At the center of the COVID-19 storm, most healthcare providers generally did an exemplary job transitioning operations from on-premises to work-from-home. But that may have been the easy part.
Now, nearly half a year into the global pandemic, we’re starting to see the good, the bad, and the—well—room-for-improvement when it comes to healthcare providers’ remote work.
First, the good. According to a general survey of several industries conducted by Airtasker, the 1.4 more days remote workers work per month in comparison with on-premise office workers adds up to more than three additional work weeks per year. Good news in particular for healthcare providers challenged by huge backlogs!
But those new-found weeks come at a cost: the bad.
That same survey also found that compared with office workers, work-from-home employees also experienced greater levels of stress and anxiety, were more likely to procrastinate tasks, and less likely to strike a harmonious work-life balance. With work-from-home now meaning balancing kids, family, pets, meals, deliveries, etc. is it any wonder productivity is falling in many sectors?
Do the Math
This reality has been especially challenging for healthcare providers lately. Why? Simple math:
The normal level of non-pandemic-related claims + the large uptick in COVID-19 claims x remote employees’ stress, procrastination, and work-life-balance issues = lower claims throughput and ultimately, lower revenue.
We’ve already seen the results with several clients who have seen productivity standards fall short. For example, let’s say one employee normally handles an average 50 claims a day with a manageable Case Mix Index (CMI) in an office setting. Now, working from home, that person only handles 35 claims a day. Worse, his or her CMI just deteriorated because more intense case volumes are up too, thanks to COVID-19. In essence, it’s a productivity double-whammy and now a major management challenge.
Based on our experience with numerous healthcare providers facing these issues—you guessed it—this is where room-for-improvement comes in, especially in three main areas:
Sometimes you have got to slow down to speed up. Continuing to use processes originally designed for on-premise work will only lead to productivity declines in work-from-home scenarios which makes no sense. It is actually a net savings of time to invest in analyzing and correcting processes and procedures in your receivables that will be more efficient over the long run.
A full receivables assessment can help determine not only where the biggest claims processing bottlenecks are, but also where you can maximize new revenue potential. In particular, in-depth reviews can reveal patterns that may not be obvious in the day-to-day blur of meeting deadlines, but can easily emerge when all the data has been collected, analyzed and interpreted.
For example, if there are specific billings codes causing the most time delays or perhaps one insurer’s specific requirements require extra steps, a root-cause analysis can help determine ways to either simplify or automate the process so time and effort are saved.
Deploy Scalable Solutions
If your assessment has determined that you simply don’t have enough people to handle the workload—on premise, work-from-home, or a blended combination of the two—it may be time to consider outsourcing/co-sourcing options.
These scenarios can span everything from front-, mid- and back-office work needed to eliminate specific backlogs that keep getting put off—or worse—keep piling up.
We have seen several clients who have chosen the outsourcing route and have cautionary advice to offer. It’s imperative to choose vendors with specific remote healthcare expertise and experience to ensure that all work is done in secure online environments—for example, using VPN and other solutions—and that it is 100% HIPAA compliant. The last thing you want are denied claims from a failure to meet minimal requirements. Or worse, a data breach and the exorbitant fines that come with them.
Once you have diagnosed the main blockers, and fixed the immediate problems, the next step is prevention. Like people in general, many organizations tend to skip this step. They have already moved on to the next item on that day’s “to do” list.
Health records are an especially good—and potentially lucrative—place to start. For example, a major healthcare system which recently invested over $1B for an electronic health record software implementation, conducted a separate data analysis to identify inefficiencies and transaction risks in their claims submissions and collections processes. This thorough but low-cost analysis ultimately helped them reduce their cost-to-collect by a significant 20%, making cash collection easier and more cost-efficient.
Another example: one of the country’s largest post-acute care systems used IT improvements in claims denials management, revenue cycle processes, and more effective vendor management to improve the bottom line by some $30M over a period of a few years. That was cash they previously left on the table. Now it is helping cover rising expenses.
Again, it often pays to slow down so you can speed up.
Given today’s patchwork reality of some states flattening the curve and other states’ healthcare systems being flattened by the virus, whether the future means more “work-from-home” or “return-to-work” is anyone’s guess.
But that question is almost irrelevant.
As perhaps the most critical frontline sector in today’s pandemic, healthcare providers need to keep their operations running efficiently no matter what the work environment. Their services are literally impacting life and death, so the room for operational failure must be as close to zero as humanly possible.
Finally, in the last five months, we have seen the good and the bad of adjusting to the new work-from-home world. With productivity dropping in many cases, however, we have now arrived at the room-for-improvement stage.
Agility is the key to getting through this successfully, but not the first step. That step is admitting the need to act in the first place before revenue losses spiral out of control. For those helping keep healthcare providers afloat financially, an ounce of prevention is indeed worth a pound of cure.
Have questions about improving healthcare provider productivity? RGP experts are ready to help. Get in touch now to learn more.