Adopting health revenue cycle management best practices among public or private healthcare providers in Saudi Arabia: a pilot study

Abstract The new era of healthcare providers in Saudi Arabia where all covered beneficiaries will receive valued based medicine with cost effectiveness. Healthcare Transformation in Saudi Arabia: healthcare transformation is aiming to restructure the healthcare providers by Health Sector Transformation Program (HSTP) including revenue cycle management project; which is the core of our study. The literature lacks evidence of scoring systems for health revenue cycle management (HRCM) assessment in Saudi Arabia. We established a gap analysis scoring system to classify healthcare providers’ HRCM readiness. This pilot study aimed to assess the rate of adopting health revenue cycle management best practices among public or private healthcare providers in Saudi Arabia. This pilot study included ten healthcare providers in Saudi Arabia. The providers were assessed during the period from August 2022 to May 2023. The HRCM phases were: contract management, pre-service, time-of-service, and post-service. Contract management and preservice assessment revealed that all of the healthcare providers had missed some or most of their sub-major functions. For time-of-service, all healthcare providers required comprehensive gap analysis and the establishment of policies and procedures. Post-service was assessed in seven healthcare providers but was absent in three. All healthcare providers required training and the activation of reporting protocols and KPIs. Overall, the assessment revealed that one HCP had a low classification, seven had a moderate classification, and two had a high classification. All healthcare providers can be enhanced by training, comprehensive gap analysis, implementing policies and procedures with ongoing monitoring. Additionally, patient satisfaction research and the development of IT/technical solutions.