The Revenue Cycle Challenges For The US Healthcare System

The Revenue Cycle Challenges For The US Healthcare System

The COVID 19 virus has put pressure on health care systems worldwide. It is no different in the United States as well. A rough estimate tells us that the United States’ healthcare system has to handle nearly 7.64 M infection cases per 1 million people daily. It is amid the pandemic that hospitals have to maintain rugged revenue cycles for the changing industry dynamics. As an industry leader, your focus should solely be on boosting up cash flows and reducing the cost to collect. This recent pandemic outburst has introduced challenges to revenue cycle managementFollowing are the changes introduced towards the hospital revenue management:

The telehealth concept lacks patient medical history

Recently plenty of hospitals have introduced the concept of telehealth because the virus has taken a toll on the hospital beds availability. The process is about delivering health services and health information over some distance via the telephone. There is scope to transfer voice, data, and even images. One of the drawbacks here is the health care provider is not interacting in person, and he/she has no idea on which patient requires more care. Therefore, this is a format, which has failed to maximize the revenue cycles. The patients requiring the highest acuity are the most billable, and hence you need this knowledge.

A constant operational billing department:  

You are perhaps looking to optimize the revenue cycle management, and we would like to say that it is essential to have a constant operating billing department. During a pandemic, one may have to attend to patients even during the odd hours. At the end of the treatment, the patient will be paying remuneration. At such times if the billing department is not operational, one may lose out on instant revenues. One can do well to check out on guidance on offer from the authorities on billing for the virus. 

The patient’s financial responsibility

The COVID 19 pandemic has thrown up a long-standing issue impacting the revenue cycle management in the healthcare system, and that is surprise billing. It is while on treatment, that uncertain health issues crop up and at the end of it, the patient has to pay a higher bill than anticipated. This additional amount will have to be collected, in due course, and it is about having full proof, cost-effective collection strategies in place. There have been instances of various healthcare providers having cost-sharing arrangements for the collection exercise.

Some indirect issues impacting the revenue cycle

Along with discussing the issues which directly impact the revenue cycle management, addressing the indirect down cash flows is also important. 

  • The first thing we would like to focus upon is a staff shortage, and it has been seen recently during this pandemic. One must note that healthcare workers are at the forefront of fighting this deadly virus. As a result, plenty of them have been impacted, and today we have a scenario where the medical industry is battling staff shortage. It is just simple that if you do not have enough manpower to treat patients, the revenue generation cycle is sure to take a hit. 
  • The system is also facing a shortage of beds to treat the patients. There has been a focus on telehealth as an alternative measure, but we have discussed earlier that it has a drawback.

Here is a list of some prominent issues, which today, are a major challenge to boost up the revenue cycle management of the US medical industry. Not only the United States, but even the global medical industry is also facing these challenges in the quest to boost up the revenue cycle. As a leader, you must be prepared to meet this challenge.

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