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Healthcare leaders reveal 3 key factors in financial recovery

Healthcare leaders reveal 3 key factors in financial recovery

Healthcare providers of all sizes continue to grapple with the financial impacts of the COVID-19 pandemic and likely will for years to come. To learn more about the recovery process and the strategies that can accelerate it, Inovalon recently partnered with the Healthcare Financial Management Association (HFMA) to host a roundtable discussion among financial leaders from healthcare organizations around the country.

From unprecedented staffing challenges to changes in the revenue cycle process, we covered a lot of ground. We’re breaking down three of the biggest takeaways below.

1. Automation will be a key factor in financial recovery

The roundtable participants agreed that automation is a crucial step toward financial recovery. To maximize reimbursements, organizations will need to leverage technology that helps prevent the errors that slow down claims. Automation can help billers keep up with payers’ unique rules, which can change frequently.

“Our billing systems have to be able to be smarter to adopt all these different changes,” said Drew Benson, chief administrative officer of the Eye Institute of Utah in Salt Lake City.

On the patient side, automation can be deployed to explain costs and collect payment in advance, rather than following treatment.

“It’s a big shift in patient behavior because they’re used to getting a bill in their hand and an EOB to balance the two. If you work with them, and they know what’s coming, you can speed that process up,” said Ryan Bell, director of patient financial services at Riverside Healthcare in Kankakee, Illinois.

Automation can also help consolidate vendors, which reduces costs and complexity. Using a single piece of software means fewer applications are needed to manage the revenue cycle, which frees up IT budgets for other purposes. Plus, it alleviates the technical burden on billers.

2. Technology is needed to address persistent staffing challenges

Staffing was a major concern cited by the roundtable participants. Medical billing, especially specialized billing like Medicare, is already a niche skill. Hiring for it during a time of record low unemployment has proven to be a daunting task.

“We have reviewed our pay scale; however, hiring is still a challenge,” said Angela Shelton, chief revenue cycle officer of Hughston Clinic in Columbus, Georgia.

The right technology can help offload some of the manual tasks that can bog down billing staff while facilitating collaboration with those who are based offsite.

Speaking of offsite workers, the healthcare leaders we heard from said remote work has gone from being a practical necessity during the height of the pandemic to a retention strategy in its wake. “We have staff across seven states that work in our billing department,” said Zubair Ansari, senior director of physician reimbursement and Luminis Health Clinical Enterprise in Annapolis, Maryland. “Prior to COVID, there was a big push to bring them on-site, but in the end, we decided to keep them off-site. If you have staff that are not happy or not allowed to work certain hours, you’re going to have resignations.”

3. Organizations can differentiate by treating patients more like consumers

Traditionally, the healthcare customer experience has been one that’s unique to the field; in no other industry, for example, is it commonplace to find out how much a service will cost you after it’s already done.

But our roundtable participants pointed out that experience is changing. Patient demand alongside new legislation like the No Surprises Act is driving a shift toward greater transparency and a digital-first approach.

Organizations that want to set themselves apart must offer an experience that fits the patient.

“We need to understand what consumerism means to our patients,” said Bell. “Consumerism for a 70-year-old with Medicare is different than for a 22-year-old who does everything off their phone.”

As digital adoption increases and services like telehealth gain traction, patients have more choices. Maintaining a healthy financial position will require evolving to adapt to that landscape.

“It’s getting more consumer-friendly,” said Benson. “If we want the business to come to us, we have to figure out how we are part of that consumer friendliness.”

View the full transcript of our roundtable conversation, Optimizing the Revenue Cycle by Streamlining and Automating Payment Collections.


About the author

Karly Rowe, Senior Vice President, Product Management

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