Understand How Reimbursement Contributes to the Need for Cost

Five cost-cutting strategies 

The increased global number of patients compels healthcare executives to contain costs, which is best achievable through reduction of expenses. The overhead expenses contribute to a greater percentage of the huge operating costs that need to be reduced to help hospitals gain immediate advantages with greater rewards. For instance, a healthcare executive committee may decide to use IT to cut costs, undertake more efficient diagnostic imaging and selective lab testing, getting the hospital staff on board, reducing overhead costs to attain better care, and provision of proactive wellness initiatives. 

Use of IT in reducing costs 

The application of IT in healthcare settings will solve the problems associated with diverse, unstructured and exponentially developing data. Therefore, the IT will help business systems manage billions of terabytes of data through the use of interconnected sensors and monitors. Additionally, cloud-based solutions will benefit patients through quick retrieval, analysis, and data sharing to achieve the most efficient care services. Ideally, IT provides binding communication processes and enhances proficient treatment of patients across all the healthcare sectors. Again, the healthcare organizations will collect, store and distribute information effectively through technically feasible leaps that promote development and cuts on costs (HealthManagement.org, 2017). Hence, the lean information flow aided by the use of technology would reduce third-party healthcare employees to help in decreasing interfaces and eventually cost reductions. 

Efficient diagnostic imaging and selective lab testing 

Additionally, the hospital executive can leverage the voluminous data from X-rays and magnetic resonance tomography to achieve efficient and systematic networking and diagnostic imaging that reduce costs (HealthManagement.org, 2017). This implies that the efficient use of each one of the expensive equipment could help organizations save billions of dollars as regards the nature, timing, and duration of diagnostic tests. Still, caregivers should be quite vigilant when first ordering tests to help patients reduce healthcare expenditures and in turn achieve cost stabilization and reduction missions. 

Getting the staff on board 

It is imperative to enlighten healthcare professionals about the organizational mission and culture to promote staff collaboration that eventually supports cost-cutting initiatives. A typical example is the Banner Health system that saved multimillion dollars due to reduced compensations and a significant drop in patient volume (HealthManagement.org, 2017). 

Reducing overhead costs 

Still, reduction of overhead costs would help healthcare organizations attain quality and more cost-efficient care as a means of eliminating economic burdens in the sector. For instance, a team of the executive committee may decide to cut down on administrative costs since they do not improve quality of care. Conversely, the healthcare managers should maximize outsourcing, centralizing and system automation to provide efficient care for the benefit of the patients as regards quality (HealthManagement.org, 2017). 

Promoting proactive wellness initiatives 

Healthcare incentives and rewards promote employees’ engagement. This is because they become fully engrossed in the wellness initiatives that help them in attaining health-related goals. Patients will similarly benefit due to the ability of those initiatives to meet their healthcare needs and interests. 

Five ways to increase healthcare revenue 

Healthcare organizations can increase their revenues through five simple strategies. Such tactics encompass ensuring that patients have health insurance, streamlining patient payments, maximizing reimbursement at every stage of care, providing effective solutions to denials and rejections and going paperless. 

Going paperless 

Going paperless would ensure that there are no outstanding days since all billings shall be communicated in an electronic form. Additionally, patients will always purpose to submit their payments for services received electronically. As a result, both the patients and the organization will benefit as regards electronic submission of payment statements and reduced mail-lag due to prompt payments respectively (Emdeon, 2014). 

Helping patients obtain health insurance 

Insurance services will eliminate non-payment risks associated with self-pay services since some patients do not pay for services offered. Hence, the healthcare organizations will benefit from the insurance services since there will be reduced risks associated with failures to pay for medical bills. Similarly, the insurance will greatly benefit patients because they will improve their own physical and financial wellbeing (Emdeon, 2014). Hence, helping patients enroll in the insurance plans reduce the needs for medical care, especially among patients with mental depressions and anxiety. Still, patients who enroll in the Medicare and Medicaid programs benefit through community outreach programs that enlighten them about the Affordable Care Act and its long-term reimbursements (Emdeon, 2014). 

Streamlining patient payments 

Streamlining patient payments would ensure the accurate flow of information concerning the amount owed. This is crucial to the patient in determining the competency levels of the caregiver in consideration of the latter's experience to decide on time-to-payment effectively. Correspondingly, the organization will reduce its inbound call volume through improved perceptions about his/her care experience, and this would enhance patient satisfaction (Emdeon, 2014). 

Maximizing reimbursement at every stage of care 

Payments for services offered must be made in accordance with the negotiated and contracted reimbursement rates to help the organization maximize on its financial returns. Still, the organization can double-check its diagnosis-related groups comprehensively to boost the levels of reimbursement of Medicare (Emdeon, 2014). Hence, the healthcare organization will maximize its reimbursements. 

Addressing denials and rejections proactively 

Finally, healthcare organizations should address renunciations and rejections proactively. Ideally, the management should determine the eligibility of benefits to properly document the correct claims that insurers should pay before care provision (Emdeon, 2014). This will aid in cutting down on administrative expenses while maximizing revenues. This can be accomplished by limiting administrative errors and the frequency of patients’ claims that might have been rejected due to formatting errors. 

References 

Emdeon. (2014). Five Steps to Capturing More Revenue for Your Hospital. Emdeon Business Services LLC. Accessed 21/8/2018 from https://www.hfma.org/DownloadAsset.aspx?id=26674 

HealthManagement.org. (2017). Seven Ways for Hospitals to Control Overhead Expenses. Accessed 21/8/2018 from https://healthmanagement.org/pdf/article/seven-ways-for-hospitals-to-control-overhead-expenses