Health systems facing financial pressure, shifting utilization, and workforce burnout can strengthen resilience by strategically applying automation to high-impact workflows like Annual Wellness Visits, lung cancer screening, and care gap closures.
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Health systems face an unprecedented financial crisis. Median organizations with $1-$2 billion in net operating revenue could see margins drop to negative 22% between now and 2028, according to Advisory Board projections based on proposed legislative changes.
The challenge extends beyond finances. Patient utilization patterns are shifting dramatically, too: routine surgeries that generate profits are expected to decline 16%, while complex care demands among Medicare patients 65 and older will surge 44%. Meanwhile, nearly half of physicians report burnout, and nursing workload remains the top concern for healthcare leaders.
Healthcare automation offers health systems a way to stabilize margins and improve outcomes in the face of shrinking reimbursements, shifting patient demographics, and staff burnout.
Healthcare executives can no longer rely on traditional operating models to maintain financial stability. A convergence of factors is driving an urgent need for operational innovation.
Leading health systems are responding by implementing automation in three critical areas that deliver measurable results without requiring massive technology investments or lengthy deployment timelines.
Medicare reimburses Annual Wellness Visits (AWVs), including telehealth delivery. Traditional AWVs require 40 to 60 minutes of physician time as standalone appointments, a significant challenge given current staffing constraints. Meanwhile, only 62% of eligible patients complete AWVs.
Successful automation strategies that leverage automation focus on three key areas:
• Pre-visit preparation: Automated systems send patients self-assessments before appointments and score responses automatically, reducing in-visit administrative time.
• Visit integration: AWVs can be bundled into follow-up appointments for other services or delivered through brief telehealth check-ins rather than separate 40- to 60-minute visits.
• Coding optimization: Automated systems identify and code additional billable services discovered during AWVs, including depression screening, advanced care planning, and social determinants of health assessments.
These changes increase AWV completion rates while generating additional revenue from add-on services—all without increasing clinician workload. This approach becomes increasingly valuable as more systems transition to value-based care models focused on preventing costly downstream interventions.
Lung cancer screening represents both a clinical imperative and a significant financial opportunity. The Centers for Medicare & Medicaid Services now includes lung cancer screening as a MIPS Improvement Activity for 2025. Yet many systems struggle with manual workflows that slow patient outreach and scheduling.
Effective lung cancer screening automation addresses three operational challenges:
• Patient identification and pre-screen counseling: Automated systems review EHR data to identify eligible patients based on age, smoking history, and other risk factors. For those patients deemed eligible for lung cancer screening, initial counseling and shared decision-making about the screening (HCPCS code G0296) can also be automated.
• Order management: Systems can automatically place screening orders and enable patient self-scheduling, reducing the administrative burden on clinical staff.
• Documentation: Results and quality data are written back to the patient record automatically, ensuring compliance reporting and continuity of care.
This clinical automation example demonstrates how screening workflows can boost compliance and generate measurable ROI.
Based on unpublished data gathered from an average-sized health system that implements comprehensive lung cancer screening automation, organizations could expect to see significant financial benefits:
• $1.4 millioni in additional fee-for-service revenue annually from improved screening rates (Current national screening rate averages remain low—less than 10%).
• $2.4-$5.6 million in potential patient healthcare savings from detecting lung cancer at earlier stages (~50% at Stage I or II), leading to significantly reduced treatment costs.
These projected returns reflect both immediate revenue increases and long-term cost avoidance through early detection.
Preventive care gaps for screenings, vaccinations, and chronic disease management directly impact quality scores, value-based incentives, and patient outcomes. However, manual outreach and documentation processes have overwhelmed already stretched clinical teams.
A large non-profit health system addressed this challenge by automating outreach, scheduling, and coding for priority quality measures. Beginning with breast and colorectal cancer screening and diabetes care management, their system now:
• Automates patient identification: The system identifies patients due for screenings and generates appropriate orders automatically.
• Enables self-service scheduling: Patients receive automated reminders and can schedule appointments through self-service portals.
• Streamlines documentation: Coded data for exemptions and completed services can be written back to the EHR automatically.
The results include higher compliance rates, reduced administrative burden on staff, and measurable financial impact without compromising care quality.
Healthcare executives considering automation investments should focus on workflows that offer immediate operational relief while building long-term financial stability.
The most successful automation implementations target processes that:
• Generate immediate revenue through improved service delivery.
• Reduce administrative burden on clinical staff.
• Support quality reporting and value-based care initiatives.
• Require minimal technology infrastructure changes.
Successful automation projects require engagement from clinical leaders, IT teams, and front-line staff. Healthcare executives should emphasize how automation enhances rather than replaces human expertise, creating capacity for higher-value patient interactions.
Healthcare automation succeeds when it addresses real operational pain points rather than pursuing technology for its own sake. By focusing on Annual Wellness Visits, cancer screening programs, and care gap closure, health systems can adapt to changing utilization patterns while protecting both financial margins and clinical quality.
The current financial environment demands strategic action. Health systems that implement targeted automation solutions now will be better positioned to navigate ongoing reimbursement pressures while maintaining their mission of providing quality patient care.
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* The Lung Cancer Screening financial data presented here is based on Health Catalyst PowerCostingTM analytics projections at one client site. These figures represent modeled estimates prior to implementation; actual post-implementation results have not yet been collected at the time of publishing.
