Ongoing staffing shortages have plagued the health care industry for years, and circumstances have only intensified with pandemic conditions and the great resignation.
Even as the pandemic subsides, hospitals nationwide continue to grapple with critical staffing shortages. Approximately 20% of U.S. hospitals reported critical staffing shortages in January 2022, reaching the highest numbers in a year, according to Department of Health and Human Services data.
Solutions can be found by reimagining how technology can deliver more efficient workflows through automation and by expanding the candidate pool through remote and offshore work.
Health care providers are unanimous in their pain. Kaufman Hall’s 2021 Healthcare Performance Report indicated 92% of providers surveyed said they had difficulty recruiting and retaining support staff, and 90% said they increased base salaries to help address the problem.1
As a result, the staffing shortage also is straining the industry’s labor expenses, as providers raise wages and offer incentives to overcome the drought. The American Hospital Association recently reported that hospitals have experienced a 15.6% increase in labor expenses since September 2019.2 Credit rating agency Fitch Ratings recently noted that average hourly hospital wages increased 8.5% between February 2020 and August 2020.3
~20% of hospitals reported critical staffing shortages in January 2022 IN THE U.S.
And the problem isn’t going away any time soon. Data from EMSI revealed there will be an estimated shortage of 3.2 million health care workers by 2026.4 Seeming to prove out this data, three in 10 health care workers said they are considering leaving their profession, according to a 2021 Kaiser Family Foundation/Washington Post poll.5
For revenue-cycle functions, answers can be found by improving efficiencies through automation and expanding the labor pool with remote and hybrid positions as well as off-shoring partners.
Automation that Focuses on Patients
Investing in technology can pay big dividends – in both dollars and time savings – and help health care providers redeploy limited staff. The key is bringing in integrated tools to automate functions and making sure they simplify processes, improve accuracy and drive results.
On the front end, automating certain patient services functions, such as prior authorization, is a prime opportunity to streamline systems in order to improve staffing while also reducing administrative costs. Choosing cohesive, streamlined technology solutions improves workflow and accuracy so that team members can focus on delivering an optimal service experience for patients.
Each manually worked prior authorization costs a provider an average of $10.92 in staff time per transaction, according a recent report from the Council for Affordable Quality Healthcare (CAQH).6 Automating the PA process would drop the cost to $1.88 per prior authorization, a savings of nearly 83%.6
Conifer Health recently automated prior authorization processes for a client across multiple facilities over 10 weeks, and disputes for prior authorization issues dropped between 80% and 90% compared to non-automated accounts. A similar rollout with another client resulted in zero authorization disputes for automated inventory.
Automation Creates Efficiencies
Another area ripe for automation is revenue integrity, such as pre-bill automation related to charges. To err may be human, but it’s also costly when it comes to charges — especially when considering the staff needed to monitor and manage the process.
Monitoring charge capture for a health system can be challenging and take up an exorbitant amount of staff time. This primarily happens because charge data is generated from various clinical areas, and in some cases crosses multiple systems, before being added to the patient’s bill. It is not uncommon for charge entry errors and abnormal revenue impacts to occur in a clinical department on any given day, which risk going unnoticed and uncorrected.
Instead, health care systems can work with a strategic partner to develop analytics that aggregate charging data from multiple sources and detect potential charging anomalies prior to bill creation. The right automation tools can catch variances based on pre-determined thresholds related to account activity while still in the pre-bill phase. These tools may include:
- Daily monitoring of charge capture activity at the department and charge line levels using automated analytics
- Automated alerts sent to revenue management stakeholders
- Department alerts that capture both positive and negative fluctuations
Monitoring charge capture for a health system can be challenging and take up an exorbitant amount of staff time.
The result: focused remediation efforts to reduce potential charging errors, rebills and inefficiencies. After Conifer activated its automated revenue and usage alert system for one client, it quickly identified $75 million in charge errors within the first 90 days, which would have resulted in rework. Also, during that time, $10.1 million in material late charge-related activities were identified before month-end. By reducing time spent manually identifying and resolving issues, staff can be diverted to more meaningful work.
Well-implemented, integrated automation offers several advantages that aid efficiency and productivity, which can help mitigate staffing shortages. One critical benefit is the ability to establish consistent standards – standard processes, expectations and performance metrics – across all teams.
Technology Expands Where People Work
Well-integrated automation also ensures the user experience is the same, no matter where the work is performed – in a facility, in a home office or offshore. This opens the door to recruiting from a nationwide pool of work-from-home candidates or considering work with a strategic partner to support offshore operations.
Each company must determine its own mix of on-site, remote and offshore workers, but a few considerations are consistent across the board:
- Equal accountability: Hold the staff equally accountable, regardless of their work location. Whether an employee or strategic partner performs the work on-site, at home or offshore, measure everyone’s performance with the same standards.
- Leadership: Before embarking on a hybrid or offshore program, ensure the right infrastructure is in place around quality and performance management. Structured quality checks across all groups, regardless of location, help ensure all standards and expectations are met.
- Payer restrictions: Be aware of and prepared to address payer restrictions and requirements that may not permit certain work to be performed offshore or put conditions on that work. These restrictions will often vary by state and by contract.
- Culture: When offshoring, take time to learn, understand and appreciate the culture of offshore teams and partners. These relationships can vary, each with unique experiences, communications or expectations. A common understanding is a critical step in bringing a team together to achieve a unified goal.
Reimagining the Workforce
Today’s staffing challenges call for leaders to look beyond their usual recruiting and retention practices. Instead, solutions can be found by reimagining how technology can deliver more efficient workflows through automation and by expanding the candidate pool through remote and offshore work.