A new national survey conducted through HFMA’s Pulse Survey program reveals rapid movement among hospitals and health systems toward generative AI solutions in the revenue cycle, with 80% now exploring, piloting, or implementing GenAI tools, up from 58% in 2023, representing 38% growth in under two years.
Across organizations of all sizes, incomplete or inaccurate documentation was identified as the top mid-cycle challenge (28%), surpassing staffing shortages (17%) and coding denials (11%). On average, respondents estimated that 8% of total revenue is at risk due to documentation and coding issues, with some organizations reporting exposure of more than 25%.
The stakes are significant:
- 89% said missed or inaccurate codes impact revenue.
- 51% described the impact as “significant” or “very significant.”
- Smaller systems report the highest exposure, averaging nearly 10% of revenue at risk.
Leaders also pointed to process fragmentation, manual workflows, and difficulty integrating documentation and coding systems as persistent sources of inefficiency.
While overall adoption of GenAI tools is strong, the data show a split by organization size:
- Larger systems: 64% are piloting or implementing GenAI.
- Mid-sized systems ($500M–$1B NPR): only 20% have reached the pilot stage.
Among organizations using AI, leaders cite the greatest expected benefits in closing documentation gaps:
- 60% believe GenAI can identify missed reimbursement opportunities.
- 57% expect it to uncover gaps in clinical documentation.
- 43% see it reducing coding-based denials.
Barriers to adoption remain consistent:
- Integration with existing systems
- Cost and budget limitations
- Data security concerns
- Unclear ROI
- Understanding available technology options
Notably, staff resistance and leadership buy-in ranked as the least significant obstacles, indicating a cultural shift toward AI acceptance.
