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R1 RCMJuly 6, 2020

10 Statistics that Show How COVID-19 Has Changed the Revenue Cycle

Financial chart with COVID-19 virus icon.

At the end of 2019, healthcare leaders projected the upcoming year would bring more consolidation and a greater focus on consumerism. While we’re now seeing these predictions come to fruition, no one anticipated the seismic shift that would happen due to COVID-19 – and the many ways the pandemic would impact healthcare.

 

Today’s providers must address a host of new revenue cycle challenges: Meeting new social distancing standards, funding personal protective equipment (PPE) and providing more digital self-service options for patients. Ramping up capacity to recover lost volume and revenue. Helping the uninsured and underinsured pay for care costs. Maximizing reimbursement for COVID-19 cases. The list is long, and these 10 statistics show how much healthcare has changed in mere months – and how providers must strategize to succeed in the new normal.

 

  1. COVID-19’s projected financial impact for the year is at least $323.1 billion. 

The American Hospital Association (AHA) reports that hospitals and health systems  are bleeding more than $50 billion per month – and  potentially up to $1 to $1.2 billion per day. “America’s hospitals and health systems have stepped up in heroic and unprecedented ways…however, the fight against this virus has created the greatest financial crisis in history for hospitals and health systems,” said AHA President and CEO Rick Pollack. Providers are turning to scheduling and capacity management solutions, telehealth and other initiatives to help ramp up elective services and boost patient volume and revenue.

 

  1. More than 7 million Americans may have been COVID-positive in March 2020, the first month of the U.S. pandemic – and an estimated 80% of these cases likely went undiagnosed.

The study points to the high number of undiagnosed cases, which can result in a greater spread of the virus – which leads to higher costs and a greater resource demand for providers. The coming months may bring an increased number of COVID-19 cases and a larger number of undiagnosed, causing the virus to spread undetected. These factors can ultimately cause more strain on an already stressed healthcare system – and providers can benefit by preparing now, looking for new solutions and lining up resources and partners that can help if needed.

  1. A recent Advisory Board estimate indicates a typical 1,000-bed hospital system with a moderate surge in COVID-19 patients will lose 50% of its quarterly revenue.

Nearly all hospitals are addressing financial shortfalls through furloughs and reduced pay, but safety-net and rural hospitals are in the greatest danger – yet their existence is critical to their community’s health and well-being. Federal funding alone won’t be enough to help these hospitals survive financially, and these next several months are a make-or-break time. Hospitals must implement new strategies to maximize capacity for elective procedures and reach out to their communities to encourage patients to receive postponed treatment and promote preventive and wellness initiatives. Listen to our webinar, Key Considerations While Ramping Up Elective Services – Patient Volume Bounce Back Is Not Guaranteed, for information on ramping up capacity.

 

  1. Only 11% of Americans used telehealth in 2019 but 76% of Americans want to use it moving forward.

According to McKinsey & Company , 76% of Americans are likely or highly likely to use telehealth moving forward and 74% say they’re highly satisfied with telehealth. Americans’ new interest in telehealth is a bright spot amid providers’ financial struggles, as it gives them a way to care for patients while minimizing their exposure to contagion – and at the same time, helps providers regain lost revenue, increase patient volume and expand services so they can recover financially.

  1. A quarter of a trillion dollars, or $250 billion, of healthcare services could be virtualized moving forward.

Pre-COVID-19, the total annual revenues of key telehealth companies were an estimated $3 billion, with the largest vendors focused in the “virtual urgent care” segment, helping consumers get on-demand instant telehealth visits with physicians who most likely weren’t patients’ regular providers.

 

The recent acceleration of telehealth by both physicians and patients – and the extension of telehealth beyond virtual urgent care – means that up to $250 billion of current U.S. healthcare spend could potentially be virtualized. That’s 20% of all office, outpatient and home health spend across Medicare, Medicaid and commercially insured populations.

 

Scaling telehealth can increase access to necessary care, improve clinical outcomes, keep patients protected from the COVID-19 virus and help providers financially recover – but only if they take the right steps to properly integrate telehealth solutions and create a seamless end-to-end telehealth workflow. Watch our on-demand webinar, Maximizing Success with Telehealth, to learn more.

