Own the Outcome: 3 Revenue Cycle Priorities for Health System Leaders Heading Into 2027
Across two days at the Colorado HFMA Fall Summit, one message kept surfacing: not every problem is a capacity problem. Here are three priorities health system leaders should act on, and where vendor accountability fits.
Fix the process before you buy the tool.
What We Heard
One revenue cycle leader offered a test for any AI idea: Is the task repetitive, rules-based, a bottleneck, and would visibility into it change a decision? The speaker's point was that winners redesign the whole journey rather than automate a single task. Another session cautioned that AI labor savings fall short because staffing rarely scales down with the work.
Why It Matters
Automating a broken workflow delivers broken results faster. Savings promised on a slide reach the income statement only when someone owns them, which is why smart leaders treat AI like an employee: monitored daily and spot-checked.
What To Do
Map the friction in one high-volume workflow, such as a single denial category from registration to payment, before approving a tool. Judge any automation on rework, first-pass yield, and cash, not hours saved.
Measure outcomes, not activity, including the work your vendors do.
What We Heard
A cost containment CFO panel stressed yield over volume: one panelist would take 10 high-yield account resolutions over 45 unnecessary claim touches. At the roundtable I facilitated for more than 130 registrants, the topics that drew the most energy were denials, payers, revenue integrity, and AI. The questions that stuck focused on accountability and priorities: How do you hold vendors accountable for performance? What would you automate first?
Why It Matters
Activity counts can look like progress while yield stays flat. If a team, or an outsourced partner, is rewarded for touches rather than resolutions, the metrics will not show the leak. Those roundtable questions are also opportunities to hold vendors accountable.
What To Do
Rebuild scorecards around aged A/R, first-pass yield, and cash, and hold outsourced partners to the same standard. Ask every department and vendor what they would start doing to improve results.
Plug referral leaks and tighten financial clearance before HR 1 finds the cracks.
What We Heard
One health system leader showed only 64% of referrals converting to a visit against an 80% goal, driven by leakage, cancellations, and never-scheduled visits. That leader's health system reported an 11.8% year-over-year gain in patient collections and credited early financial clearance, patient education and onboarding, and vendor management of its collections portfolio. The same session urged a shift from price transparency to cost predictability. Another speaker warned that HR 1, the federal budget reconciliation law, will find the cracks in financial clearance.
Why It Matters
Revenue lost before a claim exists never appears in the denial queue. Patients are behaving like consumers as financial encounters increasingly outnumber clinical ones. Coverage changes under HR 1 will push more cost onto them.
What To Do
Track referral-to-visit conversion alongside denial rates, move estimates and financial counseling earlier, give patients predictable out-of-pocket costs rather than posted prices, and stress-test clearance workflows before next year.
For leaders carrying this much volatility, sessions on wellness and radical acceptance offered one more piece of practical advice: control what you can and let go of what you cannot.
The Healthfuse Perspective
Across the sessions, the gap was not ideas but ownership. Fixing the process, measuring outcomes, and plugging referral leaks all require someone accountable for the result. Hospitals carry more vendors, tools, and contracts than any one team can monitor. A Vendor Management Office (VMO) closes that gap by monitoring vendor performance against contracts and benchmarks and vetting new technology against evidence before it scales. The payoff is yield that reaches the bottom line, so hospitals can keep serving their communities.