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A practical guide to protecting margin in a volatile healthcare economy

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96%

of health system CFOs say labor costs are the top margin pressure driver

82%

report payer denials are higher than pre-pandemic

24%

of CFO time is spent on revenue cycle and denial issues

84%

cite lower reimbursement as a leading cause of weak margin

The margin reality facing healthcare CFOs

Hospital and health system CFOs are operating in a high-risk financial environment. At the same time, expectations have not changed. Boards still expect predictable, stable margins, communities still expect access and clinicians still expect support.

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Persistent labor shortages, inefficiencies and wage inflation

Escalating denial rates and payer scrutiny

Documentation variability that affects revenue and quality metrics

Growing regulatory complexity

Capital constraints limiting large system overhauls

The revenue cycle has become one of the fastest, most direct levers for meaningful financial improvement. But incremental fixes are no longer enough. CFOs need systemic performance improvement across the entire revenue cycle, from documentation through final reimbursement.

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Workflow gaps
 

Have you invested in a complete revenue cycle platform?

Many health systems have modernized parts of the revenue cycle. But when investments are made in isolated point solutions, or in one function without another, gaps can still emerge across workflows. For example, organizations may invest in:

Coding automation without integrated CDI
Audit tools that don’t feed back into documentation improvement
Denials management without upstream prevention
Prior authorization solutions disconnected from clinical and coding workflows
These investments can create gaps such as:
  • Limited visibility between front-end care and back-end revenue processes
  • CDI, coding and quality teams that operate in parallel rather than together
  • Coding and audit functions that are not fully aligned
  • Audit insights that fail to inform future documentation
  • Denials that are addressed reactively, long after discharge
  • Manual or disconnected prior authorization workflows
This can create:
  • Revenue leakage
  • Rework and preventable denials
  • Delays in cash
  • High cost to collect
  • Staff burnout and turnover
Point solutions add complexity. Additional FTEs increase cost. Retrospective fixes do not prevent future loss. What CFOs need now is coordinated intelligence across the revenue cycle.
The solution
 

The case for an integrated, ‘human-in-the-loop’ AI platform

Al alone is not the answer. Automation without clinical context can create compliance risk and operational friction. A human-in-the-loop Al platform combines advanced technology with clinical expertise to automate with confidence and support decision-making without replacing professional judgment.

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Advanced, deep learning and neural network AI models
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Workflow-embedded intelligence
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Real-time data analysis
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Coding and compliance oversight
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Clinical expertise that trains AI
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Continuous feedback loops with transparency
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For CFOs, this can mean:

  • Scalable productivity without sacrificing compliance
  • Earlier identification of financial opportunities and risk
  • Stronger alignment between clinical and financial teams
  • Sustainable performance improvement
Integration is what transforms isolated improvements into measurable enterprise impact.
Platform capabilities
 

Coordinated intelligence across every workflow

Stabilizing revenue at the source

Revenue performance begins with clinical documentation. Incomplete or inconsistent documentation can lead to:

Under coding
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Increased audit vulnerability
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Quality score degradation
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Downstream denials
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An integrated platform embeds intelligence directly into CDI workflows, helping teams:

Identify documentation opportunities in real time

Prioritize cases with the highest financial and quality impact

Ensure accurate capture of risk adjustment factors

Improve productivity and relieve administrative burden

Improving coding accuracy and productivity

Coding remains one of the largest operational cost centers within the revenue cycle. It brings about many challenges, including complex and ever-changing coding guidelines, volume variability, talent shortages and inefficiencies and backlogs that delay billing.

Human-in-the-loop AI can enhance coding teams by:

Pre-analyzing encounters and fully automating confident ones

Surfacing suggested codes with alerts and explainers for those that fall behind a confidence threshold

Flagging missing or conflicting documentation

Prioritizing high-risk or high-value cases

Having a robust reporting system that lets administrators identify areas of improvement

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Coding teams remain in control while AI automates where confident and accelerates review where needed, reducing cognitive burden.

This can financially impact CFOs, offering:

  • Lower cost to collect
  • Reduced discharged not final billed (DNFB)
  • Mitigated audit risk with standard coding practices
  • Faster time to bill
 
Productivity gains without adding headcount protect margin in an inflationary labor market.

See how one health system achieved these results by modernizing
coding workflows

Moving from reactive to proactive denials management

Denials are no longer an exception. They are a systemic pressure point. Traditional approaches focus on appeal after the fact. That model is expensive and inefficient. An integrated revenue cycle platform can enable:

  1. Pre-bill claim review
  2. Identification of documentation and coding risk before submission
  3. Visibility into payer-specific patterns
  4. Closed-loop feedback from denials to CDI and coding teams
     
This shifts the organization from denial management to denial prevention.
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Controlling cost to collect

Cost discipline remains just as important as revenue growth. Fragmented workflows create duplication of effort, such as:
  • Manual chart reviews
  • Rework between departments
  • Redundant quality checks
  • Siloed reporting systems
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An integrated AI-enabled platform can reduce administrative friction by:
  • Sharing intelligence across CDI, quality, coding, audit and revenue integrity
  • Automating low-risk validations
  • Routing high-risk cases to the right expert
  • Providing unified reporting for leadership
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For finance leaders, this can mean:

  • Lower cost to collect
  • More efficient use of clinical expertise
  • Reduced reliance on contract labor
  • Better forecasting through consistent performance data
 
Operational efficiency directly supports operating margin.

Explore real results from autonomous coding

The framework
 

A CFO’s framework for revenue cycle transformation

Revenue cycle transformation does not require a full system replacement. It requires strategic alignment around three priorities:

Preventing leakage early

Focus upstream on documentation and coding accuracy before claims leave the organization.

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Embedding intelligence into workflows

Support teams with AI that enhances productivity and highlights financial risk and opportunity in real time.

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Aligning clinical and financial performance

Ensure quality metrics, compliance standards and reimbursement accuracy move in the same direction.

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An integrated human-in-the-loop AI platform supports this framework by connecting:
  • CDI and quality
  • Coding automation and review
  • Audit and compliance oversight
  • Pre-bill revenue integrity
  • Denials prevention


The result is not just improved revenue integrity. It is stronger, more predictable financial performance across the entire revenue cycle.

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Protect margin with a smarter revenue cycle strategy

See how Solventum helps healthcare organizations stop revenue leakage, control costs and improve financial performance.