For office-based, multi-specialty physician groups, managing the revenue cycle in-house has never been more complex – or critical. From specialty-specific coding requirements to evolving payer expectations and staffing shortages, even the most well-intentioned internal teams are struggling to keep up.
Unfortunately, this struggle is impacting the entire revenue cycle industry. The American Academy of Professional Coders (AAPC) reports that 63% of providers are experiencing RCM staffing shortages due in part to high workloads, resource constraints, and burnout. These gaps don’t just slow down the revenue cycle – they increase the risk of errors, denials, and staff turnover.
Why the traditional RCM model no longer works
Many multi-specialty, office-based physician groups built their revenue cycle operations years ago when modest in-house teams could navigate simpler payer rules, lower volumes, and easier workflows. While in-house teams have made updates and improvements over time, most have not been able to keep up with today’s billing and revenue cycle complexity, which demands speed, scale, compliance, and specialization.
As these operational hurdles stack up, many groups are rethinking their RCM approach entirely and turning to outsourced partnerships for relief and results. In fact, Medical Economics reported more than 60% of providers plan to outsource RCM tasks in the near future.
In addition to staffing shortages and high turnover, today’s revenue cycle challenges are compounding other issues, including:
- Specialty complexity: The rise of specialty-specific billing requirements makes it difficult to maintain consistent processes across services like cardiology, orthopedics, gastroenterology, and behavioral health.
- Disjointed technology systems: The use of multiple, non-connected technology creates information silos that limit performance tracking and proactive denial prevention.
- Challenging payer behavior: Payers have become more aggressive, with tighter submission timelines, more pre-authorizations, and stricter documentation requirements, all of which demand a nimble, well-coordinated response.
The result? Slower claims submission, more denials, and A/R that lingers on the books for months – crippling cash flow and provider morale.
Outgrowing a legacy RCM partnership
The demands surrounding revenue cycle are not just impacting in-house teams. In many cases, legacy outsourced vendors are also struggling to keep up with the demands and pace of today’s billing landscape.
Many groups who outsourced their revenue cycle functions during the early days of outsourcing are facing a different kind of problem: a partner who isn’t delivering optimal results. Warning signs can include:
- Claims are delayed or denied at high rates
- Aged A/R (>120 days) remains stubbornly high
- Your partner isn’t providing clear KPIs, accountability, or strategic guidance
- Internal staff are bogged down with manual tasks your vendor should be performing
If your organization has experienced any of the above warning signs, it may be time to re-evaluate your partner. Staying with a vendor who can’t meet your evolving needs can limit your growth, drain internal resources, and undermine your ability to compete, ultimately leading to inefficiencies that holds your group back.
Recognizing the signs of an underperforming model is the first step. The next step is understanding what a top RCM company can deliver.
A look at high-performing RCM partnership metrics
A smarter RCM strategy can ease the burden on your staff, improve financial outcomes, and restore visibility and control over your revenue cycle.
The opportunity is significant. Top RCM companies consistently outperform the industry average across essential metrics like A/R days, claims submission, and turnaround times.
As you evaluate potential partners, these benchmarks show how in-house team averages compare to high-performing RCM vendors:
| Metric | In-House Average | High-Performing RCM Partner |
| Days in A/R | 45-60 | 28 |
| Claims submitted in first 7 days | 40% | 95% |
| Aged A/R (>120 days) | 15-25% | 5% |
To find a high-performing RCM partner, look for one who delivers more than just back-office processing, including:
- Certified, specialty-specific coders with ≥95% accuracy
- Claims submission within 24–72 hours
- Proactive denial management and audit support
- Integrated analytics dashboards that provide full visibility
- Secure, compliant workflows with responsive U.S.-based management
Whether you’re outsourcing for the first time or replacing a legacy vendor, the right partner doesn’t just improve collections – they help stabilize your operations, reduce burnout, and support sustainable growth.
Results: How outsourcing can lead to significant cost savings
The financial impact of switching to the right RCM partner can be significant. A large 200-physician multi-specialty client projected potential annual cost savings of $2.9 million by outsourcing their coding services. Their forecasted savings are highlighted below.
| Number of Coders | Annual Client Spend | HPI Annual Fees | Annual Savings |
| Medicaid Coders (9) | $449,280 | Included | $449,280 |
| FFS/ACO/ACA Coders (20) | $1,073,280 | $660,000 | $413,280 |
| Value-Based Coders (60) | $3,369,600 | $1,320,000 | $2,049,600 |
| Total (89) | $4,892,160 | $1,980,000 | $2,912,160 |
Don’t let your revenue cycle be a bottleneck
In today’s reimbursement landscape, running a multi-specialty physician group is challenging enough. You shouldn’t have to worry about whether your claims are clean, your coders are accurate, or your A/R is dragging down performance.
If your current model isn’t delivering the results you need, it’s time to stop settling. The solution may not be just outsourcing – it may be finding the right outsourcing partner.
If you want more information about how we can help optimize your revenue cycle, please send us an email or visit us at hpiinc.com/multi-specialty.
