Electronic Health Reporter

By Teri Schmidt, vice president of business development, SYNERGEN Health LLC.

While some physicians are beginning to see patient visits return to pre-COVID-19 volume, many independent practices are still struggling. In fact, nearly nine in 10 practice owners or partners that responded to a recent survey indicated they were concerned about the future of their practices, and more than half of all respondents (54%) were “very concerned.”

Months of reduced activity, particularly at practices that suspended elective procedures in the spring, have taken a heavy toll on revenue. As a result, many practices are now compelled to take stopgap measures to contain costs.

High unemployment rates continue to create hardships that can strain patients’ finances. Even an indirect impact, such as a job loss sustained by another member in the household, can affect a patient’s willingness to seek needed treatment or impair their ability to pay for medical services.

To ensure patients can get access to the care they need, as well as their organization’s financial longevity, each health care provider needs to reassess their business strategy with an eye towards improvement in operations. The COVID-19 crisis has exposed many areas of inefficiencies that were already affecting revenues before the pandemic began.

Invest in operational efficiencies for better revenue management

Today, practices have less room for inefficiency and must take decisive steps to invest in technology that will drive increased efficiency at lower costs. Imperatives for a practice thrown into disarray by changes related to COVID-19 are to stabilize the practice by taking better control of the business process. This includes steps to strengthen contingency plans to minimize disruptions and reduce patient liability during the reimbursement lifecycle of the patient, while ensuring the safety of patients and staff during these challenging times.

Reducing patient liability is both a strategy and a desired outcome the practice should aim for as it fine-tunes its management of the revenue cycle, which extends from the patient’s initial appointment through successful payment collection.

The practice can reduce increases in aged receivables by greater attention to pre-visit efforts.  Performing eligibility checks and verification of benefits sets expectations and provides improved financial transparency for the patient which sets the stage for a smoother patience experience.

The impact of COVID-19 will continue to burden patient liability.  Take steps now to review collection practices, which may need adjustment to reflect today’s economic realities. Investigate solutions to provide patients financing options to help ease the burden of out of pocket expenses as a result of large deductible plans, rising prescription costs, or screening services. Provide upfront estimations for an improved level of transparency. Revise collection at the time of service procedures and re-assess dunning messages and transfers for further collection activity. Consider integrated payment solutions that provide easy access for the patient to make payments, receive statements, and set up budget plans.

Given that the greatest efficiency gains come from applying best practices in all these areas, it is usually better to adopt a coordinated revenue cycle management approach compared to a siloed approach – which can further destabilize a practice’s financial stability. In mapping out improvements, remember the overriding goal of minimizing patient liability at each step in the revenue cycle.

Hallmarks of an efficient, patient-centric revenue cycle management approach include:

• Provide fully integrated payment solutions that make it easier for patients to receive statements timely, pay their bill, and/or set-up payment plans
• Implement technological tools that provide automated insurance eligibility checks, coverage discovery, and verification of benefits that save staff time and reduce opportunities for rejections on the backend
• Incorporate patient estimation tools for improved financial transparency
• Investigate patient financing options to ease the burden of out of pocket expenses, ie. large deductible plans, rising prescription costs, or screening services
• Visibility into financial performance metrics, which leaders can use to monitor, set priorities and guide decisions

Economic pressures may weigh on patients and health care providers long after the pandemic has ended. Providing a patient-centric revenue cycle management process can improve operational efficiencies, reduce costs by automating manual tasks, increase financial transparency and improve patient experience while helping physicians manage cashflow during these challenging times.