The Ins and Outs of Hospital Reimbursement Wars

There is a war being waged in the healthcare industry and it’s not between insurers and hospitals.

It’s happening within the hospital walls, as CEOs, CFOs, Revenue Cycle Directors and other healthcare executives grapple with reimbursement rates that are decreasing faster than they can keep up.

What’s causing this war? How can you win?

Let’s take a closer look.

What’s Causing This War?
Reimbursement wars have been going on for decades since cost containment measures began in the late 80s. What has changed over time is the rate of decrease in reimbursements. In the early 2000s, reimbursements were staying steady or even increasing slightly but more recently, there has been a sharp decrease due to government regulations and changes in payer policies. As a result, hospitals have had to adjust their expectations for revenue from reimbursements accordingly.

How Can Hospitals Win This War?
The key to winning this war is understanding your data. Data-driven decision making is essential to ensure reimbursement rates remain competitive while still allowing you to cover costs associated with care delivery. To achieve this balance requires analyzing existing data points such as patient demographics, payer mix, coding accuracy and more. Once these data points are analyzed, you can make adjustments based on findings to reduce costs while still maintaining a competitive edge in terms of reimbursement rates.

Another way to win this battle is through automation and technology that streamlines processes within your revenue cycle operation such as patient registration or eligibility verification systems. These solutions allow staff members to spend less time on tedious tasks so they can focus on activities that directly affect revenue such as improving coding accuracy or negotiating rates with payers. Automation also helps ensure that billing processes are accurate from start to finish which reduces the risk of rejected claims down the line.

The war for reimbursement rates continues despite decades of cost containment measures by hospitals and insurers alike – but there are ways for hospitals to prevail in this battle by analyzing their data and investing in the right technology solutions that streamline operations within their revenue cycle departments. By taking control of their data points and automating processes where possible, hospitals can keep their reimbursement rates competitive while still covering costs associated with care delivery – all without sacrificing quality of care or patient satisfaction levels along the way!

To learn more join our upcoming webinar on March 23rd at 1 pm CST.