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The following article was written by Kassandra Kurth, Director of Strategic Initiatives for Experian Health, and featured in Executive Insight:  Touchless Healthcare is Becoming More Prevalent The revenue cycle, however, is anything but Telemedicine has transformed the healthcare industry. From rural America, where in-person doctor visits are difficult, to the farthest reaches of the globe, internet technology allows doctors to visit the sick, diagnose illness, prescribe medicine and even perform surgery without ever actually touching a patient. The recent focus of healthcare automation for providers has been on electronic clinical documentation, but providers also have opportunities to automate revenue cycle functions. Identity verification, insurance validation and payment responsibility now demand a disproportionate amount of a medical staff's time. This is true for both specialist care and elective services, in which approval and payment processes require the provider to supply clinical information to the payer prior to treatment. This need for human involvement invariably bogs down the revenue stream. For patients, the overall healthcare experience suffers. Administrative payment uncertainties become a greater concern than the actual treatment. It's difficult for a medical center to predict the extent of insurance coverage and the patient's out-of-pocket costs. There are just so many variables impacting projected liability that it's unreasonable for facilities that rely on manual processing to provide estimates. While a facility may have an established book of clinical charges, specific procedures can carry variable costs, which must be verified with the appropriate department. In addition, individual insurance carriers have contracted coverage rates and policyholders have varying deductibles, copays and limits that must be considered. The cost-estimation process is so time-consuming – and requires such an abundance of coordination between the physician's plan of care and services provided and the healthcare facility -that many caregivers do not attempt to provide estimates. These concerns are echoed by Lisa Rickey, Patient Access Manager at Brazosport Regional Hospital in Texas. "We had three employees working on estimates for scheduled events and never knew how long each would take to produce," she said. "Because it was not a seamless part of registration, it actually became a negative part of the patient experience." Another concern is remote access to documents – not just by caregivers, but also by insurance providers, labs and patients themselves – via patient portals. While this is becoming the norm, it introduces the same security vulnerabilities seen in financial transactions. To address these issues, robust revenue cycle management (RCM) solutions are being developed that combine a number of analytical tools similar to those used by the credit industry. Medical document processors are now adopting the same information-processing and security technologies used in the financial services and credit industries. In fact, RCM is one of the fastest-growing health information segments. A recent article cited no fewer than 83 companies that are staking a claim in this space. These integrated patient information access, claims management and collections products automate many patient care administrative functions. By leveraging data and analytics, manual tasks such as eligibility and benefits verification, preauthorization, medical necessity, and billing and collections can be streamlined, reducing handling and shortening the payment cycle. Initially these systems were adopted by larger hospitals, which have the technical staff needed to support RCM implementation and benefit most from RCM automation. However, recent advances in ease of deployment have led to more individual practices and private physicians' offices recognizing the benefits as well. Information management companies with legacy workflow, business intelligence and data analytics tools also recognize the overlap between their existing products and the need for comparable tools tailored to healthcare. These providers either have customized established products or partnered with (or acquired) healthcare information companies. Experian Health's acquisition of Passport Health, for example, ties Passport's well-established RCM technology to Experian's established data analytics and revenue-recovery expertise. This powerful combination is expanding RCM to more than 3,000 hospitals and more than 10,000 other medical and ancillary groups across the U.S. Integrating RCM Practices are challenged by the need to integrate RCM with their existing workflows and those of partnering providers. Referring doctors, testing labs and a host of insurers each have their own technology. On the back end, credit and collections procedures may carry another set of tools that must be compatible. For many medical professionals or specialty medical facilities, this is a major barrier to adopting better platforms. A practice can't stop its current process while it ramps up a new one, and few have a large internal IT staff to complete the task. For this reason, it's important to partner with a skilled integrator to maximize the benefits of a revenue cycle solution. A product integrator can assess the unique workflow and objectives and determine the optimal combination of solutions. Ideally, users will be able to make updates to their existing process to align with RCM products. For specialty medical practices such as oncologists or radiologists, each step in the care process carries a measurable cost. Minimizing the time and labor required for each workflow stage translates into better patient care and improved revenue cycles. Each phase – from initial patient identification, service ordering and scheduling through patient admission and treatment, insurance coverage verification, and finally payment collection and archiving – can benefit from a streamlined process. A comprehensive RCM solution can help providers manage the entire patient continuum from registration through recovery. Tasks such as eligibility and benefit verification can be analyzed in batches or in real time at the point of service, ultimately reducing readmissions. Manual data functions like patient verification and prospective financial responsibility assignment can be streamlined. In addition, risk scoring, preauthorization and medical necessity evaluation (critical for Medicare eligibility) can be analyzed. "Many healthcare delivery organization CIOs resist making changes to revenue cycle management applications at their own peril," cautioned HIM Consultant Melanie A. Meyer, writing for Gartner. "CIOs should make investments now to achieve an enterprise view of RCM and deliver these next-generation capabilities." Integrated patient and payment RCM systems, which offer insights from real-time data-handling capabilities and advanced analytics along with competent integration and consultative services, are giving healthcare providers greater control over their revenue processes. By leveraging data in beneficial ways, caregivers finally can move away from pushing paper and get back to the business of healing patients.

