This past year has been a tough one for US healthcare systems. In the wake of the COVID-19 pandemic, over half of the health providers in the US operated at a loss in 20221,with big name health systems like University Hospitals losing $184.6 million over the first 8 months2 and Ascension Health closing their fiscal year with a $1.8 billion loss3.
There are many contributing causes to those losses but most healthcare leaders will point to lost revenue from delayed or avoided care, increased labor costs, clinician burnout, and the Great Resignation.
Heading in to 2023, it appears many of the same issues and trends impacting 2022 are not going away and may get worse. And with the looming economic uncertainty of 2023, most organizations are going to be forced to stretch their investment dollars as far as possible. Here are the top 5 areas healthcare organizations should focus on to successfully navigate the challenges of 2023.
As stated previously, the economic uncertainty heading into to 2023 is forcing most providers to prioritize lower cost and higher return-on-investment initiatives. Generally speaking, fostering loyal patient relationships has a higher ROI than acquisition focused efforts4.
A 2019 survey commissioned by Cedar, showed that 41% of patients say they’d consider switching to a provider that offered a better digital experience and 20% of respondents said they have left a provider due to a poor digital experience5. If this same survey were conducted in 2022 it likely would’ve made an even stronger case for improving the patient’s digital experience with the acceleration of asynchronous communication and remote interaction that accompanied the pandemic.
So what is a low cost option with high ROI to retain patients?
Optimize the patient engagement tools you are already paying for within your EHR and other technology platforms while ensuring a safe and secure experience.
I know we just made the argument for prioritizing patient retention over new patient acquisition. But that doesn’t mean we can ignore patient acquisition entirely.
Generation Z is made up of people ages 9 to 24 in the US and among them, 33% do not have a primary care physician6. That is over 20 million patients that will hopefully have a lifetime of healthcare needs ahead of them. Providers should focus on attracting this generation and making it easy for them to be a new patient.
It is important to make sure you have a suite of workflows for patients that are not yet in your system – scheduling, estimates, and payment. Additionally, your organization’s website is the true first impression for any patient looking for a new provider. Prioritizing search engine optimization along with simplified site navigation will help ensure your potential patients can find everything they want.
In 2021, almost 63% of physicians reported experiencing burnout. Additionally, satisfaction with work-life integration fell to just above 30%7.
For nurses, of the over 400,000 that left their jobs last year, nearly 1 in 3 cited burnout as the reason for their departure8.
Apart from wanting to promote healthy lifestyles for your employees, another incentive to reducing clinician burnout is the cost. Physician burnout can cost your organization anywhere from $500,000 to $1,000,000 per doctor when factoring in recruitment, sign-on bonuses, lost revenue, and onboarding costs9.
One way to reduce burnout is to reduce or eliminate redundant tasks, like providing the same patient update, discharge instructions, or answers to the same questions from different patient family members.
However, keeping family members updated, informed, and engaged in patient care promotes measurable improvements in patient outcomes and satisfaction, increases in safety and quality, and reductions in cost10.
Therefore, Incisive recommends utilizing platforms to provide all of this patient information one time, while making it available to all patient family members. Additionally, Incisive recommends reviewing operational workflows to identify quickstep actions and auto-population text to mitigate the amount of time it takes for operational employees and clinicians to respond to patients.
You’re probably sensing a theme now that our recommendations for 2023 are focused on reducing costs and getting more value out of what you already have. Increasing the amount of patient care delivered outside of the traditional four walls of the hospital is no different.
In a study conducted by Dr. David Levine, a physician and researcher in Internal Medicine and Primary Care at Brigham and Women’s Hospital, it was shown that total costs of care were 38% lower for patients who received care at home. Dr. Levine said this about the study11:
“This work cements the idea that, for the right patients, we can deliver hospital-level care outside of the four walls of the traditional hospital, and provides more of the data we need to make home hospital care the standard of care in our country.”
For those worried that the CMS waiver that allowed many organizations to expand their hospital-at-home offerings will expire upon termination of the public health emergency (PHE), we have an encouraging update. Congress included a two-year extension of the Acute Hospital Care at Home (AHCAH) waiver in the Consolidated Appropriations Act of 2023 that recently passed in December 202212.
Additionally, 63% of clinicians believe that most consultations with patients will be remote in the next ten years, and 49% of clinicians state the majority of healthcare will be provided in a patient’s home within that same time period13. Clinicians will be looking for organizations that have, at a minimum, a roadmap to expand these services with an emphasis on user experience (provider and patient).
Incisive recommends laying the foundation for Hospital at Home programs through the expansion of telehealth use cases, remote patient entered data, and remote patient monitoring (automated device integration).
Just over two years ago, in 2020, CMS issued a proposed rule to improve the electronic exchange of healthcare data and streamline processes related to prior authorization requests. More recently, in December 2022, that rule was withdrawn by CMS and replaced with the CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P)14.
This proposed rule came after a 2019 report produced by the Council for Affordable Quality Healthcare (CAQH) found that the amount of time required to complete a prior authorization request manually was 21 minutes, compared to 8 minutes through a web portal and only 4 minutes through an electronic exchange15. The same report stated that “prior authorization is the most costly, time consuming administrative transaction for providers.”
With the newly proposed CMS rule not scheduled to go into effect until January 1, 2026, many states are not waiting on CMS and are passing legislation that will accomplish the same goals. For example, in Michigan, Senate Bill 247 will reduce administrative burden by requiring insurers to make available, by June 1, 2023, a standardized electronic prior authorization process16. At least 10 other states have some form of universal or standardized electronic method for submitting medication prior authorizations16.
Incisive recommends that providers begin the work of optimizing their prior authorization workflows to reduce administrative costs and prepare for the increased access to electronic prior authorizations through current and future federal and state regulations. If you’re not sure where to start, Incisive recommends conducting a current state assessment to identify the specific gaps in your processes where either existing or imminent technology can be used to automate the process.
[1] Becker's Hospital Review | [2] News 5 Cleveland | [3] Becker's Hospital Review | [4] Forbes | [5] HubSpot - Healthcare Consumer Survey | [6] Patient Bond | [7] AMA | [8] Becker's Hospital Review | [9] AMA | [10] Agency for Healthcare Research and Quality | [11/*] Harvard Gazette | [12] Moving Health Home | [13/**] Elsevier | [14] CAQH Index | [15] Michigan State Medical Society | [16] Cover My Meds
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