Rethink Patient-Facing RCM during Labor Shortage Part 3: Challenges of Small Hospitals

April 20, 2022

Imagine this predicament: You manage the registration and admissions functions at a small hospital in rural North Carolina. You’ve recently lost several staff members to retirement, family moves and other routine causes of attrition. However, several of these staff vacancies occurred simultaneously and have made filling your weekend shifts particularly difficult for you.

Then the real bombshell hits: All your emergency department admissions staff tests positive for COVID-19 the weekend after New Year’s Eve. You have no registration coverage for the department on the first Saturday of the year. So you end up doing the best you can, using various administrative and clinical staff members to register patients as needed.

A hospital’s revenue cycle management (RCM) team faced this situation earlier this year. Unfortunately, many small, standalone and rural hospitals find this scenario far too familiar and simply have no breathing room to accommodate unexpected staff absences. While the natural landscape around such facilities may be superb, the talent pool surrounding them often is not.

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Novel solutions for unique challenges

Most small and/or rural hospitals and health systems quickly find filling vacant RCM positions difficult. The group of qualified RCM applicants tends to be just as limited as the number of employees available to pitch in during peak times of need. Moreover, budget constraints typically prevent small healthcare organizations from leveraging solutions larger organizations use, such as paying increasingly higher wages to hire more temporary or permanent staff.

Since the pandemic’s onset, however, new attitudes are emerging toward remote work that may prove especially beneficial for small and rural organizations. Although few hospitals historically have considered remote or outsourced RCM workflows, many are beginning to ask: Why not?

Remote work has suddenly gained popularity among job seekers for many reasons, including its inherent flexibility, stability (e.g., work can continue even during lockdowns) and safety (e.g., less exposure to potential pathogens). For hospitals, remote workers can often provide cost, scale and scope efficiencies by handling RCM needs across multiple settings or locations. Plus, without traditional geographic constraints, hospitals can vastly expand their RCM candidate pool.

Another alternative to allowing RCM employees to work remotely is to partner with outsourced solutions that use the right mix of remote staff, on-site staff and automation to manage the entire financial function — thus freeing hospital staff to devote more time to individual patient care, driving greater overall levels of satisfaction. With such remedies in place, hospitals can ensure their staff members have the capacity to focus on high-complexity tasks while technology handles the mundane, transactional work that doesn’t require human cognitive skill.

Small and rural hospitals have always faced unique labor challenges, but the COVID-19 pandemic’s push toward remote work could be advantageous over the long term. It has led hospitals to rethink many things, including patient-facing RCM workflows. By leveraging all the tools at their disposal — including remote and outsourced solutions — even the smallest hospitals can improve their RCM efficiencies and effectiveness.

Author bio: Philip Milsom is a regional vice president of Enterprise Revenue Cycle at R1 RCM.

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