The rural healthcare landscape: a snapshot

While the entire U.S. healthcare landscape has been deeply altered by the COVID-19 pandemic, rural health systems have been disproportionately devastated by its effects. In fact, hospitals in rural communities have been suffering from financial vulnerability before the pandemic even began, with 116 rural hospitals closing between 2010 and 2019. Today, these pre-existing trends have been exacerbated.

Whereas large, urban health systems often have the scale and efficiencies to weather cost impacts, rural hospitals remain increasingly susceptible to hospital closures, provider shortages, and operating margins below pre-pandemic levels. Despite efforts to stabilize financial and operational health through federal relief, smaller rural providers are stuck in a cycle of declining access to care on every level. This is especially problematic considering rural Americans, on average:

  • Are older and lower-income than urban Americans
  • Suffer from higher rates of severe health conditions than urban Americans
  • Are more likely to be uninsured or covered by Medicare or Medicaid (which pay healthcare providers less than private insurance) than urban Americans

The high costs associated with treating a shrinking and underinsured population put significant financial pressure on rural hospitals. More often than not, the burden of uncompensated care leaves hospitals in the red.

Relieving the burden of uncompensated care

As the healthcare market evolves through the latest phases of the pandemic, it is necessary for hospital decision-makers to address concerns about uncompensated care to overcome the escalation of healthcare costs and hospital spending. Uncompensated care, a key indicator of economic vitality, plagues rural and urban hospitals alike: according to a recent AHA report, U.S. hospitals have provided more than $745 billion in uncompensated care to patients over the past two decades.

While navigating this complex reimbursement landscape requires coordinated and systematic action, there are steps rural hospitals can take today to ensure access to quality health care and strengthen financial health. With a successful revenue strategy and the right tools, rural health systems can simplify the reimbursement process at every stage of the patient journey, while boosting revenue, recuperating uncompensated care, and promoting overall provider resiliency.

Implementing a proactive revenue recovery strategy with maxRTE Insurance Discovery

Most conventional insurance discovery solutions don’t look beyond self-pay receivables. However, it is crucial to implement software that can identify insurance coverage opportunities at all four stages of the patient journey:

Before a patient receives care

    • Verifying a patient’s insurance status, coverage, and benefits with a single click before they receive care using maxRTE’s Insurance Eligibility Verification software helps avoid denials and payment delays. It can also empower patients to understand exactly what insurance will cover for their visit and what their financial responsibility will be.

At the point of care

    • When a patient receives treatment, maxRTE’s Insurance Discovery software can check for any unknown billable commercial and government coverage that may have been missed during registration, combatting out-of-control costs of uncompensated care.

Aftercare

    • When a patient receives treatment, maxRTE’s Insurance Discovery software can check for any unknown billable commercial and government coverage that may have been missed during registration, combatting out-of-control costs of uncompensated care.

Final check before writing off to bad debt

    • Hospitals should be constantly scrubbing their self-pay accounts to make sure they aren’t leaving money on the table. maxRTE Insurance Discovery helps hospitals locate previously unknown coverage in real-time, but also via batches daily and weekly.

Bottom line

Overall, an end-to-end approach can proactively and sustainably optimize the revenue cycle for hospitals and health systems that need to rescue their bottom line, while plugging revenue leaks, improving cash flow, and reducing bad debt. In addition, hospital staff can manage their cash flows and operating income while better understanding what drives their margins.

Supporting rural healthcare is not just important for rural communities, but also for all of our communities. Learn more about how maxRTE’s Insurance Discovery software stands above the rest and request a free test file today.