From a Single Point of Failure to Multiple Paths: Industry Shifts in Response to Major Disruption

On February 21, 2024, the healthcare ecosystem became more aware of supplier risk and connectivity interdependence when a key partner for providers and health plans became unavailable for weeks as a result of a cyberattack.

How the industry is responding

While the immediate sentiment across the healthcare landscape was a heightened focus on security and privacy, the long-term message is clear: the time has come to embrace multi-vendor strategies for revenue cycle management. Relying exclusively on one vendor to submit or track claims leaves organizations vulnerable to payment delays or more significant damage to their revenue cycle in the wake of security incidents.

"The industry is realizing that the single point of failure is just too risky in the current environment," said Eron Kelly, President of Inovalon in a recent Reuter's article.

At single practices and large, multi-location groups alike, providers must diversify the relationships and connections that keep their organizations running smoothly every day. Inovalon spoke with Nick Knowlton, VP, Strategic Initiatives at ResMed and Chair of the Board of Directors for CommonWell Health Alliance, on the importance of diversification when faced with RCM disruptions. Knowlton shared, "diversification provides opportunities to navigate problems that occur in the claims submission process - that's part of our future across the entire ecosystem, to ensure that we're ready for whatever events are thrown at us."

As supplier and partner risk evolves, diversification is how healthcare vendors and provider organizations can maintain flexibility and drive financial success.

Rerouting efforts and trusted connections support providers

Inovalon witnessed the emphasis on diversification grow overnight as providers needed new connections right away. In the days and weeks after February 21, Inovalon created over 350 new payer connections and implemented many new customers.

This was critical for small practices whose only connection for processing had been eliminated, putting all of their cash flow in a standstill. Similarly, large organizations with thousands or millions of dollars in claims needed to continue their high-value cash flow - and didn't have the time or resources to process their claims manually in the meantime.

For PAM Health, a network of over 100 long-term acute care, physical medicine and rehabilitation, and behavioral health hospitals, "[Inovalon's] rerouting of claims was the most important thing that kept our revenue cycle afloat," shared William Borrego, Vice President of Revenue Cycle Operations. The organization had $5 million in pending claims in the time between losing connectivity and implementing with Inovalon. Within 24 hours of implementation, pending claims had been cut in half, down to $2.5 million as rerouting efforts restarted their claims processing operations.

Eliminate a single point of failure and explore RCM workflows powered by Inovalon

Inovalon's Provider Cloud is trusted by 25 of the top 25¹ U.S. provider systems, and these solutions maintain 2,300 payer connections² and process over 1 billion² claims and remits annually.

Increase your organization's peace of mind by diversifying your RCM connections. Learn how Inovalon can help establish and maintain new, efficient RCM workflows - explore our revenue cycle management solutions

Sources:

¹ Top 25 provider systems based on Becker's Hospital Review list of 100 largest hospitals and health systems 2023. Inovalon internal reporting. April 2024.

² Internal reporting, Inovalon, August 5, 2024.

Inovalon and design®, Inovalon®, and the Inovalon ONE® Platform are trademarks of Inovalon, Inc.

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