Medicaid funding cuts aren't just a challenge; they’re a wake-up call for healthcare providers across the nation. Reduced supplemental payments, rising uncompensated care, and increasing operational pressures leave revenue cycle management (RCM) teams struggling to balance the books. For many, maintaining financial stability while ensuring quality care feels like an impossible task.
Purpose-built to help providers face these challenges head-on, Adonis marries cutting-edge AI and intelligent automation to protect your revenue, streamline operations, and reduce reliance on shrinking supplemental funding. Whether you're a community cancer center or an FQHC, a rural hospital navigating razor-thin margins or a safety-net provider dealing with a surge in uncompensated care, Adonis has the tools to help you thrive in this challenging landscape.
Challenges of Medicaid Cuts
Cuts to Medicaid Funding and Supplemental Payments
Shrinking Medicaid reimbursements continue to erode revenue, creating a ripple effect of financial challenges. Providers are grappling to recover denied claims, detect underpayments, and offset the loss of supplemental payments, causing undue strain on already-stretched teams.
How Adonis Helps:
- Denial Prevention and Recovery: Adonis Intelligence alerts teams to any issue that would impact a provider’s revenue. For example, Adonis proactively detects trends like prior authorizations or eligibility issues, and recommends fixes before denials escalate. This ensures your revenue is safe before it’s even at risk.
- Underpayment Detection: By leveraging advanced AI, Adonis quickly identifies and recovers underpaid claims while highlighting patterns that manual reviews could miss.
- Supplemental Payment Loss Offset: With shrinking supplemental funds, Adonis uses automation-led denial appeals and payment accuracy workflows to help reclaim lost revenue across both Medicaid and commercial payers.
- Superhuman Accuracy: Adonis AI agents outperform manual teams in consistency, precision, and auditability. Our AI Agents are always-on, systemically learning and executing 24/7. This frees up your team to focus on the important stuff: strategy, compliance, and exceptions.
Coverage Loss and Increased Uncompensated Care
Medicaid cuts often result in coverage gaps, leading to an increase in uninsured or underinsured patients. For providers, this translates to higher write-offs, unpaid bills, and increased uncompensated care.
How Adonis Helps:
- Real-Time Alerts and Eligibility Checks: Adonis flags eligibility-related denials and downstream accounts receivable risks in real time, empowering teams to address them before they evolve into write-offs.
- Claim Status and Timely Filing Automation: Missed filing deadlines or administrative errors can result in lost revenue. Adonis ensures these errors are caught and corrected through AI automation, improving your yield from insured patients.
Disproportionate Impact on Rural and Safety-Net Hospitals
For rural and safety-net hospitals, thin margins make Medicaid cuts particularly devastating. Coupled with operational challenges, they often face a higher burden to do more with less.
How Adonis Helps:
- RCM Efficiency Without Headcount Growth: Adonis AI agents can replace significant manual RCM labor. For example, at AdventHealth, savings equivalent to 27.7 full-time employees (FTEs) were modeled through claim status automation alone.
- Lower Cost-to-Collect: Automation of tasks like appeals generation, documentation follow-up, and claim status calls significantly reduces the labor intensity of Medicaid-heavy RCM teams. This efficiency is crucial for maintaining margins in resource-constrained settings.
Downward Pressure on Payment Rates
Medicaid reimbursement rates are often the lowest. This downward pressure places providers in a constant struggle to optimize revenue capture without overburdening teams.
How Adonis Helps:
- Contract Variance Analysis and Payer Scorecards: Adonis identifies underpayments at scale, offering providers valuable benchmarking data to negotiate fairer terms or strategically escalate denials.
- SmartPolicy Real-Time Alerts: Part of Adonis' 2024 roadmap, SmartPolicy notifies providers of payer policy changes—including Medicaid updates—in real time, allowing team workflows to adapt proactively.
Unlocking Additional Strategic Levers
Adonis doesn’t stop at solving today’s problems; it builds a foundation for tomorrow’s success by uncovering meaningful operational insights.
- Executive Insights Dashboards: Adonis offers leadership a bird’s-eye view of critical metrics, including denial trends, cost-to-collect, and reimbursement erosion. With data at your fingertips, advocacy for operational adjustments becomes strategic and data-driven.
- End-to-End Orchestration: Adonis integrates seamlessly into existing practice management (PM) and electronic health record (EHR) systems, coordinating workflows from claim submission to final payment.
Reshape RCM With Adonis
Medicaid cuts demand new solutions, and Adonis delivers precisely that. Our combination of real-time insights, automation, and intelligent workflows is designed to help healthcare providers overcome revenue risks while building a more efficient, data-driven RCM foundation.
Whether you're tackling denied claims, offsetting supplemental payment losses, or improving operational efficiency, Adonis is here to empower your teams to achieve more with less.
Picture your RCM future with Adonis: super-human accuracy, 24/7 productivity, faster processes, fewer errors, and greater revenue capture. The Adonis difference means all of this without increasing labor costs.
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