Becker's Hospital Review

61 RCM LEADER always deliver at scale," she said. "A human-centered AI framework is important as it reduces compliance and quality risk but also protects the organizational knowledge and reasoning capability that experienced staff carry." However, deploying AI without change management, human oversight and training can result in employees "disengaging from the reasoning process," which can validate the myth many are working to remove. e real work is organizational Across all leadership responses, the consistent message was that organizations will benefit most from AI in the revenue cycle if they invest in the operations around it, not just the technology. "e biggest myth in healthcare AI is that it's a plug-and-play solution that delivers instant transformation," Gloria Glover, vice president of business operations for Harris Health System, told Becker's. "Meaningful impact depends on data quality, workflow integration and aligning AI to real clinical, operational and financial problems, not replacing human expertise." n How Mount Sinai is transforming its revenue cycle By Andrew Cass I n 2025, Debra Jaeger, MSN, RN, was hired as New York City-based Mount Sinai's first chief revenue officer, tasked with unifying the system's fragmented revenue cycle. The role was designed to elevate Mount Sinai's revenue cycle into a center of excellence, aligning it more closely with the system's clinical and research reputation, Ms. Jaeger said on a recent episode of the Becker's ""CFO + Revenue Cycle Podcast." That effort included building a fully integrated revenue cycle across front-end, mid-cycle and back-end billing functions, while also expanding the system's focus beyond transactional revenue to include value-based payments. In the first year, the transformation resulted in improvements in cash collections and reductions in denials. "Much of that is done by just bringing these teams together and having collaborative conversations and leveraging each other's skills in this area to be more uniform," she said. She said the team has spent significant time focusing on standardizing practices and policies, along with Epic optimization. Looking ahead, the system is looking to utilize tools and education to improve the patient financial experience, particularly as healthcare costs and coverage complexities continue to grow. The health system is also exploring the use of AI and predictive analytics to better anticipate revenue trends. Ms. Jaeger said predictive tools could help identify potential delays in payment earlier in the claims process and improve cash forecasting, allowing teams to take a more proactive approach to revenue cycle management. n What's stressing out revenue cycle leaders? By Andrew Cass Payer challenges remain the top stressor for revenue cycle leaders, according to an April 7 report from Guidehouse. Guidehouse and the Healthcare Financial Management Association surveyed 191 provider executives in late 2025 about their challenges and investments in revenue cycle management. Fiy-two percent of those surveyed were hospital leaders, 39% were from health systems, and 9% were from medical groups. Nearly every provider executive (88%) said that payer challenges were among their top three stressors, according to the report. at figure is up slightly from 86% in the previous survey. Most leaders pointed to multiple shis in payer behavior over the past year. Health system and hospital executives were most likely to report issues. e payer behaviors observed by health systems include: • Increase in denials: 81% • Increase in prior authorization delays: 74% • Increase in unclear or vague denial reasons or underpayments: 73% • Excessive information requests: 69% • Reduced reimbursement rates: 41% According to the survey, the top five revenue cycle stressors are: • Payer challenges: 88% • Front-end and prior authorization attainment: 42% • Impact of regulatory and legislative changes: 34% • Workforce challenges: 33% • Technology adoption and integration: 29% Guidehouse noted that 25% of leaders surveyed said that cost to collect was a top stressor in 2025, while only 12% placed it among their top three stressors in 2026. Guidehouse said the shi may reflect the expansion of revenue cycle automation and self-service patient payment tools, "or simply a reprioritization of challenges." n

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