5 Healthcare Industry Trends Contributing to the Rise in BPO

5 Healthcare Industry Trends Contributing to the Rise of Business Process Outsourcing Services_blog header

Growing challenges, restrictions and mandates across the healthcare spectrum are driving more and more hospital and physician practice managers to consider healthcare business process outsourcing.

The Affordable Care Act has created an influx of new patients with insurance coverage, and coupled with an increase in the size of the aging populations, medical office staff and payers alike are struggling to keep up with the boost in complex claims. The implementation of ICD-10 is placing more strain on already understaffed reimbursement departments, and the shift toward value-based healthcare is leaving practices working harder than ever before to comply with conflicting mandates for improved quality and reduced costs.

As a result, the revenue cycle management outsourcing market is expected to grow at least 12% annually through 2019, adding to the nearly 75% of US healthcare companies already outsourcing back office tasks exponentially year over year.

Still, the decision to outsource revenue cycle tasks can be a difficult one. Review these five common industry trends that are putting pressure on  hospitals and medical practices. If any of these are creating issues within your organization, it may be time to consider seeking outside assistance.

Reimbursement Delays

With new codes and procedures for requesting reimbursement from payers, it takes longer than ever to receive payment for services rendered. Coupled with the rise in the number of claims submitted under the Affordable Care Act, medical offices are consistently receiving inadequate reimbursements.

Your current in-office staff may not have the experience, or the time, to keep up with that growing pile of claims. Instead of having a medical assistant lose time away from patients each day process endless reimbursement paperwork, consider outsourcing the task. Your payments will grow and your staff will get time back to focus on what really matters – providing quality patient care.

Staffing Shortages

Hospitals across the country are experiencing staffing shortages on every level. Understaffing can drive costs up and negatively affect the health and happiness of the existing team members. More significantly, it can result in a threat to patient satisfaction and safety. Make the best use of your medical staff and leave time-consuming back-office tasks to a team of professionals better equipped to handle them.

Regulation Changes

It is no secret that keeping up with regulation changes is a full-time job. Not only must you keep up with industry-specific regulations surrounding the security of patient information, maintenance of tax-exempt status and the delivery of care, there are also those updates than span multiple industries, such as the FCC’s recent declaratory ruling on the TCPA, that may affect business processes as well. With more people than ever eligible for care, regulation changes are only expected to increase. Understanding them and implementing protocols requires specialists that can dedicate the time to ensuring your compliance.

Technical Innovations

Technology changes almost as quickly as compliance requirements do. BPO providers can offer newer technology to assist in optimizing your revenue cycle that may be too costly or time consuming to implement within your own practice. Keeping up with the latest innovations can improve data security, customer service, and receivables.

Better Informed Patients

Patients are more informed about their own health than ever before. With the rise in patient responsibility on marketplace and high deductible health plans, patients are taking care into their own hands, and shopping for the best experience for their dollar. Access to providers is essential to patient satisfaction, but that access suffers when providers are losing time with their patients to endless stacks of paperwork and tasking.

Is BPO right for your medical practice?

Medical customer service, payer reimbursement follow up and denial management, and early follow up are all tasks that are critical to the success of a healthcare organization. Yet each of these take up valuable time for busy physicians and staff – time they should be spending providing an excellent patient experience.

The shift in focus to improving quality while reducing costs is expected to lead to even higher rate of adoption of healthcare business process outsourcing services. With the growing complexity in reimbursement  models, it is more important than ever to optimize the revenue cycle.

It is time to reassess your practice’s strategy to include an alternative delivery service for core revenue cycle management functions and processes. Want to learn more about how healthcare business process outsourcing can benefit your organization? Contact us today.

Written by Ali Bechtel, Public Relations Coordinator

This information is not to be construed as legal advice. Legal advice must be tailored to the specific circumstances of each case. Although we attempt to provide up-to-date information, laws and regulations often change. We make no claims, promises, or guarantees about the accuracy or completeness of this document. For legal advice, please consult an attorney.

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