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

Philip MilsomApril 20, 2022

Doctor and nurse in hospital

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 it particularly difficult for you to fill your weekend shifts.


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.


This was the situation faced by one hospital’s revenue cycle management (RCM) team earlier this year. Unfortunately, it’s a scenario that sounds far too familiar for many small, stand-alone, and rural hospitals that 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 find it difficult to fill vacant RCM positions quickly. 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 used by larger organizations, 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 to be especially beneficial for small and rural organizations. Although few hospitals historically have considered remote or outsourced RCM workflows, many are beginning to question: 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 efficiencies of cost, scale, and scope 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 the individual patient care that drives 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 caused 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.