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Navigating the Recurring Trends in the Healthcare Environment

April 2024

Marilyn Burgos, MS CDMP - Marketing Manager

In 2001, the National Library of Medicine (NLM) released an abstract outlining the top trends expected to shape the healthcare landscape in the coming decade. Three trends stand out: advancements in technology, the emergence of new delivery models, and reduced compensation for providers. While this abstract primarily focused on trends impacting Academic Health Centers (AHCs), it is appropriate to acknowledge that these trends resonate with the broader healthcare industry.

Similarly, in 2023, a Becker's article explored hospital executives' visions for healthcare in the coming decade. Notable mentions included trends such as increased mergers and acquisitions; personalized, coordinated care models; integration of technologies in healthcare; decentralization of healthcare service centers; CMS influencing care delivery locations; the adoption of consumer-centric models; and the rise of SMART hospitals incorporating artificial intelligence (AI).

Many of these predicted trends align with those highlighted as early as 2001. However, the key drivers propelling these shifts weren't explicitly outlined. Factors such as the aging population, a spike in uninsured patients, workforce shortages, events like the COVID-19 pandemic, and cybersecurity concerns were the primary catalysts influencing these new perspectives.

Ultimately, organizations that successfully navigate and adapt to external and internal transformations are positioned for sustainability. The onset of the COVID-19 pandemic particularly underscored the imperative of adaptability within the healthcare industry. Irrespective of an organization's current phase, it remains crucial to stay abreast of regulatory changes and payer denial strategies, comply with new standards (especially within the digital realm), and ensure that new delivery care models align with your organization's revenue integrity objectives.

When do revenue cycle firms come into play?

A revenue cycle firm not only offers a benchmark for systems and organizations that are currently meeting their financial goals, but also plays a crucial role in guiding hospitals that are facing challenges in reaching their revenue objectives. The approaches adopted by each firm may vary; hence, it is vital to ensure that their strategies align with your organization's goals and objectives.

While certain firms solely offer consultation services, others may provide service lines encompassing automated tools and software to address specific concerns. Although these services and tools can serve as interim solutions, organizations contemplating long-term strategies involving expansion or revising delivery models are advised to invest in firms that offer a blend of technological solutions and consultative expertise to facilitate successful, sustainable growth.

This process typically commences with a comprehensive assessment of the organization's revenue cycle, followed by implementing strategic measures to optimize financial operations by identifying avenues for improvement and growth.

Key Benefits:

Revenue Integrity Optimization: Healthcare revenue cycle consulting firms like CBIZ KA Consulting Services prioritize identifying revenue leakage points and implementing strategies to enhance revenue. Our comprehensive approach includes assessing existing processes to identify growth opportunities and crafting customized solutions to augment revenue generation.

Expertise and Industry Knowledge: We possess an in-depth understanding of healthcare regulations, billing processes, and reimbursement systems. Leveraging our experience aids hospitals in optimizing revenue collection, reducing claim denials, and adopting best practices for efficient financial operations.

Adapting to Regulatory Changes: Regulatory dynamics frequently influence healthcare institutions' financial landscapes. As a collaborative partner, we help your team navigate these changes by providing:

  • Guidance on compliance with regulatory requirements.
  • Offering education and training to ensure staff remain knowledgeable.
  • Assist hospitals in implementing changes to stay in line with industry standards. 

These steps ensure that your organization complies with regulations, mitigates financial risks, and avoids penalties or revenue loss due to non-compliance.

In forthcoming content, we will dive deeper into these topics.

At CBIZ KA Consulting, we provide a wide range of revenue cycle solutions and enterprise risk management (ERM) solutions to assist you in making well-informed decisions. Contact us today if you're interested in a snapshot of your current revenue cycle.

A bit about the author:

Before diving into the world of marketing, Marilyn spent over 15 years working in various roles within the healthcare community. Her extensive experience in the field has provided her with valuable insights and a deep understanding of the industry. In addition, Marilyn's passion for sharing knowledge led her to coauthor a medical billing and coding book. Follow her on LinkedIn.

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