Healthcare Loss Mitigation Strategies

The pandemic has disrupted revenue cycles for providers and hospital systems across the country. Recouping those losses will take time, concerted effort, new operating strategies — and close collaboration with payers.

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While the pandemic has been a major cause of revenue loss in the last 20 months, it’s also revealed several long-standing causes of revenue leakage. But providers and hospitals can mitigate all these revenue losses with a few proactive measures.

Healthcare revenue loss

According to a recent report from Kaufman Hall, 75% of hospital and health system administrators surveyed said their organizations experienced “adverse revenue cycle impacts” as a result of the pandemic. Reasons cited include decreases in inpatient and elective procedures, provider burnout, staff shortages, new employee training costs, and expenses related to social distancing, sanitation, and the purchase of personal protective equipment (PPE).

On the patient side of things, job losses due to layoffs, illness, and fear of COVID-19 exposure have left many with financial hardship and unable to pay for healthcare without employer sponsored health insurance. Significant increases in Medicare, Medicaid, uninsured, and self-pay patients, contribute to revenue losses across the healthcare system.

Mitigating provider revenue loss

Stopping the drain on revenue means getting patients back in the office, whether virtually or in person. Reach out and engage with your patients — especially those you haven’t seen in a while and those with chronic illnesses who may have neglected their health in recent months. Inspire trust by assuring them of the safety precautions you have in place, such as limiting people in waiting rooms, stepping up sanitation procedures, and encouraging staff to wear “vaccinated” stickers. To further protect skeptical patients, provide telehealth options for virtual consultations.

Another significant source of revenue loss is provider burnout. It leads to more sick days, ill-timed vacation leave, and high turnover rates. Burnout also causes frustration and inattentiveness, which increase the risk of mistakes in healthcare delivery — which in turn increases the risk of poor healthcare outcomes or even lawsuits. Check in with staff, and take measures to reduce burnout before it results in serious problems.

Mitigating hospital revenue loss

Hospitals can also take measures to mitigate pandemic-related revenue loss. Start by gathering patient and payer information — prior to treatment if possible — to ensure healthcare services are covered. Improve clinical documentation to increase efficiency and reduce billing mistakes and the chances of payer denial. Use real-time monitoring to track initial denials, so they can be addressed quickly, and your billing staff can identify common or recurring reasons and take a proactive approach to prevention in future.

Healthcare systems can leverage digital technologies to improve efficiency and healthcare outcomes across the board. By incorporating artificial intelligence (AI), machine learning (ML), and computer assisted coding to increase billing speed and reduce errors. Manage electronic health records (EHR) to optimize communication with payers. Payment is a faster process when payers can easily access the patient data necessary for processing claims.

For help with coding and billing, consider outsourcing to an experienced third-party partner, contact TruBridge.

Written by Alexis Roberson
TruBridge Sr. Director, Revenue Cycle Solutions