Healthcare executives have a lot on their plate. With the new year right around the corner, we thought it would be good to take a look at 3 areas of healthcare leaders should give their utmost attention to in the new year:
- Reimbursement
- Patient satisfaction, and
- Efficiency
Reimbursement
With revenue strain a concern for many providers, reimbursement should be a key area of focus. Of particular note, the Centers for Medicare and Medicaid Services (CMS) just released their final 2023 Medicare reimbursement rules. Hospital leaders should familiarize themselves with the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) rules for 2023. Additionally, the Protecting Access to Medicare Act (PAMA) still looms in the distance, although the penalty phase has been delayed again, this time indefinitely. Healthcare providers should take advantage of the extended testing phase to get familiar with the PAMA reporting requirements, particularly using a qualified Clinical Decision Support Mechanism (qCDSM).
A 2021 Harmony Healthcare survey highlights the need for adherence to insurance reimbursement requirements. The survey found that around 30% of hospitals are in the “danger zone” of insurance denial rates, which is 10%. Survey respondents listed the following as top concerns in regards to insurance denials:
- Coding – 32%
- Medical necessity acute IP – 30%
- Front end – 20%
- Clinical validation denials – 18%
Fixing these issues can have a great impact on your reimbursement rates. A referral order management solution in conjunction with a qCDSM is a great tool to address all these issues and more. Learn more about our flagship, award-winning referral order management solution iOrder and start capturing more reimbursement.
Patient Satisfaction
Another revenue driver is patient satisfaction. Satisfied patients are loyal patients and can also help drive in more patients through reviews and referrals. Conversely, dissatisfied patients can result in revenue leakage in the form of negative word of mouth and seeking care at competitors’ facilities. This is especially true as healthcare disruptors like Walmart and CVS offer more and more healthcare services to consumers.
Providence CIO B.J. Moore highlighted the importance of IT teams and tech in patient satisfaction and loyalty in a recent Becker’s Healthcare webinar. “We’re really the only ones that stitch together all aspects of the patient journey,” Moore said of the IT team.
“It’s really building that patient or caregiver vision first and then coming with technology to solve those problems…We’re far away from other consumer experiences. Most people are used to Expedia, Uber or Amazon where they get amazing consumer experiences.”
To ensure patient satisfaction and loyalty, a commitment to tech that provides a streamlined, consumer-focused experience is imperative. Consider solutions that provide features like:
- Online self-scheduling
- Automated appointment reminders
- Procedure preparation instructions/videos
- Navigation assistance
Efficiency
The final area of focus that deserves 100% is efficiency. Efficiency can be just as important as reimbursement and patient satisfaction, and it can also affect those two areas. Inefficient processes, such as those that lead to coding errors can result in delayed or denied reimbursement, while improve efficiency in this area can minimize denials and speed up reimbursement. Inefficiencies in scheduling, procedure preparation, billing and other patient-facing processes can lead to frustrated patients.
On the other hand, patients are sure to be satisfied when efficiency leads to a seamless care journey that saves them time and ensures they’re properly prepared for their treatment. As mentioned in the previous section, this is extremely important as healthcare providers face more competition from disruptors like Walmart, CVS, and Amazon. A focus on efficiency can help providers attain a level of patient experience akin to that provided by consumer-focused disruptors. For more tips on disrupting the disruptors, read our blog on the topic.
Focusing Together
With so much to focus on, healthcare executives may feel overwhelmed and stretched too thin. Resources – time, staff, and money – are limited. Deciding which areas on which to focus can seem an impossible task. Based on industry trends, patient surveys, and other key data, we believe reimbursement, patient satisfaction, and efficiency should be at the top of every provider’s initiatives for 2023 and beyond. Focusing on other initiatives is important as well, but these three should receive nothing less than 100%.
At iPro, we’ve been helping healthcare providers fulfill their initiatives for nearly 25 years. Our flagship referral order management solution, iOrder, can help in all three initiatives we’ve discussed:
- Reimbursement – iOrder generates an electronic order that eliminates faxes and minimizes lost orders. Orders generated through iOrder are completely validated and transparent to ensure accuracy and traceability. iOrder also offers integrated clinical decision support and prior authorization assurance to minimize claim denials and care delays and maximize reimbursement.
- Patient Satisfaction – In addition to ensuring order accuracy and minimizing care delays, iOrder’s integration with Twilio helps achieve patient satisfaction through automated appointment reminders, links to procedure-specific instruction videos, and facility navigation assistance. This all helps ensure patients are properly prepared for their procedure.
- Efficiency – iOrder helps improve efficiency by streamlining workflows and reducing workloads. Order validation and transparency, prior authorization assurance, and clinical decision support all aid in these initiatives. iOrder’s patient engagement tools also increase efficiency by automating routine tasks, helping free up staff to focus on other tasks.
If you’d like to learn more about how iOrder can help in your initiatives, register for a free live demo today.
