A Window Into the State of Medical Coding in the US

High-quality, compliant medical coding is vital to ensuring the financial viability of healthcare organizations as they continue to operate within razor-thin margins. However, this is easier said than done. With an estimated 30% shortage of professional medical coders, healthcare organizations are experiencing increased levels of coder burnout, significant delays to payment cycles, and other significant operational and financial challenges.

To better understand the state of medical coding and the different ways that healthcare providers are solving current challenges, we recently surveyed over 240 medical coding personnel (coding managers, coders, etc.) from various health systems and hospitals at The American Academy of Professional Coders (AAPC)’s HEALTHCON 2023 conference. Here’s what we found:

Note: The survey findings summarized below are not intended to be used as research-backed statistics, but rather to provide helpful insights into the state of the industry and the biggest challenges that medical coding/revenue cycle staff face today.

Survey Findings:

How does your company handle medical coding today?

When asked how their company handles medical coding today, “in-house coding team / computer-assisted coding (CAC) solution” (75%) was by far the most common answer by survey respondents, followed by “outsourced vendor” (12%), “other” (10%), and “autonomous coding solution” (3%).

It is no surprise that most healthcare providers continue to rely on in-house medical coding teams and coding software such as CAC, as these have been the standard methods of handling medical coding in recent years. According to a report by Gartner, today, CAC is considered a mainstream technology, and its use is expected to increase. However, the report also noted that the transition from CAC to autonomous medical coding is likely.

Historically, providers have kept the majority of medical coding operations in-house. However, in recent years, the growing shortage of medical coders and its impact on day-to-day operations has led providers to seek out outsourced service providers and solutions for medical billing functions. This trend will continue as providers look for different ways to improve efficiency and reduce costs, and autonomous medical coding is poised to play a critical role in this transformation. In a recent article, Keith Olenik, Chief Information Officer at the American Health Information Management Association (AHIMA), commented that “we need to embrace [autonomous medical coding]. It will become the standard.” This is further supported by an increased focus on revenue cycle management software investment, which providers view as a top priority in 2023 and beyond.

What pain points or challenges do you face when it comes to medical coding?

When asked about the pain points or challenges they face when it comes to medical coding, “staffing shortages” (39%) and “employee burnout” (25%) were the two most common selections from survey respondents, followed by “compliance issues” (13%), “high-costs / thin operating margins” (12%) and “other” (12%).

The data from our survey is in line with what we’ve been hearing for months (if not years) - there is a significant shortage of medical coding staff, which is only getting bigger over time. Unfortunately, this issue goes hand in hand with the second largest challenge survey respondents noted, “employee burnout.” With fewer medical coders available, current medical coders are tasked with coding a higher volume of charts, typically with little adjustment to the expected turnaround time. This increased workload can easily result in added stress at work and potentially lead to burnout if not addressed appropriately. 

Survey respondents cited “compliance issues” among the top three largest challenges when it comes to medical coding. This isn’t surprising, as medical coders must adhere to a number of frequently-updated guidelines from countless organizations, making it difficult to remain compliant.

The challenges noted by survey respondents heavily influence one another, which is why there is a critical need for a solution that can address staffing, burnout, compliance, and high-costs all together. 

Leveraging Autonomous Coding to Solve Current Medical Coding Challenges

With autonomous coding solutions such as Nym’s medical coding engine, healthcare providers can fully automate coding for a significant percentage of their chart volume, taking the burden off of medical coding staff while maintaining high coding quality and accelerating payment cycles. 

In addition to the questions in the previous section, we also asked survey respondents about autonomous medical coding. Our goal was to identify what types of resources would be helpful for anyone interested in learning more about autonomous coding, how the technology works, and its many benefits for both healthcare providers and revenue cycle management departments. Survey respondents showed a clear desire for client success stories, case studies, and product whitepapers, all of which we’ve linked to below.