Although the United States is still in the thick of its COVID-19 response, many healthcare leaders are starting to anticipate several challenges and opportunities that could emerge once the pandemic wanes. To gain a better understanding of healthcare executives’ perspectives on the post-pandemic future, the Healthcare Financial Management Association (HFMA) surveyed 151 healthcare leaders, asking about their projections for five areas, including payer mix, consumer and employee experience strategies, revenue cycle IT budgets, electronic health record (EHR) satisfaction and price transparency preparedness. Participants included C-level executives as well as vice presidents and directors of finance across hospitals and health systems. Through its Center for Health Insights, Guidehouse analyzed the research conducted by HFMA, and the following sections discuss key takeaways.
Most leaders anticipate major shifts in payer mix
Approximately 70% of hospital and health system leaders are preparing for an increase in self-pay consumers and Medicaid beneficiaries post-COVID-19. Around this same number foresee a decrease in commercial reimbursement. These predictions stem from the volatile unemployment picture, which is causing a significant number of people to lose access to their employer-sponsored health plans. Without these plans, an individual may change to self-pay status or have to seek Medicaid benefits depending on their economic situation.
“With health system margins primarily driven by elective services, the pandemic is gravely impacting provider revenue streams and payer mix,” says Timothy E. Kinney, Guidehouse partner. “As our economy labors post-pandemic, insured patients will struggle to shoulder greater cost sharing through high-deductible plans coupled with volatile unemployment rates. Healthcare leaders need to closely evaluate their payer mix and develop winning consumer experience strategies to overcome a slow recovery in patient volumes and an uptick in self-pay and Medicaid enrollees.”
Providers are ramping up consumer engagement strategies
During this time, hospitals and health systems have amplified patient engagement, pursuing new strategies and expanding on existing ones. Notably, 92% of executives say their organizations have increased telehealth, with 73% using it to better engage patients and address consumer responsibility. Leaders also indicate their organizations are expanding financial counseling and payment plans (63%) in response to patients’ changing financial circumstances, and more than half (56%) are using online portals to deliver price estimates and receive payments.
“Hospitals and health systems have always prioritized meeting patient needs, but those needs and how to best address them are changing as the pandemic endures,” says Rick Gundling, senior vice president, healthcare financial practices for HFMA. “Going forward, organizations have to be flexible, continuously looking for effective strategies that can meet patients where they are and engage them in care and payment.”
Changes in the coming year