Over the past decade, we have seen a tremendous evolution in healthcare, particularly in healthcare payments and revenue cycle management. But how far have we come since 2014?
In 2014 we sat down to talk to Mark Brousseau, President of Brousseau & Associates, to get his perspectives on the challenges and opportunities facing healthcare payments in an environment of change as The Patient Protection and Affordable Care Act (PPACA or ACA) continued its roll-out after passage in 2010. Today, we can see in hindsight that Mr. Brousseau was prescient in his recommendations, pointing to the distinct challenges facing healthcare providers.
A Deeper Dive into the Challenges
Rise in Consumerism, Mr. Brosseau points out that in 2014, with patients having to watch individual costs closer and closer due to higher deductibles and co-pays, it was incumbent upon healthcare providers to control costs and anticipate expenses. This continues to ring true - take this 2018 brief by Rice University’s Baker Institute for Public Policy, which says the rise and permanence of healthcare consumerism makes it clear that providers should prep their practices for a far more "retail" model.
Reconciliation, because matching claims, remittances, and payments were about to become more complex in the mix of paper and electronic payments and remittances as more healthcare providers moved towards full adoption of electronification. One of our recent white papers takes a look at the diversification of paper and electronic items - viewing these items as Healthcare's "New" Strategic Assets - and the benefits of electronifying paper-based remittances and correspondences letters.
Cost reduction, due to shrinking margins that resulted from market pressures, regulation, and ACA. It was (and is) critical for healthcare providers to reduce costs. One area that revenue cycle management can impact cost savings is through electronification of paper-based remittances. According to the 2019 CAQH Index, there is a potential savings of $1.9B for full adoption of electronic payments.
Source: 2019 CAQH Index
Challenges and Progress Interpreted: Where Are We Now?
Mark Brousseau's 2014 insights on the challenges the healthcare payments industry continue to hold true today. However, the challenges outlined in the video -- consumerism, reconciliation, and reducing costs -- display a common theme -- the continuing rise in healthcare costs.
So how are we doing, as an industry, in reducing costs? We are making great strides and much of the progress has to do with the adoption of new technologies, particularly with Artificial Intelligence. We have seen reports of AI diagnosing illnesses, as well as eliminating manual tasks that inundated revenue cycle like manual posting paper remits and EOBs. These efficiencies continue to help healthcare providers reduce their costs.
As we move forward, the healthcare industry must continue to develop techniques and adopt technologies, creating the efficiencies that will reduce costs while still providing quality healthcare.