2012 Healthcare Provider Survey Results: Revenue Cycle Management, Audits, Automation

2012 is gearing up to be a watershed year as healthcare providers continue to grapple with a weakened economy, high unemployment, reductions in claims reimbursements, new federal health regulations, and a projected increase in services resulting from the growing Baby Boomer population. While these issues are not new to the healthcare industry, what makes this year different from 2011 are two important factors: the upcoming presidential election and the Supreme Court decision on the Affordable Care Act. Both events could lead to sweeping changes that would impact millions of Americans and thousands of healthcare businesses across the nation.

On a more micro level, providers continue to face a myriad of challenges closer to home. Hospitals and private medical practices are experiencing shrinking patient volume, an increase in audits and limitations on organic growth due to constraints being placed on accessing capital for investment purposes. Long term care providers – such as home health agencies, hospices and skilled nursing homes – are confronted with cuts in Medicare reimbursements, new administrative requirements and payment system reforms, while medical equipment suppliers struggle to remain profitable amid new bidding requirements and Medicare mandates created to reduce fraud. As a result, many healthcare organizations find themselves either consolidating, merging or forging new partnerships to remain competitive. And, almost all providers are evaluating how they can do more with less to survive in a brave new world that is changing daily. This is where technology can help and is the premise behind IVANS 2012 Healthcare Provider Survey.

Key findings from the IVANS study indicate that providers would like to submit more healthcare information electronically, but it needs to be offered in a cost effective manner and guidance in its implementation is critical for widespread adoption to occur. Readily-available solutions, such as automation software and web-based portals, can significantly improve revenue cycle management, but these types of technologies must demonstrate a high degree of usability and affordability among providers to be successful. Further, these solutions must empower providers so they have more visibility and control over their cash flow, and not be based on the number of claims filed which can become cost prohibitive. It is in this area where the IVANS survey found that health insurers – in particular commercial payers – have a golden opportunity to offer a paperless, electronic environment for processing claims which will save significant time and money for health payers and providers. In addition, both groups will be better prepared to support upcoming federal initiatives, ultimately leading to greater adoption of health information exchanges (HIEs) across the country.