Critical access hospitals fill a much-needed care gap for rural communities in America. They serve an estimated 18% of the US population. While Congress created the CAH designation to assist in the budgetary challenges of operating these critical care facilities, establishing improved reimbursement programs and resource grants, there are still a variety of challenges unique to these models.
1. Staff Training
The combination of limited resources and a limited candidate pool means that comprehensive training is essential. Support staff often cover a variety of areas that may be delineated more distinctly in organizations with a larger employee pool. Wearing many hats means they must be proficient at many things, which, without proper training, can leave serious gaps in critical parts of operations. These gaps can be costly, perpetuating the cycle. Failures in patient access and onboarding, for example, can directly impact the revenue cycle.
2. Medicare Tunnel Vision
Since the majority of the CAH benefits are tied to Medicare, and maintaining the required status for the Centers of Medicare and Medicaid conditions of participation, it is easy to hyper-focus on Medicare and neglect other payers. Leveraging commercial payers can greatly impact the health of the hospital’s revenue cycle. Commercial billing for secondary coverage is another area that plays a major role but is often neglected. Failing to recognize how a broader payment mix can help cover the cost is likely directly tied to the fact that approximately 40% of these organizations operate at a loss.
3. Patient Experience
CAHs, especially those that are not a part of a larger health system, lack access, and resources to create a good patient experience. Patient-centric technologies, which can also lighten the load for internal resources when it comes to scheduling and billing, are often out of reach. This lack of convenient options combined with an overburdened staff that cannot properly provide a personalized experience to every patient diminishes the quality of care experience. This is perhaps the most detrimental to hospitals in this position as they are built on repeat business from their patient community.
We understand the complexities of revenue cycle management for Critical Access Hospitals and the importance of maximizing resources so you can focus on your patient community. Both of our service lines Professional Credit collections and Ensource self-pay early out services include dedicated patient technologies that provide transparency and a better billing experience. Also, in an effort to assist our clients in these special positions, we have a strategic Revenue Cycle Consulting Program that assesses each level of operations to identify the areas of greatest need and help you prioritize improvements based on time, cost, and ROI.
Contact Professional today to schedule a complimentary consultation.
