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Baylor Scott & White Health’s use of AI in the revenue cycle is expected to result in an annualized $42 million net revenue improvement.
The large Texas health system of 52 hospitals was able to accomplish this through a partnership with Accuity, a physician-led technology company. BSWH started with a two-month pilot of Accuity’s tech-enabled physician-led review in February 2025 at two of its flagship hospitals and realized strong ROI, according to Sarah Knodel, senior vice president of Revenue Cycle.
After the pilot proved successful, in May BSWH deployed Accuity’s Amplifi AI technology at 26 of its acute care locations.
Six months later in November, BSWH had captured an incremental $20.6 million in revenue, according to Knodel. Annualized, that number is projected to be $45 million, she said.
The Case Mix Index impact on cases with opportunity has shown an average 3.5% improvement, leading to greater reimbursement.
“BSWH views AI solutions as having great potential to enhance its revenue cycle efforts,” Knodel said. “AI has added efficiencies that allow resources to be freed up to focus more on quality capture and other key initiatives.”
WHY THIS MATTERS
Accuity partners with hospitals and health systems on clinical documentation improvement (CDI) and coding review.
“Mid revenue cycle is where you find greater opportunities,” said Candice Daszewski, chief client officer for Accuity.
AI focuses on CDI and coding, pointing out inconsistencies in the patient chart that can prompt a query to the physician. This occurs in improved clinical documentation in an estimated 8% to 9% of cases.
Amplifi analyzes complete patient chart data, Daszewski said, as compared to the Diagnosis Related Group, or DRG, a classification system for medical conditions.
Leveraging AI in algorithms is creating a more efficient process, , Daszewski said.
“It gives our partners an AI solution without having to own it, without concerns of accuracy,” she said.
Knodel said her team felt like it had a strong Clinical Documentation Improvement program but wanted confirmation of that and also to go further to determine what dollars they could be leaving on the table and in what other areas they could enhance their effectiveness for net revenue capture.
“It’s really been exciting, they have validated we have a strong program since our opportunity rate is almost half their client average,” she said. “But even with a strong program, AI and the additional physician resources allows us to identify additional dollars that we may not have captured otherwise”
THE LARGER TREND
BSWH’s view on AI and automation in the revenue cycle began over 10 years ago with Robotic Process Automation bots. That evolved to layer in machine learning, natural language processing and now agentic AI for more advanced capabilities.
“Our goal,” Knodel said, “is to use AI to optimize net revenue, reduce cost to collect, and enhance the patient financial experience.”
In June, the conversation around AI and revenue cycle was part of an HFMA panel presentation between Daszewski and clinical and revenue cycle leaders from Prisma Health, Mass General Brigham and MultiCare Health.
One key takeaway, said Daszewski, is the influence AI-driven automation is having on the revenue cycle.
Email the writer: SMorse@himss.org