From changing payer mixes to significant revenue losses, a slew of business challenges caused by the COVID-19 pandemic have confronted hospitals across the U.S.
Despite these challenges, 2021 can be a bounce-back year for hospital finances if providers prioritize staff efficiency, stay on top of changes in the industry and use analytics and automation, Daniel Low, director of operations at Healthcare Financial Resources, said in a Feb. 22 webinar.
The webinar was sponsored by Healthcare Financial Resources and hosted by Becker's Hospital Review.
Here are four key takeaways from the webinar:
1. Optimizing staff efficiency is key to driving reimbursement. Employees in the revenue cycle space often have quite complex jobs with hundreds and even thousands of processes they must become masters of, Mr. Low explained. To ensure staff is performing at the highest level and to boost reimbursement, it's imperative to equip them with the necessary tools and training, he said. "The best way to squeeze out every dollar while still keeping up on the most pressing items is to ensure our staff have tools and skill sets needed to eliminate all possibilities [for] confusion," Mr. Low said. "Doing everything it takes to make a successful team member is worth every minute and every dollar."
2. Payer mix changes add reimbursement challenges. The higher rate of unemployment seen amid the pandemic is forcing more patients to turn to government-run insurance plans, Mr. Low said. Specifically, Medicaid enrollment volume increased more than 9 percent since 2019, he said. The payment rate on these plans is less than commercial plans, which will have an effect on overall reimbursement. It is important for providers to recognize this trend, but also know how to get every dollar out of their commercial and managed care claims, Mr. Low said.
3. Conduct contract management and zero balance review to improve collections. Performing a bad debt review and looking into potential lost revenue is a great way to improve future performance and collect some older cash, Mr. Low said. "Just because a balance is zero doesn't mean that there's not a way to collect on some of those accounts," Mr. Low said
4. There are opportunities to improve denial management and accounts receivable follow-up. There are a lot of industry solutions that can ease the burden on revenue cycle staff to work through the less collectable and older claims and allow them instead to target newer claims or higher dollar accounts, Mr. Low said.
To learn more about Healthcare Financial Resources and how the company is helping health systems collect more money, listen to the full webinar here.