Healthcare Industry Leaders Weigh In On How COVID-19 Changed Revenue Cycle Management

COVID-19 has irrevocably changed our lives. But, going beyond the unparalleled devastation it has caused to human lives, it has absolutely decimated the economy. Business and livelihoods of countless people was lost during the course of the pandemic and the worst is yet to come. While it is true that all the industries have had it bad, it cannot be denied that the pandemic has disrupted the Healthcare sector the most.

Healthcare has changed, from its access to its delivery, nothing is as used to be. Healthcare has transitioned to virtual care and it has become more tech reliant. While this means that it’s great for operations and it improves patient outcomes and also delivers more in terms of revenue but it also means that healthcare is now more exposed to cyber attacks than before. 

Moving past the changes healthcare has undergone, let us focus on how it has changed the workflow of the Revenue Cycle Management process. RCM is considered to be the backbone of healthcare operations and right now it has had to bear the brunt of COVID-19, and if not developed correctly to handle the stressors, it can cripple the entire system.

Some of the most common changes noticed in RCM in the wake of COVID-19 are:

• Erratic and unpredictable claim volumes
• Increased workloads due to confusion over codes and requirements for COVID-19 claims
• Overstaffing due to decreased claim volumes
• Staff productivity falling due to a rapid and unplanned shift to remote work
• Decrease in staff capacity due to lay-offs, furloughs and other staff reductions

In an effort to understand how RCM has changed and how healthcare organizations are dealing with the operational stressors of the pandemic, a survey was conducted by Alpha Health, one of the most prominent RCM service companies. Alpha Health commissioned the Healthcare Financial Management Association’s (HFMA) Pulse Survey program to survey 587 chief financial officers (CFO) and Revenue Cycle leaders across the country. The survey was conducted between May 19, 2020 and June 22, 2020 and the results are illustrated in the below infographic. Also, it is to be noted that the survey has a confidence level of 95 percent with a margin of error of plus or minus 5 percent.

Conclusion

1. While the healthcare industry works to better understand COVID-19 both clinically and administratively, the survey results show that revenue cycle teams at healthcare organizations face a number of challenges, including: Erratic and unpredictable claim volumes Increased workloads due to confusion over codes and requirements for COVID-19 claims Overstaffing due to decreased claim volumes Staff productivity falling due to a rapid and unplanned shift to remote work Decrease in staff capacity due to lay-offs, furloughs and other staff reductions
2. Due to COVID-19, the American Hospital Association (AHA) estimates $120.5 billion in total financial losses from July 2020 through December, or an average of $20.1 billion per month.
3. These estimates are in addition to the $202.6 billion in losses the AHA estimated between March 2020 and June 2020, bringing the total projected losses to hospitals and health systems in 2020 to at least $323.1 billion
4. These financial losses put increasing pressures on revenue cycle teams at health systems to process claims as efficiently and effectively as possible to protect revenues and manage costs.
5. Due to these losses, hospitals and health systems are now experiencing:
   • An increase in workloads due to confusion over codes and requirements for COVID-19-related claims
   • Overstaffed due to decreases in claim volumes
   • Decreases in staff productivity due to rapid and unplanned move to remote work
   • Decreases in staff productivity due to layoffs, furloughs and other staff reductions

At BillingParadise, ever since the beginning of the pandemic, we have somehow managed to adapt and transition to the changes and stressors in the community. This allowed us to serve our clients in a more efficient manner. It also enabled us to equip our clients to handle their share of COVID-19 challenges. Our quick transition to virtual services and telemedicine billing pushed us a long way, but, at our core we are a billing & RCM service provider and our experts ensured that regardless of the predicaments, BIllingParadise’s RCM will function on all cylinders.