The American healthcare system has long been burdened by interoperability issues preventing easy access to and sharing of important patient health data. Amid the ongoing COVID-19 pandemic, those issues have created additional challenges for physicians, administrators, and other industry partners. If these problems persist, they could impact provider business models negatively.
Increased consolidation among physician groups during the pandemic has resulted in a corresponding increase in coding operations for many practices. Given the gap between the demand for coders and the trained talent available to meet that demand, organizations have increasingly shifted toward outsourcing to fill critical technical roles. The process of outsourcing these skills, combined with a surge in the number of labor hours needed to meet organizational objectives, could increase the time to code or decrease the quality of output, ultimately creating revenue cycle issues.
If not careful, staffing issues can cause fluctuations in data quality. With less personnel available to ensure the correct information is entered into the correct fields, some organizations have found it difficult to fully harness the power of healthcare solutions to streamline revenue management and operations. Moreover, understaffed facilities may struggle to make the changes to technologies and internal processes that would equip them to take advantage of government programs providing reimbursements for COVID patient care. New CPT codes for COVID have also required insurance companies to update their processes during the pandemic, adding complexities for providers in how quickly they can exchange medical information.
From a clinical perspective, the pandemic’s far-reaching impact on the healthcare system has manifested in the form of lost productivity, resource deprivation, HIPAA breaches, and other, often severe, consequences. However, the strain it has put on payers and revenue cycle management systems has been somewhat less visible from the public eye. In the concerted effort to support clinicians and mitigate the pandemic’s effects on frontline workers, the focus for getting the right data into the right hands to ensure services could be paid for in a timely manner was temporarily deprioritized. Unless these interoperability challenges are addressed as an industry, the cost of healthcare will continue to rise, as will the clunky experiences for both providers and patients.
The global healthcare analytics market is set to balloon to a value of $129.7 billion by 2028. It doesn’t take much digging to figure out why. Data analytics tools used in healthcare are invaluable assets for providers looking for ways to improve the patient experience, as well as their own bottom lines. These tools allow them to perform a wide variety of tasks — including risk assessment, debt reduction, and revenue optimization — in more streamlined, efficient, and accurate ways.
However, this growth has also come with a spike in analytics challenges. Many providers are overwhelmed by trying to understand and utilize all of the information that analytics tools deliver. Without a clear way to analyze the wealth of data collected, healthcare analytics can often seem like a job that providers don’t have the knowledge or bandwidth to take on. With the right revenue cycle management solution, healthcare practices can collect, digest, and react to data for the betterment of business.
Best Data Practices for Utilizing Healthcare Analytics
If you’re a provider who wants to make the most of the data you’re collecting and the analytics tools you’re using, here are four strategies that can help you better understand and translate information into consumable, actionable insights:
1. Configure data based on your priorities.
Part of the value of data analytics tools in healthcare is that they can be used to pinpoint information that’s important to your organization. To accomplish this, however, you need to figure out what key performance indicators are most valuable to you in advance and focus on measuring those specific numbers. Otherwise, you’ll end up spending too much time sifting through data in search of a needle in a haystack.
Let’s say that your main priority is reducing bad debt. You would need to make sure that you (or your outside partners) were using analytics tools to build reports around this data specifically. The relevant data should be front and center in your dashboard and easily exported so it can be shared with stakeholders.
We’re living in a world where consumers demand more from every transaction. Exceptional service is no longer a nice-to-have — it has become the status quo. Whether it’s a traveler paying for an Uber through an app or a patient receiving emergency department service, people want and have come to expect great service.
The healthcare industry is working to quickly adapt and meet these expectations as they come, often leading to a disheartening or unpleasant experience for patients. Why? There are complex infrastructure challenges in healthcare.
For example, consider the patient billing process: It may have stumbling blocks that can lead to friction, such as surprise at the final price when the medical bill arrives, limited bill payment options, insurance denials, or reduced coverages. These problems tend to come after patients receive clinical care, adding more stress on top of an already stressful situation. Essentially, people receive the care and treatment they deserve but could feel blindsided later because of a lack of price transparency.
That said, providers may not be in a position to have patient-focused financial conversations at every point of the journey from pre-registration through post-discharge. Often, providers are just as in the dark about what a procedure may ultimately cost patients out of pocket because data often is siloed within different systems. And even when those systems try to communicate, they don’t necessarily speak the same “language.”
Is the task of reinventing American healthcare billing a major undertaking? Sure. But improving the patient experience is still doable. It just requires every entity involved — from third-party payers to insurance companies to physicians’ offices — to treat patients while considering their perspectives and needs.
How to Overcome Barriers in Healthcare
Tackling this challenge now is key for a few reasons. First, providers will be able to more clearly empower patients to make the best decisions for themselves and their families. When healthcare providers operate with patient needs in mind, consumers feel less confused, more curious, and better equipped to make crucial health decisions.
Providers that offer simple billing and upfront costs analyses may also reduce patient noncompliance and nonpayment. When patients understand their financial obligations before receiving services, they can make better choices and plan ahead. The result? Healthcare providers will be able to stay in business and thrive.
With the advantages of taking a more patient-centered approach in mind, healthcare providers can take steps to make that approach a reality.