The COVID-19 outbreak has placed an immense amount of stress on healthcare organizations of every size over the last several weeks. As hospitals and health systems have navigated through the reduction in non-emergent services, the need for coders and coding auditors has dropped off significantly, resulting in furloughs and layoffs. For payers, data quality during this time may result in an increase in over or underpayments to providers. So, how has our healthcare system been coping with the recent changes while trying to make sure providers, payers and patients are getting what they need?
Providers Adapted to Safety Regulations for Patients and Staff
With the quick emergence of COVID-19, hospitals had to find a way to serve their patients under strict new regulations and keep their staff safe. These new regulations such as social distancing or stay at home orders have been tricky for many healthcare systems. Some hospitals were already allowing coders to work from home, so the need to have these professionals safely distance themselves from their other team members was not something that interrupted the day-to-day workflow. Hospitals and health systems that haven’t typically allowed coders to work from home have had to either change long-standing policies or modify the physical environment to safely distance their staff from one another.
Regardless, the decrease in volumes due to the lack of elective surgeries has greatly reduced the amount of work to be done from a coding perspective and is costing providers millions of dollars in lost revenues. The resulting financial impact to providers is tremendous and will likely take months or longer to get back to the numbers they were working with before the spread of COVID-19 hit.
Long-term impacts will likely result in hospitals and health systems reevaluating what business they are in. Are they in the business of community wellness or in the business of running administrative services? One does not have to dig too deeply to find news reports of health systems laying off hundreds of non-essential/non-clinical staff members.
Here are a few things to consider:
- Does it make sense to fully staff the coding and coding auditing functions going forward?
- What if COVID-19 has a second or third wave, do the health systems have to go through the stress and cost of ramping staffing levels back up only to go through future furloughs?
Granted this is speculative, but with some coders electing to retire or perhaps change jobs, hospitals and health systems may want to consider partnering with a professional onshore outsource company for coding and auditing and other administrative services. This will minimize future staffing issues and will help to bend the curve on administrative costs.
Payers Focus on Safety and Data Quality
Much like providers, payers have had to navigate their business model and approach from a new perspective during COVID-19 in order to keep their staff safe. Quality of data in the payer sector has always been an essential aspect of the industry, but with the constant changes in coverage being implemented due to COVID-19, over and underpayments to hospitals and health systems will likely be a bigger problem than ever. This type of error will create an environment whereby staff from the payers and health systems spend inordinate amounts of time dealing with claim issues and resolving payment errors, resulting in escalated administrative costs as reworking and refiling claims is an extensive and expensive process.
Signature Performance is Here to Serve
During this unusual time in healthcare, our team is ready to lend a helping hand to keep administrative and coding operations flowing. Our track record over the last 15 years proves we can tackle any administrative burden with a thoughtful approach, while improving the overall workflow with a customized design. Our experience in serving both the payer and provider side of healthcare financial management allows us to implement innovative solutions for every administrative demand.
We believe the healthcare industry in the United States deserves only the finest and that sentiment is what motivates our dedicated team to do our very best each and every day. Now more than ever, it’s our calling to bend the curve of healthcare administrative costs through improved quality and outcomes. To learn more about Signature Performance, contact our team today or check out our career page for a list of our latest career opportunities.
Doug Bilbrey is the Vice President of Business Development at Signature Performance Inc., in Omaha, NE. Signature Performance is an industry leader in reducing healthcare administration costs for private and public healthcare sectors. Our unmatched experience in serving both the payer and provider side of healthcare financial management allows us to implement innovative solutions for every administrative demand.