Managing Cost and Reviving Revenue With COVID-19

As healthcare organizations recover from the challenges of the COVID-19 pandemic, leaders are devising creative ways to bring back key revenue while preparing for additional waves. At the same time, significant financial challenges related to COVID-19 response are requiring organizations to curb costs. In our July 23 webinar, experts discussed how leaders can effectively balance these demands as they guide their organizations into this new normal. To access the full webinar, visit: modernhealthcare.com/ManagingCostWebinar.

1 Health systems are trying to stabilize costs and bring back revenue as COVID-19 continues to present a significant challenge.

Between March and June, the COVID-19 pandemic is estimated to have cost health systems $202.6 billion, or an average of $50.7 billion per month, according to the American Hospital Association. This stems from costly treatments, lost revenue, and operational costs, including PPE and employee support. Health systems across the country are taking various approaches to safely resuming services that are key sources of revenue, and providers are doing their best to limit costs while still needing to prepare for additional surges.

2 COVID-19 has created a new, growing patient population that is “between insurance.”

Beyond the typical uninsured population, economic conditions created by the pandemic have resulted in an additional category of individuals who are “between insurance.” This group is accustomed to being insured and has a high propensity to pay, but the pandemic has left them unemployed and ineligible for subsidized coverage. Providers looking to effectively manage revenue cycle within this population should create a prepaid self-pay policy, identify top service lines for prepayment based on out-of-pocket payment volume and train staff to identify prepay patients and collect early.

3 Healthcare is now regional, instead of local—a trend that will be accelerated by COVID-19.

Scale is critical to address the downward pressures of reimbursement and regulation, and enables the shift to value-based care. Providers need scale to be able to afford IT investment, ensure physician network effectiveness and withstand unexpected shocks like COVID-19. Scale also ensures providers have enough attributed lives to take on performance-based risk. Scale—and integrated care delivery—ensures that health systems have flexible capital beyond bonds that allows them to take on major, competitive projects like building out a physician network or a consumer-friendly platform.

4 Documentation has been vital to ensuring that COVID-19 is properly tracked.

Proper documentation has long been a challenge for providers, and the stakes are raised with a pandemic. As physicians are faced with unfamiliar ICD-10 codes, documentation templates are a great tool to ensure providers accurately capture the appropriate diagnosis and any secondary diagnoses, to enable accurate billing, but also to support public health officials in tracking virus patterns. Leaders should consider how they can use AI-enabled tools such as virtual assistants and ambient documentation to reduce the burden on clinicians during this challenging time.

5 As the pandemic continues, it will challenge providers to think creatively.

As providers look ahead, they must create flexibility that allows them to regain revenue when conditions allow, while being able to quickly shift operations when crises occur. Consider moving some elective procedures to outpatient and secure that revenue through self-pay prepayment. Empower clinicians to better document care so that you can uncover new opportunities and quickly respond to trends. Finally, don’t let the pandemic distract you from M&A—the overarching issues driving consolidation existed prepandemic and will continue to exist once it is over.