With 2023 well underway, healthcare leaders are strategically looking ahead to what the industry will navigate this year. The last few years have proven that innovation is the driving force within the healthcare industry in the United States. Patient preferences for points of care, changes in insurance coverage, the evolving role of AI, and the continued administrative burden of healthcare represent key topics healthcare leaders are discussing. While not exhaustive, the following examples illustrate challenges healthcare leaders must solve for in order to promote financial viability.
Refining the Digital Healthcare Landscape Post Pandemic
With 37% of adults using telemedicine in 2021, chances are high that you or someone you know has logged onto a virtual care appointment over the last year. The pandemic ignited a massive demand for a timely and easily accessible telehealth experience. According to the American Medical Association (AMA), 14% of physicians were available for virtual visits in 2016; that number jumped to 80% in 2022. Over the last few years, virtual care has become less of a novelty, and many patients now prefer telehealth over in-person visits where wait times can be long and exposure to illness has become a concern. In order to attract new patients and retain their current patient base, providers will need to decide if and how they can expand their virtual care offerings in a way that provides a positive patient experience. Efficient virtual care is an investment that has many components for healthcare leaders to consider. Some of those considerations include remote patient monitoring, integrating technology for meaningful data solutions, and examining how automation can be utilized to reduce administrative burdens for providers and payers.
Medicaid Redeterminations to Pose Coverage Challenges
At the height of the pandemic, Congress passed the Families First Coronavirus Act (FFCRA) which included a requirement that Medicaid programs keep individuals continuously enrolled through the end of the month in which the Public Health Emergency (PHE) that the pandemic insighted ends. That PHE is projected to end in May 2023. With redeterminations of coverage imminent, there are concerns with how many individuals will lose coverage and how states will navigate the 12-month redetermination process and continuous enrollment provision. According to Kaiser Family Foundation (KFF), it is estimated that between five and 14 million individuals could lose Medicaid coverage once the continuous enrollment provision ends. In order to ensure consistent revenue capture, healthcare leaders will need to proactively assist individuals losing Medicaid in their transition to other forms of coverage, including Affordable Care Act (ACA) marketplace plans with premium assistance or employer-sponsored benefits.
Exploring the Capabilities of AI in Healthcare
Investments in machine learning, AI capabilities, and natural language processing have been accelerated in the last few years and have shown what is possible as the healthcare industry continues to transform. The opportunities are proving to be endless when it comes to implementing AI technology that expands access to care, promotes healthy lifestyle choices through wearable technology, and eases the administrative burdens within the industry. In 2023, it is projected that AI-aligned technologies will play an important role in prescription drug discovery and predicting patient outcomes. AI testing allows for clinical trials to be done faster, more cost efficiently, and can help discover potential side effects of new pharmaceutical drugs. In conjunction with clinical work, AI applications are also expanding in ways that streamline administrative tasks, including insurance claims processing, analyzing patient medical data, and record keeping.
Streamlining Administrative Demands for Providers
Did you know that providers spend approximately 16 minutes on administrative tasks for every patient encounter? This results in providers spending almost the same amount of time on administrative work as they get face time with their patient during a visit, if not more. This year, healthcare leaders will continue to navigate how to efficiently implement solutions to make EHR system designs not only more agile but ensure that best practices are properly adopted. According to a 2021 study by the National Library of Medicine, researchers found a significant relationship between the Electronic Health Record (EHR) design and provider stress. The study reported causes of burnout due to how information was presented within the EHR. Prioritizing proper adoption and system training in 2023 are essential components to alleviating physician burnout symptoms, improving continuity of care, and overall patient outcomes.
Delivering Tailored Solutions
Administrative costs accounted for less than 10% of total medical expenses just 40 years ago; today these costs can be as much as 40%. Now more than ever is the time to implement an innovative approach. At Signature Performance, we have the subject matter expertise, program management approach, and tools to promote the financial health of healthcare facilities of every type. Our proven results help us to progress toward our mission of reducing the overall administrative burden of healthcare. Contact our team today to learn more!