Hospitals Look for Digital Lifeline to Rescue Sinking Margins
Christopher Fisher, CRCP-I, maxRTE Business Development Director
While hospitals struggle to keep up with COVID-19 challenges, they see digital transformation as a critical strategy and investment for surviving the repercussions of the pandemic and beyond. Costly COVID-19 treatment is dominating hospital, making it more essential than ever to correctly identify insurance coverage, especially for so-called self-pay patients to provide a financial safety net.
Never in my lifetime have hospitals struggled to keep up with the public’s need for treatment…until COVID-19. Stories about their struggles to keep their head above water are well documented in every type of media. However, their behind-the-scenes financial challenges are not nearly as public but no less devastating.
The pandemic that has created an unprecedented public health emergency quickly turned into an economic crisis for a variety of businesses. But suffering in the business of healthcare is borders on cataclysmic, with the mounting decline in revenue threatening the ability of treatment centers to operate.
Hospital operating margins were already on a downward trend as the first confirmed cases of COVID-19 were identified in the U.S. But by a couple of months later, margins dropped by 282 percent as providers across the care continuum experienced dramatic reductions in utilization, consulting firm Kaufman Hall recently reported.
Digital transformation for service delivery and financial improvement
Despite their dire financial situation, hospitals and clinics are not reducing spending on technology and automation, according to a recent Black Book survey. All healthcare CFOs in the Black Book survey said they expect their organizations to experience a significant revenue decline this fiscal year, yet, just 12 percent said they will need to reduce or defer spending on digital transformations for their financial systems.
The pandemic has driven, many, if not most, clinicians to embrace virtual healthcare in response to the decline in procedure volumes resulting from COVID-19. In addition to virtual treatment, these organizations are pushing for accelerating the digital transformation of their financial systems, according to 81 percent of survey respondents.
Automating insurance discovery for and COVID-19-related and other self-pay patients is the most obvious and least costly (link to maxDiscovery) way to support the revenue cycle. First, COVID-19 requires expensive treatment. While the government has pledged to reimburse providers for this type of care, the flood of requests will no doubt delay the reimbursement process. Secondly, these patients often enter the hospital unaccompanied by someone who can assist with the intake process. Running COVID-19 patients through an automated process will identify unknown coverage(s) with minimal information.
From here to recovery
“Our nation’s hospitals are in a perilous position,” stated Jim Blake, managing director at Kaufman Hall. “They are serving as the frontlines of our battle against this virus, but the pandemic is threatening their fundamental financial viability at a time when we need them most.”
As hope for steady recovery has been dashed by a resurgence of COVID-19 cases in many states, hospital executives are under pressure to try new ways to boost waning margins. Our lives depend on their success. If you’re interested in learning how technology can help you and your budget, we’re here to help. Schedule your free demo of our maxDiscovery software at www.maxRTE.com