Healthcare Provider Pain PointsSummary: What are your healthcare provider pain points? What are you doing to overcome them? What advice can you offer your colleagues?

From a provider perspective, healthcare, as we know it, is changing rapidly. At times your head might be spinning when you think about the impacts of the Affordable Care Act as well as other healthcare legislation. How can you be sure the priorities you have established will help you comply and meet all established deadlines? What do you feel are the most critical pain points you are facing? You may be a physician’s office, you may be a hospital or healthcare system, you may be a rehab facility. All of these providers are experiencing similar issues, which vary from one degree to another. Let’s delve into a few of these.

Paperwork | Healthcare Provider Pain Points

Paperwork is a staple of any healthcare provider. Paperwork is generated when scheduling patients. Paperwork is generated when registering patients. Paperwork is generated when a patient is seen by a provider. Paperwork is generated when the patient leaves the office/facility. Paperwork is generated to comply with quality and regulatory requirements. Paperwork is generated to maintain staff documents such as employment. Paperwork is generated in every facet of every provider’s business. The burden of coordinating all of this paperwork requires additional staff dedicated to sorting, maintaining, filing, and accessing.

Technology | Healthcare Provider Pain Points

Technology is changing on a daily basis – some changes are required while others are to obtain a competitive advantage. From a regulatory perspective, issues such as EHRs, HIEs, and ICD-10 have come to the forefront. Technology can provide a method for alleviating the burden of paperwork. However, in order to implement these initiatives, additional staff needs to be hired, processes and procedures need to be evaluated, and enormous amounts of training is required. The cost of implementing these systems can make your head spin. For some of these initiatives, financial assistance is available, while others are financed 100% by the provider. Additionally, an emphasis is being placed on mobile technology and Tele-Health. While these aren’t required, they are certainly rising in popularity and quickly becoming the wave of the future. As with anything technology oriented, there are significant costs involved.

Staffing | Healthcare Provider Pain Points

Staffing is always an issue, whether it is the front line staff, the c-suite, or physicians. Providers are consistently being asked to do more with less. When an employee leaves, the first question to arise is “are we going to fill this position or are we going to assign the tasks and duties to current employees”? More often than not, the answer is to shift the work to others. This constant shifting and asking employees to do more causes discontentment and increases the likelihood the employee will seek employment elsewhere. There are only so many times work can be shifted. With all of the mergers and acquisitions occurring in the healthcare arena, leadership is often downsized.  Duplication among positions at this level is generally eliminated in order to contain costs and improve efficiency. The last piece of the staffing puzzle is physicians. We have been experiencing a nation-wide shortage of physicians which is growing in intensity. With all of the new requirements, changes in delivery system, moving toward pay for performance, and just general burn-out, individuals are opting for other lines of work or retiring early. This is especially true with primary care.

Delivery System | Healthcare Provider Pain Points

Hold on to your hats. The delivery system as we know it is going through dramatic changes. In the past, providers were paid almost entirely on a fee-for-service basis. The mindset was the more volume and quantity we generate, the more we will earn. Not so anymore. The delivery system is changing emphasis  to quality and value. Along the way, new delivery systems are emerging such as bundled payments and ACOs. Changing the mindset and culture of an organization is no easy task. To add insult to injury, the traditional fee-for-service is still in effect. So, it becomes a balancing act for the time being. Focusing on both quantity and quality will bring in the most revenue during the transition period.

Cost Containment | Healthcare Provider Pain Points

Cost containment has always been an issue, but has become even more so recently – in part due to the ACA. Healthcare costs are increasing in leaps and bounds. Providers are faced with searching for lower cost alternatives, finding more efficient processes, reducing staff, and as mentioned above, shifting to new delivery systems. Some of the areas providers are concentrating on are claim denials, medication management, and efficiency in the emergency rooms.  All of these initiatives provide challenges to the provider.

Quality | Healthcare Provider Pain Points

As referenced above, quality and value have become the new buzzwords. The difficult part is coming up with standardized definitions for these. They are relative in nature. The bottom line is providing healthcare that is seen in the eyes of the patients as providing quality and value. HHS and CMS have been working on quality initiatives such as HCAHPS and AHRQ. Part of the confusion arises in capturing and reporting on these required quality measures to many different regulatory bodies. Some of the metrics are similar across the different platforms while others are completely different.

What healthcare provider pain points are you experiencing? We would love to hear your thoughts and comments.

BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services  including healthcare transformation assistance, strategic planning and organizational analysis, accreditation consulting, healthcare financial analysis, physician advisor/peer review, and organizational development. Contact Us :, 1-888-831-1171