 

  1. Up to 60,000 primary care practices across the U.S. may close by the end of June.

The American Family of Family Physicians indicates primary care practices have been hit particularly hard by the pandemic, projecting that up to 60,000 practices may close by the end of June. Because we’re already facing a primary care physician shortage, these closings may impact our nation’s care delivery model. If this trend continues, the primary care provider as the central figure in the patient’s care may devolve – leaving patients without a trusted provider who assesses their needs, provides referrals, coordinates care and oversees their health.

 

Independent physician practices can stay financially healthy in difficult times – review our case study with Holston Medical Group to see how the practice improved operations and revenue cycle management so they could remain independent while achieving financial success.

 

  1. COVID-19 may cost our healthcare system up to $654 billion if virus continues to spread.

According to Health Affairs, a study leveraging a simulation model that represents the U.S. population shows the potential downstream financial impact of COVID-19, indicating it may cost up to $654 billion in direct medical expenses and resources. Per the study, reducing the spread of the coronavirus can substantially reduce this cost – and the stress on our already-taxed healthcare system. The potential spread of the virus due to undetected and undiagnosed cases may complicate efforts to contain it, however. As COVID-19 continues to spread, consumers must stay vigilant in taking preventive steps – and providers must be their trusted source to provide ongoing information about the virus and their wellness.

  1. An estimated 27 million Americans may lose their employer-sponsored health insurance due to job loss.

Since the start of the pandemic, more than 33 million workers have filed unemployment claims. According to Pew Research, our unemployment rate shot up from 3.8% in February 2020 – among the lowest on record since World War II – to 13.0%, the era’s second highest rate. The economic toll may have a triple negative effect on Americans: they may become sicker due to stress; illnesses may go undiagnosed and chronic conditions may go untreated due to missed treatments; and patients may be unable to pay their medical bills. Financial clearance and compassionate, knowledgeable counseling can help mitigate this problem – as can ongoing outreach and patient engagement by providers.

  1. For care scheduled but not yet received, 74 to 79% of patients expect to receive treatment in person.

Whether they’re visiting a primary care physician or specialist or having lab work done, the overwhelming majority of patients expect to receive healthcare services in person before the end of the summer. More than 1/3, however, have concerns about visiting healthcare facilities and staying safe, and they feel less comfortable than before the pandemic visiting common sites of care. Providers can alleviate these concerns with proactive communications that educates patients about precautions to help keep them safe, such as PPE and digital self-service for tasks like scheduling and registration.

  1. Nearly 1/3 of patients plan to or have already adjusted their spending on healthcare visits due to COVID-19 – but many will have complications due to deferring necessary care.

Consumers everywhere are concerned about COVID-19’s impact “on their health and their wallets,” according to a  PWC survey, and are behaving accordingly. For instance, 78% of these consumers said they’d cut down on spending by skipping at least one physician visit, elective procedure or recommended lab test or screening. At the same time, Health Affairs says health systems must be prepared for an influx of patients who deferred care due to COVID-19, and should anticipate a surge in complications of cardiovascular disease, diabetes, cancer, infection, mental illness and other urgent conditions.

At a time when providers need to recoup patient volume but patients are foregoing treatment, the result may be sicker patients and greater financial challenges for some providers. A patient experience platform that offers digital self-service scheduling and engages with patients on an ongoing basis can encourage them to get the care they need.

Creating a strategy to move forward and succeed

Although healthcare has been hit hard by COVID-19,  providers can develop a plan to regain revenue and succeed in our challenging new normal. Examine your revenue cycle from end to end, looking for any areas where you can maximize payer and patient revenue – from the point of order or scheduling, all the way through claims reimbursement and post-service patient collections.

 

Strategies for maximizing capacity, leveraging consumerism and improving patient engagement, and using revenue integrity to achieve an immediate revenue lift can help you financially recover. Taking a step back to evaluate your comprehensive revenue cycle can be challenging – particularly now. Consider engaging a trusted, proven partner who can help you get the most out of your revenue cycle – and develop a plan to succeed and thrive.

 

 

Outsourcing Webinar Graphic

Check out our "Maximizing Revenue and Improving the Patient Experience" webinar series to learn more about how providers can financially recover and thrive amid healthcare's significant changes during and after the COVID-19 pandemic.