This content was adapted from a whitepaper published by TriZetto Provider Solutions in June 2022
It’s known that pandemic-related factors have caused major staffing shortages across all sectors and geographic areas, leading providers to reconsider how they run their businesses. In fact, the numbers show that turnover of clinical staff workers has increased from 18% to 30% since the start of the pandemic. These shortages – either due to illness, burnout, budget reductions or the Great Resignation – threw a wrench in the standard operations of offices.
The times are changing
As organizations are trying to get back to pre-pandemic operations this year, they are now facing higher labor costs than ever before. According to a September 2022 MGMA poll, 58% of medical practices said staffing was their greatest challenge, followed by expenses (20%) and revenue (17%). With the rise of staffing costs and adequate staffing impacting revenue, it’s easy to see how staffing challenges bleed into all areas of the practice.
The pandemic has brought many changes, and one thing is for sure: the way things have been done in the past may change if they haven’t already. According to renowned industry speaker Elizabeth Woodcock, “It’s about changing the way we work.”
The role data plays
More patients are using high-deductible health plans and there is more emphasis on patient responsibility. This, coupled with factors like the staffing crisis and in addition to the move to value-based care, means identifying claims with a high percentage of patient responsibility is key. According to an article by Healthcare IT News, the Great Resignation has “highlighted the need to strategize and prioritize to more fully leverage a leaner staff, encouraging a hyper-focus on key analytical data that could net the most positive impact.”
With all of this, data becomes more important than ever for optimal reimbursement. A key tool that’s critical to the success of any business is a proper analytics program. Advanced analytics can help an organization by:
- Providing real-time analysis
- Identifying trends and patterns
- Mitigating risk for any potential loss in revenue
- Benchmarking against metrics of similar practices
Robust, easy-to-understand dashboards can identify trends and patterns, easily compare data and break down KPIs by NPI, Payer, CPT codes and more. Comprehensive data analysis also gives organizations the chance to “step back” and take a full assessment of activity. Additionally, benchmarking capabilities exist that will help you learn how your organization is performing against its peers, and identifying areas that need change.
Investing in the right data analysis tools mean that workflows can also be streamlined by identifying trends or issues, and then working toward remedies. In fact, a Midwestern health system improved physician productivity by 30% by consolidating and aggregating their data into a standard analytics package that called out areas with the most significant performance improvement opportunities. Costs most likely will also be reduced in the long run.
Healthcare is at a place where data is widely available. It’s now about how to organize and use that data to make decisions and predictions. While the vast amount of data that exists within many organizations can be overwhelming, getting a grasp on the numbers no doubt has its benefits.
The bottom line is that companies need to learn to operate with leaner staff and smaller budgets. Because of this, analytics are a key component of an organization’s success. Every organization should have a robust analytics tool in place in order to have the transparency that places a spotlight on claims, thus improving cash flow and increasing revenue.
How healthy is your organization? If there is any pause, outside resources may be needed. Thankfully TriZetto Provider Solutions can help your practice navigate reimbursement and any complexities your office may be experiencing.
