compliance changes based on the federal No Surprises Act that went into law in 2022. This law protects patients from incurring unexpected medical bills, but many physicians have argued that federal involvement in insurer-practice disputes violates the Act’s guidelines. In fact, between February 2022 and February 2023, two federal district court rulings invalidated certain parts of the Act.
The confusion doesn’t end there. In July 2023, federal executive agencies asked a district court to reverse a previous ruling invalidating part of the Act. Furthermore, by late November 2023, approximately 30 public businesses had labeled the Act as a risk.
These worries may have come to fruition as per the Biden administration’s February 2024 progress report. According to this report, the three federal agencies co-managing the Act are spending substantially more time enforcing it than predicted. Additionally, in more than 80 percent of Act-related disputes, insurers were ordered to pay more to out-of-network providers than they would to contracted providers.
Medical practice and billing service requirements may fluctuate as courts and influential businesses weigh in on the No Surprises Act to change its scope. This makes the No Surprises Act key to watch in 2024.