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Five Concerns for Hospital CEOs in 2015

Concerns for Hospital CEOs to Address 

As 2015 approaches, many C-suite executives are bracing themselves for financial changes in the coming year. And as healthcare continues to rapidly evolve, addressing these five major concerns will help healthcare systems large and small anticipate any curveballs that come their way.

Healthcare CEO Concerns

1. Decreased patient volume

It seems strange to think that in a system that just gained millions of new patients, the volume of care being provided would be on a downhill slope. However, as the quality of care continues to increase, the volume of individuals needing care is decreasing. Utilization and readmissions are down, thanks to preventative care and value based payment methods. In 2015, hospital CEOs need to plan for this decreased patient volume and find other areas to focus the revenue cycle on.

2. Health plans with high deductibles

Collections will be a challenge for health systems as more and more patients take on high deductible plans with greater cost-sharing. Communicating payment responsibility early on in the continuum of care and keeping on top of payments will help manage this concern, but it will still be a pressing issue. Some healthcare providers are instituting pre-service centers that educate patients about what to expect and their financial responsibilities.

3. Credit Ratings

With more and more hospital mergers, some of these organizational changes are creating negative credit ratings. Others are preparing for value-based purchasing, with also creates a flux in credit ratings. And for some, the downgrades are not just a single level–they’re multiple.

4. Payer Mix

Medicaid expansion raises many questions about payment methods in 2015. Cuts to the Disproportionate Hospital Share means uncertainty for healthcare systems and hospitals who have a large patient base with Medicaid cards. However, as more uninsured are transferred over to Medicaid, it also means many hospitals will finally have a way to be reimbursed for care provided. Focusing on denial reduction will also help boost their bottom line.

5. Continued EHR

Electronic health records continue to be costly and time consuming, but many providers are still struggling to use those tools to analyze the data they provide. Instead, they’re forever just trying to keep up. Tapping into that powerful resource and making efficiency improvements should be a major priority for hosptial CEOs in the coming year.

 

Bottom line

Revenue cycle improvement has to be on the radar of every hospital CEO–now more than ever. Whether it’s through assistance from an outside consulting firm, or via an internal group effort, without a spotlight on this area, many hospitals will suffer.

We want to hear from you: What concerns would you add to this list?

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15 Responses

  1. Concern #2-Health plans with high deductibles. In 2009 I was a Medicare Advantage Provider Services Representative in Las Vegas Nevada. The Valley Health System in Las Vegas, Nevada has a program called the Senior Advantage Program for 55+ consumers. This program waives the Medicare Part A deductible (I think it also included coins) There was a $100 or less lifetime enrollment fee associated with this program; I purchased this program for 3 seniors that I knew. Just think if there was a program similar to this that waived the inpatient plan $1,000+ deductible. The hospital would charge a $250 admission fee instead.

    1. Admissions would increase not because there are more people needing hospitalization, but because consumers would choose to be admitted to the facility with the $250 admission fee over the $1,000+ plan deductible.

    2. A hospital is more likely to collect a $250 admission fee prior to or during the admission process than a $1,000+ deductible that could take 24+ months to collect.

    3. The program enrollment fee and $250 deductible is revenue.

    4. Every consumer that joins the program will not be hospitalized, this program provides consumers a sense of security incase they do need to be hospitalized.

    The revenue cycle flow would improve, there would be a reduction of write-offs and a reduction in revenue cycle time