Healthcare technology company athenahealth, introduced new automation and AI-based software innovations that streamlines and lowers the burden of revenue cycle management (RCM) for thousands of physician practices. 

The company aims to eliminate at least half of the work currently handled by athenahealth practices over the next three years, while increasing the speed, accuracy and quality of RCM processing. 

According to the company, 160,000 clinicians will have immediate access to the AI and automation tools via the cloud-based platform. 

athenahealth's AI-enabled insurance package selection capability, built directly into athenaOne, automatically reads insurance card images and recommends the correct insurance package for later claims filing. 

The company touts that in the last year, the feature has delivered a 36% cut in insurance-related claim holds for practices using the capability while saving practice staff more than 6,500 hours of administrative time.

Additionally, athenahealth's Auto Claim Create feature helps practices create claims automatically after a patient is seen. 

According to the company, the feature has resulted in a 40% reduction in charge entry lag and a 24% decrease in time to submit a claim to an insurance company. The company started testing this feature across 15 practices in 2023. 

Currently, Auto Claim Create is automating 10% of all claims athenahealth processes on behalf of its customers.

"Revenue cycle management has long been a pain point for physician practices," ​​Paul Brient, chief product officer at athenahealth, told MobiHealthNews.

"athenahealth's innovations are designed to dramatically reduce the administrative complexity that burdens practices and improve revenue cycle outcomes – which means that practices on the athenahealth network receive the right amount of reimbursement as quickly as possible with far less work. With these tools, we’re helping practices remain independent and allowing physicians to focus on what matters the most – ensuring their patients receive the best possible care.”

THE LARGER TREND

In 2023, maternity-care management platform Dorsata filed a lawsuit in Suffolk County, Massachusetts Civil Court against athenahealth and nationwide women's health company Unified Women's Healthcare. The lawsuit included 11 counts against the providers, including theft of trade secrets, unjust enrichment, breach of contract and tortious interference with current customers. 

That same year, athenahealth laid off 178 employees, less than 3% of its workforce. One-hundred employees were "redeployed to higher priority areas" of the business. 

According to an email obtained by The Boston Globe, athenahealth CEO Bob Segert pointed to industry trends, hiring that outpaced the company's revenue growth and economic conditions, such as higher interest rates, inflation and "changing tax regulations," to explain the layoffs and reorganization. Segert said the company would do away with its home internet and mobile-device reimbursement programs, as well as its transportation subsidy, and pare down its office footprint.

In 2022, athenahealth introduced new capabilities focused on making healthcare more inclusive for transgender and nonbinary patients. On its athenaOne platform, an EHR, medical billing and patient care tool, doctors can input data about a patient's name, pronouns and gender identity, in addition to their legal name and assigned sex or gender at birth.

In 2021, athenahealth announced it would be jointly acquired by affiliates of Bain Capital and Hellman & Friedman for $17 billion.