Through Experian’s long-standing partnership with the UCI Paul Merage School of Business, I had the pleasure of participating recently in UCI’s Distinguished Speaker Series. I spoke about the role big data plays in today’s economy, and how data is being used as a force for good. My message to the 300+ attendees was clear – big data is everyone’s business. And it’s only going to get bigger. We have 90% more data today than we had just 2 years ago. What will happen in the next 2 years, much less the next 10? As big data gets bigger, how can we use it in even better ways, as a much greater force for good in society? Where we’re headed In the next decade, I predict that: Every single industry – from food service to entertainment to technology to retail – will be using big data in some way. We’re moving quickly in that direction already. A recent Gartner survey found that three-quarters of companies plan to invest in big data over the next 2 years. We’ll be using big data to cure big diseases. I believe we can fully cure cancer and HIV, among others, if we can tap into new insights from wearable technologies and genetic mapping, and put all that data to good use. Big data will help our economy improve. The presidential candidates may argue about the best way to create jobs and increase wealth, but any way you look at it, big data has to be a part of it. The more we can capture trend data on spending patterns and investment returns, the more we can be smart about where we spend our tax dollars, and even how we manage our personal finances. In other words, big data is going to become the backbone of society in ways we least expect today. Sometime in the future, when you go to a museum or an art gallery, big data will make your experience  more personal, more customized, and more relevant to your interests. We’re starting to see hints of this now. Think of how you might receive coupons on your phone for cheaper drinks at the ballpark food counter, because your phone realized you were at the game. “But I think we’re going to take this to an even higher level.” Imagine if we could add virtual reality to your experience – so that, when you walk into an art museum, your phone generates a hologram of your favorite artist. Overall, you’ll be getting a lot more value out of your everyday experiences. Some of the best uses of big data will be in the public sector, an area we’re already achieving significant benefits. Right now, big data is helping to improve public services, transportation and land use. Of particular interest these days, big data is helping to protect public safety in large crowds. And it’s helping people at hospitals figure out how to pay for their care, and pinpointing the most cost-effective payment plans. I think opportunities for big data will continue to expand within the public sector. How we get there But this will only happen if we take the right steps now: We all need to keep learning. This is the message I emphasized with the audience at UCI. No matter where you are in your career, it can only help to sharpen your skills in data and insights analysis. There’s more to discover, every day. Develop policies that encourage data-sharing. We can only benefit from big data if we make it easy for companies and governments to exchange the type of information that will ultimately make our world better. We have a tremendous responsibility to help implement policies that support that goal. Look beyond the obvious. Keep thinking of new sources of data and new applications for it. We’ll all benefit from thinking creatively. That’s the focus we’ve been taking at Experian. One example is our DataLabs, where we are using breakthrough experiments to take risks, so we can do good things with data on behalf of our clients. And we think the world will be better in the long run because of it. Watch these video excerpts from this event: Using Big Data For So Much More How is Big Data Helping Entrepreneurs Big Data Hurdles ### Craig Boundy is the CEO of Experian North America

In a recent report, the Consumer Financial Protection Bureau (CFPB) estimated that there are more than 45 million American consumers that are “credit invisible,” meaning that they either have no credit history or a credit file too thin to receive access to mainstream credit products. This limits their ability to get an affordable loan for a car, realize the dream of homeownership or even restricts access to capital to start a small business.  More frequently, a lack of credit history forces consumers to turn to more expensive, short term lending options. While credit invisibles may not have a traditional credit history, many make their cable, utility and mobile phone payments on time. However, this on-time payment data is not being included in their credit file. Historically, telecom and utility companies have only reported instances when a consumer is behind on payments or an account has been turned over to collections. This means that credit invisibles may have negative data from telecom and utility companies in their file, but are unable to build their credit file with positive data even if they make on-time payments each month. The good news is that Congressional leaders have recognized the need for action. On December 3 the Credit Access and Inclusion Act (H.R. 4172 and S.2355) was reintroduced in Congress, with Representatives Mike Fitzpatrick (R-Penn.) and Keith Ellison (D-MN) taking the lead in the House and Senators Mark Kirk (R-Ill.) and Joe Manchin (D-WVA) taking up the effort in the Senate. The bipartisan bill would amend the Fair Credit Reporting Act to make clear that utilities, telecommunication and rental companies can report on-time payment histories and positive data to the nation’s credit reporting bureaus, rather than just late payments or collection actions that they are currently furnishing. It would in no way require these companies to do so, but would help reassure these entities that there are no regulatory barriers to reporting on-time payment information. There is a detailed track record of research showing how the inclusion of alternative data will enable millions of credit invisible American consumers who have a proven track record of meeting financial obligations to access mainstream credit. A recent study by PERC and the Brookings Institution found that when energy utility and telephone firms report timely and late payment data alike, those who are deemed credit invisible shrunk to around 5 million. A separate study has also shown that the inclusion of this credit data would be a net positive for traditionally underserved populations, including minorities, young adults and the elderly. Moreover, a 2014 Experian study found that by including on-time utility payments in credit reports, there was nearly a 50 percent drop in subprime consumers with credit scores* between 300 and 600; a 54 percent increase in consumers considered nonprime with credit scores between 601 and 660; and a 15 percent increase in those with credit scores over 661, generally considered prime. I encourage lawmakers to take up this legislation and move it forward to ensure that consumers receive credit for meeting their financial obligations.