Over the past few months, we’ve watched a global pandemic impact every facet of American life — and American healthcare. When it became clear in March that Covid-19 was going to hit the U.S. hard, healthcare organizations scrambled to prepare for an unprecedented time. This meant figuring out how their typical workflows and organizational processes would be able to handle a pandemic, the effects of which could not be foreseen.
Under normal circumstances healthcare processes are often blocked or impeded by more traditional methods of management. The pandemic has made it clear how important it is to leverage new technology in healthcare. Definitive Healthcare’s study of ACOs during the Covid-19 pandemic found that 36% of practices are at risk for closure due to the financial impact of the virus, and 69% of those are practices with 10 practitioners or less. With limited staff and such high stakes, it has become increasingly clear that there is a case for utilizing automated and technological tools that ultimately reduce the overall costs associated with healthcare administration.
In payer organizations as well, technology has a decidedly critical role in keeping costs low and efficiency high, which in turn enables organizations to avoid negative impacts during crises such as the Covid-19 pandemic. So what are some ways that both patient-facing organizations as well as payer organizations can streamline work using technology?
For providers, patient care has been improved by technologically enabled EMR systems as well as payment portals, patient communication tools, and revenue cycle management. These technology or cloud-based tools allow providers to work more closely with patients. During a healthcare crisis, communicating effectively with patients regarding? their care plan, as well as having immediate access to patient records, is critical to providing the best care possible — and possibly even saving their life. According to the Harvard Business Review, one medical center implemented technology-powered order entry for prescriptions and saw a 50% drop in confusing or incorrect orders from physicians. Impacts such as this demonstrate concretely that technology has the power to drastically impact a patient’s life through more accurate and effective care.
The Covid-19 pandemic has also revealed the power of telemedicine: in a world in which person-to-person contact must be limited, but medical care is required, technology-fueled medicine quickly became the norm for patients across the globe. Medicare is an excellent case study to examine the impact of telemedicine during the pandemic.
When the virus began to spread in March and early April, CMS moved to make telehealth more accessible to Medicare beneficiaries in order to enable safer and more effective care. Although CMS had already taken some steps to expand telehealth coverage, the pandemic provided a forcing mechanism for the Center to broaden its range. First and foremost, CMS expanded the scope of geographic locations from which beneficiaries could receive care, from strictly rural areas to anywhere in the country. Additionally, they doubled the number of services available via telehealth.
The results have been astonishing: prior to the pandemic, approximately 13,000 people per week in Fee-For-Service (FFS) Medicare received care via telemedicine – in the first week of April alone, that number had skyrocketed to 1.7 million. By June, that number had climbed to over 9 million. In addition to making it safer to receive medical care, easing restrictions for telehealth also eliminated any barriers for patients who may otherwise not have sought treatment. Leveraging technology in this way has made it clear there is a need for it, and that it can make a significant difference for beneficiaries. But using telemedicine hasn’t just made care easier to access – it also saves money. In a 2019 study of the tool JeffConnect (the telemedicine platform used by Philadelphia-based Jefferson Memorial), it was discovered that leveraging telehealth saved anywhere from $19 to $121 for typical visits and over $1500 when a patient was diverted from going to the emergency department. These cost savings not only impact the consumer but have a significant downstream impact on overall healthcare spend.
For payers, the utilization of technology has more of an impact on back-office administration than on patient care directly – however, we should not discount the importance of reducing the costs associated with administration since those costs are ultimately reflected in overall healthcare spending. One of the areas where payers have been able to streamline is in managing their provider networks – this encompasses building, managing, and credentialing large networks of providers, and maintaining a compliant roster of providers that meet all regulations. During the pandemic, this need has been made even more relevant.
Credentialing is one specific example of technology and its impact on effectiveness and thus cost. According to Becker’s Hospital Review, credentialing providers – especially for large healthcare organizations – can take anywhere from 90-120 days, and in some cases over 200 days. The overhead costs implied by this extensive time frame are undeniable – it is typically a very manual process, with many staff members working long hours to complete credentials. With technology such as a credentialing verification organization (CVO), this timeframe can be decreased significantly – in some cases moving as quickly as 15 days. When leveraging technology for this process, staff costs decrease substantially, and the process moves along efficiently, enabling providers to begin caring for patients.
In the midst of a global health crisis, ensuring provider credentials are accurate and up-to-date is even more critical; with so many patients’ lives at risk, having the best care available is not only important but mandatory. To accommodate the recent spike in healthcare needs, many organizations have had to scale up their provider networks rapidly; this is difficult to do with manual processes and heavy overhead. By streamlining credentialing operations and leveraging technology, organizations can scale their networks quickly and compliantly – ensuring they are ready for anything.
With so many incredible advancements in technology in the healthcare space, it’s important to understand where exactly these developments have a measurable impact. During the Covid-19 pandemic, these impacts have become even more clear, and it has shown what a drastic difference these technologies can make not only to an organization’s bottom line but to the quality of care given to their patients or beneficiaries. It will be important as the pandemic unfolds in the coming months to continuously evaluate and re-evaluate the effectiveness and measurable outcomes of healthcare organizations, so that key lessons are taken away and implemented as the industry begins to move forward in a post-Covid world.
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