Data analytics can help providers deal with existing and emerging challenges in the new year.
As we enter another new year, it is time to take a step back and look at the overarching trends that are driving decision-making across the industry.
The massive shortage of health care workers across the country, even globally, is shaping up to be the biggest challenge organizations are facing. All health care jobs, including those at entry level, are facing a competitive job market, but nursing is particularly worrisome.
Five years ago, wages and benefits made up the largest category of expenses for hospitals at around 56%. According to the May 2022 Kaufman Hall report, labor expenses have jumped 37% between 2019 and 2022. This represents an increase of between $4,009 and $5,494 per adjusted discharge, mostly driven by the need to hire contract nurses.
Hospitals will be allocating resources to attract and retain affordable clinical staff and looking for innovative ways to use technology to augment existing resources.
Telemedicine and RPM
Adoption of all types of telemedicine accelerated during the pandemic, so the technology is primed and ready. CMS is maintaining reimbursement for services, and organizations are embracing the population health value of remote patient monitoring (RPM).
Chronic diseases like heart failure and diabetes are the leading causes of death and disability in the United States. Successfully managing these and other chronic conditions through telemedicine and RPM has a multitude of benefits for patients and the bottom line, including:
- Reduced hospitalization
- Shorter hospital stays when patients can be safely discharged with RPM
- Fewer ED visits
- Better health outcomes and lower mortality rates
- Reduced risk of exposure to COVID-19, influenza, and other illnesses
- Better adherence to treatment plans and fewer issues due to travel and costs
Providers also are able to see and manage more specialty patients in areas with little access, such as mental health services.
Prioritizing Cost Savings
As revenue fails to keep up with inflation in a difficult economy, cost-saving strategies are permeating all parts of the health care ecosystem. Successful organizations must invest in their workforces to remain competitive. This includes reimagining their services and optimizing the patient experience.
Sadly, many hospitals are predicted to fold over the course of 2023. Forrester predicts that up to one-third of hospitals will file Chapter 11, with rural hospitals especially at risk due to low financial reserves.
To remain afloat, hospitals will need to analyze each avoidable expense and create new efficiencies. For example, the average cost of boarding a psych patient in the ED is $2,264 over the cost of the patient simply occupying an ED bed. A comprehensive behavioral health strategy that addresses provider shortage, community resources, and plans to handle peak volumes can help hospitals navigate these challenges.
One thing is certain, strategic planning for 2023 will be heavily data-driven as providers aim to maximize efficiency while maintaining patient outcomes.
Profitable Growth Still Possible
Despite a challenging reimbursement environment, all is not doom and gloom: Hospitals and independent physician practices can still find a profitable growth strategy. Embracing and maximizing pay-for-performance programs will be especially important in 2023.
MIPS reporters, who were given a free pass during the pandemic, should organize their documentation and data strategy now for reporting to harvest the 2023 9% reimbursement boost (and avoid a potential 9% penalty). To do so, providers will not only need claims data, but EHR data as well, to leverage the MIPS measures with the greatest potential for avoiding penalties and maximizing upside incentives.
Hospitals should also be sure they are adequately meeting the documentation requirements for higher E&M levels and encouraging a robust clinical documentation improvement (CDI) program. Proactively working to pinpoint and reduce denials is another important strategy to speed up needed cash flow.
d2i is sponsoring EDPMA’s virtual workshop Facing Reimbursement Headwinds: Planning for Profitable Growth in 2023 and Beyond. Moderated by d2i’s Executive Vice President, Business Development, Alan Eisman, the workshop will provide an opportunity to learn how emergency medicine group leaders plan for and move towards a business model less reliant on fee-for-service brick and mortar emergency medicine revenue. Register here for the February 2, 2023 virtual event.
Considering today’s challenges, data-driven insights are needed to form winning strategies and plans. For any challenging job, the right tools are necessary. Access to comprehensive, clean, and curated data sets along with data analytics is crucial when organizations are struggling to navigate strong headwinds. For a review of available solutions and demos of our products, contact us to help you prepare for 2023.