|Editor’s Note: Outsourcing review services improves workflow and lowers staffing expenses. CLICK HERE for our white paper on the leveraging the value of Peer Reviews for organizational improvements.|
Outsourcing is not a new word for healthcare. The speed of growth of outsourced services is new. Now administrative services joins the ranks of services under outsourcing consideration. A recent survey indicates providers look to outsourcing Physician Advisor complex case review and complex claims review, because they anticipate a decline in reimbursements and inpatient margins narrowing further next year. Almost a 20% growth from 2013 to 2016.
Black Book’s 2016 Revenue Cycle Management survey responses of 1,309 hospital chief financial officers and business office leaders reveals that outsourcing of complex claims to a specialized provider climbed from 20.4% of all US hospitals in 2013, to 39.8% in Q3 2016.
“Hospitals must do more with less, even with the accelerating pressure to streamline claims processing efficiencies and maximize profitability,” said Doug Brown, managing partner of Black Book, in a statement.
Releasing in-house staff to focus solely on optimizing traditional claims also improved internal productivity according to 77% of all current hospital outsourcing users surveyed.
- 81% of hospitals state they lack the specialized talent to resolve very difficult claims/cases, including 92% of hospitals under 150 beds.
- 69% of hospital CFOs state the[y] must staff with high cost back office employees to compensate for current patient accounting systems which lack in functionality to manage complex types of claims activity.
- 49% of hospital CFOs acknowledge that outsourcing is becoming a more viable alternative in 2017 for more parts of their organizational claim processing.
Indeed, the report found that the complex claims outsourcing market would likely grow 18% annually through 2019, adding to nearly 76% of U.S. hospitals already outsourcing some extended business office tasks.Outsourcing Physician Advisor
Outsourcing review services improves workflow and lowers staffing expenses. CLICK HERE for our white paper on the leveraging the value of Peer Reviews for organizational improvements.