How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang. EP521
Summary
Host Stacey Henke interviews healthcare analyst Andrew Tsang on the $200 billion revenue cycle management industry. They describe RCM as a "hot potato" game where administrative burdens, rather than clinical quality, dictate outcomes. The discussion highlights how this system disproportionately harms patients, independent providers, and self-funded employers. Tsang suggests direct contracting as a way to escape this costly, adversarial cycle.
Topics discussed
Introduction: RCM as a consequential healthcare force
The $200B RCM industry and the 'hot potato' metaphor
Guest intro and the illusion of opting out via direct contracting
Defining RCM: Front, middle, and back-end processes
Patient burden: Spending more time on admin than care
The Trolley Problem: Avoiding proactive cost decisions
Who pays and why? The lack of clear responsibility
Case study: The surprise bill of a diagnostic colonoscopy
Scale favors systems: Indie practices vs. consolidated health systems
Self-funded employers and the cost of medical miracles
Conclusion: Direct contracting as an escape from RCM
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