Hospital operating margins were hovering in the 2% range before the global pandemic wreaked havoc on providers and payers in March 2020. Even with two “normal” months in 2020, operating margins plummeted 55.6% compared to 2019. Even with CARES funding, margins remained down nearly 17%.
At the same time, demand for healthcare professionals continues to grow, depending on medical specialty and geography. The shortage is especially acute in rural areas. Reasons include an aging and sicker
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8 Key Areas Representing $13.3B in Cost Saving Opportunities for Healthcare Administration
According to the 2020 CAQH Index report, an annual report published by the Council for Affordable Quality Healthcare, a study of eight key transactional areas revealed opportunities for cost savings totaling $13.3 billion for medical providers and plans willing to move to fully electronic administrative processes. The CAQH report examined eight key transactions: Eligibility and Benefit Verification, Prior Authorization, Claim Submission, Attachments, Coordination of Benefits, Claim Status
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The Future of Revenue Integrity: From Reactive to Predictive – RCM
Healthcare organizations have witnessed an explosion of new opportunities to extract value from the industry’s treasure trove of data in recent years, with success stories related to using advanced technology such as artificial intelligence (AI) and machine learning found in every sector.
Revenue integrity is no exception.
Error-prone manual processes that were formerly characterized by painstaking line-by-line analyses of claims are giving way to automation and analytics that
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Cancer Centers: Here’s How We Can Restart Clinical Trials Today
Biopharmaceutical companies developing cancer treatments need to restart the clinical trials shut down or delayed during the early stages of the coronavirus pandemic. Some are holding back, however, due to a lack of confidence that sufficient eligible patients can be recruited and enrolled in the trials. Recruiting patients into a clinical trial was challenging before COVID-19 hit, and it has only become exponentially more difficult. Sponsors also know many patients have been putting off
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Effectively Handling Clinical Denials Amid a Pandemic Backlog of Elective Surgeries
Throughout the pandemic, many hospitals had to delay elective procedures for several months or cancel them altogether. Surgical volumes decreased over 35% in 2020 from March to July. This has led to a projected backlog of elective procedures and surgeries. For example, in orthopedic surgeries such as joint replacement and back fusion, it was estimated the pandemic would generate a backlog of over one million surgical cases. If you multiply that across all the surgical
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HCPs: Breaking Through The Noise with Digital Engagement
In 2020, the pandemic forced a dramatic switch to a 100 percent remote commercial model for the pharmaceutical industry virtually overnight. While many digital technologies had already been evaluated or implemented by pharmaceutical companies, this event accelerated a digital-first approach with many enterprises deploying and scaling new technologies in days; events that would previously have taken months or years.
Today, even individuals that were digital novices a year ago can navigate the
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How Mobile Channels Improve Patient Engagement and Outcomes
The past year’s pandemic struck a painful blow to health organizations’ pre-COVID patient engagement efforts. A recent report detailed fewer patient visits amidst coronavirus fears and stay-at-home orders. People are simply not going into clinics to address non-COVID medical needs. The result is more serious health issues developing, such as cancers being found at later stages and chronic conditions advancing beyond easy treatment options.
As patient engagement strategies ramp up, mobile
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Why the Digital Front Door is Critical to the Healthcare Revenue Cycle
The COVID-19 crisis has upended many of our traditional business procedures and processes. However, because digital transformations were well underway before the pandemic, the shift to remote work and contactless consumer self-service was swift. In healthcare, digital strategies that were expected to take 10 years to accomplish may now be compressed into three. That acceleration is especially evident with the “digital front door” – a strategy for engaging patients at every major touchpoint of
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Digital Transformation: 4 Moves Finance Leaders Can Make to Emerge Stronger
In this time of crisis, the U.S. healthcare system has struggled to safeguard lives and suppress the COVID-19 virus, while buckling under financial strains, low consumer confidence, and the burden of persistent clinician burnout. And yet, the industry is experiencing an unprecedented digital transformation. Between regulatory changes and billions of dollars of investment into new disruptors, the stage is set for transformative change.
In the midst of uncertainty stemming from the pandemic,
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4 Ways Health Systems Need To Reinvent Themselves to Compete
For about a decade, digital health has been slowly winning the battle against healthcare’s slow pace of change. Digital found an unexpected ally in Covid, as the pandemic forced health systems to adopt virtual solutions wholesale.
As we start to come out on the other side, though, some health systems are contemplating returning to the status quo, especially as they’re feeling acute financial strain.
The majority, however, understand that the pandemic constitutes a sea change in the
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