While still in the midst of a pandemic, the healthcare industry is settling into a “new normal.” The pandemic has not only shined a light on existing issues within the healthcare industry but created new challenges as well. Healthcare organizations are struggling to decide what to prioritize between these new and existing issues while staying on top of the ever-changing pandemic situation and its effects on the healthcare industry.
Now more than ever, leaders in the healthcare industry need to stay ahead of upcoming challenges and prepare for how to improve healthcare processes for this year. Below is a brief breakdown of five challenges facing the healthcare industry that should be considered a priority for 2022.
Integration of Virtual and In-Person Appointments
Throughout these last two years, telehealth appointments became ubiquitous to keep everyone safe. While the pandemic waxed and waned, the desire from the public to continue virtual appointments remained steady with 88% of Americans preferring virtual appointments. Healthcare organizations scrambled to effectively incorporate virtual appointments and many still scramble to this day.
Now that most healthcare organizations implemented virtual appointments and continue to use them, it's time to look into more effectively integrating virtual and in-person appointments. One major challenge facing healthcare leaders in 2022 is deciding which appointments can be virtual and which appointments should remain in-person. This may depend on the type of appointment, the healthcare practitioner, or health care protocols.
At the same time, healthcare industry leaders need to balance revenue integrity while delivering the best patient care in both virtual and in-person settings. This includes finding the right platforms and business automation tools to help healthcare practitioners and patients alike.
Cyber Security
With the challenge of integrating virtual and in-person appointments comes the threat of cyber security. While many healthcare organizations put safeguards into place as virtual appointments became the norm, cybersecurity requires constant vigilance and quick responses.
If a breach occurs, private patient information could be leaked, which could lead to a healthcare organization facing penalties, particularly if they violated the industry’s compliance standards. Knowing what's at stake, healthcare leaders need to ensure a team is prepared to handle any cyber security breaches while implementing the proper safeguards to ensure client confidentiality.
As healthcare organizations continue to integrate technology and business automation, it's also imperative to ensure that any third-party vendor an organization partners with is compliant with HIPPA. Third-party vendors such as Exela Technologies offer products that are compliant with the healthcare industry standards.
Increasing & Adapting to Automation
The healthcare industry has been slow to adopt automation processes. While organizations focused on technology that advanced the consumer experience, healthcare automation to help clinicians and workers fell behind.
This leads to a huge loss in the healthcare industry as automation frees up time for healthcare practitioners to focus on patient care while reducing errors in processing. An example of this is the payment processing systems that many healthcare organizations utilize.
Many organizations developed in-house solutions to manage their payment processing. However, these solutions often demand more resources and tend to be slower than purpose-built solutions from third-party specialists. Solutions like Exela’s Medical Lockbox alleviates these issues, simplifying the payment process while freeing up time for healthcare workers to focus on their core competencies. Consolidating all incoming receivables, Medical Lockbox speeds up the payment process ensuring healthcare providers receive accurate payments.
Mental Health of Healthcare Practitioners
Practitioner burnout has been a concern in the industry for years and, given the effects of COVID, should be at the forefront of the healthcare industry for 2022. According to a 2020 survey, 49% of nearly 21,000 physicians and other healthcare workers reported experiencing burnout. Burnout not only affects the mental well-being of the healthcare worker but also their ability to deliver quality patient care and quality work.
Due to healthcare worker burnout, organizations experience reduced employee hours, physician turnover, and the time and expense of hiring replacement healthcare workers. It is estimated that the healthcare industry loses 4.6 billion a year due to physician burnout. With the increasing percentage of healthcare workers experiencing burnout, it’s more important than ever that healthcare organizations find ways to help support the mental health of their workers.
Claims Processing
A known cause of revenue leakage is the tedious, costly, and cumbersome task of claims processing. With many claims being denied due to minor errors and the cost of manual processing, it’s time healthcare organizations look into ways to automate their claims processing operation. On top of that, insurance companies have shown a 77% payment accuracy rate, requiring healthcare organizations to look into and recoup any lost income.
Solutions like Exela’s PCH Global aid healthcare organizations in automating claims processing, decreasing first-time claim denials, and identifying inaccurate payments. Exela’s edit engines contain more than 119 million recommendations based on general care guidelines for commercial Medicare and Medicaid processing. With these engines, PCH Global corrects any errors in the claim, thus submitting clean claims that are more likely to be accepted within the first submission.
With PCH global, Healthcare organizations can automate and streamline their claims processing, which leads to better revenue integrity and allows healthcare workers to focus on their core competencies.
For more information on claims processing and preventing revenue leakage, take a look at Exela’s PluggedIn newsletter on Revenue Integrity.
