Tag: healthcare RCM

Recapturing Revenue During the COVID-19 Pandemic: A Critical Healthcare Imperative  

Victoria Wickline

By Victoria Wickline, SVP of partnership success, Get Well.

More than 2.5 years after COVID-19 was first identified as a global health crisis, the healthcare industry continues to grapple with the challenges the pandemic has laid bare, including harsh realities surrounding unequal distribution of care and health inequities.

Further exacerbating these devastating care gaps is the fact that the pandemic caused many people to put off aspects of their healthcare, with 41% of U.S. adults reporting that they have delayed or avoided medical care — either because of job loss, health insurance coverage losses, closed facilities, or just simply wanting to avoid being exposed to the virus.

As patients avoided hospitals and doctors’ offices, conditions like cancer, heart disease, and other chronic illnesses went undiagnosed or untreated during the pandemic. In the first four months of 2020, breast cancer screenings were down by 89% and colorectal cancer screenings were down by 85%. As a result, The National Cancer Institute anticipates a surge in cancer death and predicts that the number of people who will die from breast or colorectal cancer in the United States will increase by nearly 10,000 over the next decade because of COVID-19’s impact on care.

Healthcare System’s Loss in Financial Revenue:

Besides the obvious detriment to public health, especially for vulnerable and underserved populations, these care gaps have drastically cost health systems financially. Revenue lost in 2021 was projected between $53 billion to $122 billion due to the lingering effects of COVID-19.

Fast forward to 2022, U.S. hospitals and health systems continue to struggle with regaining their financial health and many are facing another year of negative operating margins, with most organizations seeing declining margins, revenue, and inpatient volumes following the surge of the Omicron variant. Just this past month, the healthcare industry was reported to have the most job cuts compared to any industry in 2022 with a 54%  increase in layoffs compared to numbers reported in June 2021.

Re-Engaging Patients Through Personalized, Digital Experiences:

Today, the healthcare industry is trying to pick up the pieces and health systems are looking to re-engage patients in their care —  and improve the overall health of their patient populations as a result. To do so, health systems must redefine what the patient experience looks like. This re-engagement should center on providing a personalized, digital experience. Innovative AI-driven technology layered with an empathetic human element that adds a personal touch can lead to engaged patients and improved outcomes.

  1. Leveraging AI-driven Technology for Patient Retention:

Healthcare organizations must reach out to patients where they are, with the information they need. This means not waiting for the patient to proactively engage and request care; information and scheduling resources should be at their fingertips. While everyone may not have access to the internet, the vast majority of the population – 97% – own a cellphone with access to text messages. In healthcare’s effort to digitize, we must also keep in mind not to marginalize underserved populations with lower socioeconomic statuses. However, with a read rate of approximately 99%, text messaging provides a solution to engage populations across all socioeconomic statuses with personalized messages to re-engage people who have been avoiding or delaying medical care, while fostering healthcare plan loyalty and closing care gaps.

But for this type of outreach to work, it must go beyond simple text messaging. Automated text messages sent to patients who need to schedule appointments is only a small slice of effective re-engagement. Successful personalized digital outreach should be based on a comprehensive 360-degree patient profile, ensuring that patient needs and offered resources are tailored to their particular health journey. This comprehensive patient profile should include patient-specific engagement data, such as the last time they visited their primary care physician, and personal preferences, including language choices. It should also incorporate location data, like what relevant providers are practicing in the patient’s preferred location.

The key is that behind the actual text messages is a real human providing personalized healthcare guidance. The combination of targeted outreach and human touch points will provide that personalized, digital experience that healthcare systems have been struggling to prosper. A tailored message that sounds authentic and empathetic can make a significant difference with re-engaging patients and driving them to take action with their care.

  1. Don’t forget the Human Element:

The support of someone who can intervene, scale care, and escalate to care teams if needed means that the patient can more quickly get back on track with their care, and the healthcare organization can scale outreach and non-clinical tasks without additional internal resources.

“How do I access my medical records?” “I’m unsure how to schedule an appointment through my primary care provider?” “Where can I access this healthcare information?” These are all questions patients ask when navigating the healthcare system that need the human touch to ensure patients’ needs and resources are tailored to their particular health journey.

A high-tech digital strategy paired with high-touch human intervention combines the best of both worlds: innovative AI-driven technology and a caring touch that leads to engaged patients and improved outcomes. As an organizational retention strategy, this kind of holistic virtual care navigation can be a win for both health systems and the patients they serve.

  1. A Digital-First Strategy That Yields Tangible Results:

Take Adventist Health for example, a nonprofit integrated health system that designed a digital-first patient outreach service that initially targeted adults who had not had a routine wellness appointment in the past 18-24 months. This outreach leveraged community-based virtual navigators  and consisted of multiple SMS messages to engage patients and offer assistance with scheduling appointments with a primary care provider. Within four months, this digital-first strategy reached over 160,000 inactive patients and produced the following results:

The Bottom Line

A digital-first consumer experience enables organizations to retain patients in networks, provides an enhanced experience, and improves patient health — all invaluable benefits, for both patients and providers alike. Every patient who receives outreach to re-engage them with their care is one more patient who is more aware and active in their own health journey. Revenue recapture is a positive side effect of ensuring that the healthcare industry is succeeding with what it’s meant to do — keeping populations healthier for the benefit of society.