The following is a guest article by Eric Demers, CEO at Madaket Health
The recent CWH Advisors’ 2022 Patient Pay study unearthed some troubling trends in the administration of RCM. The dearth of healthcare professionals impacting the entire healthcare industry is only adding fuel to the fire. 63% of respondents indicated that they were experiencing RCM staffing shortages, contributing to slower revenue cycles and affecting both patients and payers.
With a steady decrease in overall healthcare workers, the staffing shortages in revenue cycle departments are dire. A recent survey by Elsevier Health predicts that up to 75% of healthcare workers will leave the profession by 2025. More hospitals have tightened their belts in the wake of reimbursement pauses necessitated by COVID-19. Couple this with the burnout many professionals in the medical industry are facing, and it’s not just harder for those organizations to hire staff but to do so at the appropriate level to meet the needs of their business requirements.
Easing the Administrative Burden
Thanks to the tremendous amount of administrative requirements, burdens, and compliance tasks to fulfill, staffing shortages significantly strain an already stretched workforce. With less manpower, it’s harder to manage the numerous administrative tasks providers grapple with. Hospitals are stuck wondering: Can we offset some of that manpower decline with better technology that can fulfill or replace tasks that don’t require a high touch?
It certainly appears that way. Providers are looking to third-party vendors to automate portions of their administrative burden to offset staffing shortages and stabilize revenue. Per Patient Pay, 61% of providers expect to make greater use of these options in the coming years, with the aim of ultimately helping deliver better, more streamlined care for patients.
Many of these providers find themselves wondering what areas have the greatest potential for automation and external support, how quickly solutions can be deployed, how quickly they can expect to see returns, and are third-party data security protocols up to snuff.
Aided by Automation
With the healthcare industry still largely rooted in an old-school, siloed approach to data management, administrative backlogs are a regular occurrence even in the best of times. This makes it more challenging for physicians to provide the adequate care needed to run a successful business.
What providers need to deal with staffing shortages and other administrative burdens is a comprehensive data management platform (DMP). DMP’s centralize tasks like credentialing, licensing, and verification into a single integrated hub, streamlining the frequent data updates required and automating crucial administrative projects. Not only are these solutions able to be set up relatively fast, but the return on investment is often almost immediate.
Third-party vendors can help monitor to ensure providers are compliant and up to date both at the payer level and among their broader provider groups, keeping data in sync between the needed parties. Given the struggle to complete administrative tasks today, payers need a better way to understand where the providers are practicing, what services they are providing, and whether they’re in-network.
Protecting Patients
Alleviating the administrative burden has tangible ramifications for patients as well. Because third-party solutions help providers complete administrative work upfront, it’s easier to be transparent in regard to costs, helping providers stay compliant with consumer protections like the No Surprises Act. Provider data has a major impact on cost-of-care: From practicing location to insurance enrollment and more, the cost of services can wildly swing based on an incorrect or outdated piece of information. Third-party vendors help to ensure providers are not accidentally mischarging their patients or payers, protecting them from any No Surprises violations.
Automating these tasks frees up essential time for providers to care for patients. There are staffing shortages in nearly every hospital department, which are driving up the cost of patient care while lowering the quality. Providers need to be on the floor addressing medical issues, not in an office manually entering data. Less time spent on manual tasks is a win for everyone.
Without an efficient way to sync data, payers and providers are operating with a hand tied behind their backs. And these inefficiencies end up costing patients and taxpayers the most. But there is a way to avoid triggering this cycle: Having third-party automation solutions in place to guarantee that the provider’s administrative work is done upfront.
