Healthcare in Crisis: Resource Constraints Add Mounting Pressure
Morethan130ruralhospitalshaveclosedoverthepastdecade;arecordbreaking20shuttingdownin2020.AccordingtoareportfromtheCenterfor HealthcareQualityandPaymentReform,anestimated500+ruralhospitals areatimmediateriskofclosureduetofinanciallosses.Theseclosuresare occurringbecauseruralhospitalslosemoneydeliveringservicestopatients. Historically,manyreceivedgrants,localtaxrevenues,orsubsidiesfromother businessesthatoffsetlosses.Still,thereisnoguaranteethatthesefundswill continuetobeavailableorsufficienttocoverthehighercostshospitalsare experiencing.Short-termfinancialfixeswon’tfixthislong-termproblem. Ruralhospitalsrequireadequatepaymentsandabetterpaymentsystemif theyaretocontinuetoprovideessentialhealthservicestotheircommunities. Untilsuchmeasuresareinplace,healthcareexecutivesarescramblingto containrevenue,optimizereimbursements,andpreventleakagesotheycan keeptheirdoorsopen.
The Root of the Problem
Smallruralhospitalsdon’tmakelargeprofitsonpatientswithprivate insurance–moneythatcouldhelptooffsetlossesonuninsuredpatientsand patientswithMedicaid.It’scommonforsmallruralhospitalstobepaidless forservicesbyprivateinsuranceplansthanbyMedicareorMedicaid.Losing moneyyearafteryear,thesehospitalscan’tmaintaintheadequatecapacityto respondtoemergencies.Sadly,closuresrestrictaccesstotimelycarefor millionsacrosstheU.S.,andtherippleeffectoftheseclosuresneedtobe understoodandaddressed.Thesehospitalsservemanyemployedbyour nation’sfarmandranchworkers,andsolarenergyfacilities,andtheyarethe closestsourceofcareformanynationalparksandrecreationsites.The financialstrengthofhealthcareorganizationsisessentialforadequatecare delivery.
Andit’snotjustsmall-townhospitalsthatarefeelingfinancialpressures.The issueiswidespread–hospitalsofallsizesarestruggling.What’shappening withruralhospitalsisanearlywarningsignofamuchlargerproblem–the financialstabilityofhospitalsacrosstheU.S.
Oneareahealthcareexecutivesseekingtocontainrevenueandcombat growingfinancialchallengesshouldconsideristherevenuecycle.It’sonearea thatcanyieldsignificantimprovementandsavings.Therightchangesto revenuecycleoperationscanhelphealthcareorganizationsrunlean.
The Need for Lean Healthcare
HealthcarewassparedmajordisruptionduringtheGreatRecession(20072009),buttheindustrywon’tbesoluckythistime–asevidencedbyclosings, layoffs,andservicereductions.Whilesomeeconomistsbelievehealthcareis recessionproof,therearewarningsignsthatmanyhealthcareexecutivesare monitoringsotheycanmitigaterisks.
Escalatingoperatingexpensesduetoinflation,drugcosts,andlaborexpenses hashealthcareexecutivesquestioninghowtheycanoperateleaner.Lean
healthcareembracescontinuousimprovementandminimizeswasteinevery process,procedure,andtask.Forrevenuecyclemanagement,thereare opportunitiestoautomateworkflowsandprocesses–eliminatinghuman intervention,whichhelpstominimizerisks,andreassigningthosestaffso theycanfocusonmorecomplexcasesormission-criticalworkthatwillhelp maximizereimbursementsandcontainrevenue.Theneedtoautomatetasks issupportedbyvacantpositions,andreportsindicateresignationsand retirementsamonghealthcareworkerswillcontinue.Additionally,as regulatoryrequirementsandtheneedfordocumentationincreaseandcoding becomesmorecomplexwiththerolloutandimplementationofICD-11,the decisiontousetechnologybecomessimple.Technologyadvancements, includingartificialintelligence,machinelearning,computer-assistedcoding, andCDI,haveprofoundlychangedrevenuecyclemanagement.Smart technologyensureschartsarecoded,documentationisthorough,and reimbursementsaretimelyandmaximized–helpinghospitalsnotonly containrevenuebutautomatetaskssostaffcanbebetterutilized.
Automation Allows for Focus
Inrecentmonths,therehasbeenaninfluxofnewsabouthospitalscutting servicestoaddressstaffingchallenges.Thegreatresignationhashit
healthcarehard–losinganestimated20%ofitsworkforce,including30%of nurses.In2022alone,nearly1.7millionhealthcareworkersresigned.Those whoremainareexperiencingburnout,which,ifnotaddressed,willresultin manyleavingtheprofessionaltogether.Infact,anewsurveyshowsupto47% ofU.S.healthcareworkersplantoleavetheirpositionsby2025.Theimpact thesevacancieswillhaveonthehealthcaresystemasawholeandcare delivery,inparticular,isunfathomable.
Conclusion
Howmanymorehospitalswillcloseorreduceservicesbecausetheycan’t meetminimalrevenueneeds?Timewilltell.Whatwedoknowisthatforthe healthcareindustrytoprovidethehighestqualitycaretopatientsacrossthe U.S.,itrequiresfinancialstability–foreveryhealthcareorganization.With healthcareconstantlychanging,technologyoffersasolutiontothestaffing problem.Applyingleanprinciplestotherevenuecycleisawisefirststep becauseoftheabilitytoimmediatelyautomateworkflowsandoptimizehow staffareused.
Ifyouneedhelpevaluatingyourrevenuecycle,contactAGStoday.
Source of content: AGSHealth Blog - Healthcare in Crisis: Resource Constraints Add Mounting Pressure
