Streamlined UM: How new tech is driving efficiency + cost savings at major health systems
Sponsored by
Optum
November 27, 2023
As health systems confront inflation and labor shortages, efficient and accurate utilization management processes are paramount. In this on-demand webinar, you’ll see a case-based demo and learn how some prominent health systems are using the InterQual® AutoReview technology to streamline their UM processes.
You'll hear:
How artificial intelligence applied to EHR data can create and populate medical reviews
The ways hospitals nationwide are leveraging medical review automation to gain much-needed efficiencies
Lessons learned from UM transformation journeys of early adopters
We live in a world of instant access and gratification. For healthcare, that means patients are demanding timelier care.
In particular, self-rooming, a new way to bypass the waiting room, has gained popularity in 86% of patients. But outpatient clinics struggle to optimize their workflow for this patient-centric approach. They don’t have the staff, space or resources to keep up with demand.
Fortunately, advanced technology, greater connectivity and the push to create a more patient-centered experience have created a myriad of valuable data that is fueling workflow designs and the evolution of care delivery.
This white paper, Workflow Design Trends: Transformations Fueled by Technology, highlights workflow trends that use real-time locating system (RTLS) technology to impact the health of your organization.
From self-rooming to dynamic room assignments, these emerging workflow approaches are gaining traction in ambulatory care and redefining how care teams work—turning them into highly efficient and patient-centric care areas.
When budgets are tight, leaders need to be strategic when investing in technology. Because cost efficiency is so important, healthcare systems and hospitals alike need to get a lot of bang for their buck when considering technology - ROI is always key.
Nicole Clawson, VP of Finance and Revenue Cycle at Pennsylvania Mountains Healthcare Alliance (PMHA), feels these same pressures at her health system - a collaborative network of independent community hospitals located primarily in Western and Central Pennsylvania.
Read the exclusive HealthLeaders Revenue Cycle Technology Week eBook to hear Clawson detail the health system's quest to secure more revenue, reduce denials, and support better outcomes.
This report, based on a survey of 200 healthcare employees responsible for staffing the revenue cycle function at healthcare providers, examined the long-standing, chronic shortage of non-clinical staff within the healthcare vertical and its impact on the revenue cycle and patient engagement.
Preparing claims correctly and modifying and resubmitting claims in the case of denials require a significant amount of time. Staffing shortages are leaving this work to be managed by fewer individuals, resulting in reduced productivity and increased risk of errors – and revenue loss.
Similarly, in most provider operations, patient intake suffers significantly from staffing shortages, affecting both employees and the patients they serve, leading to negative reputational impacts and compromised performance in patient collections.
The situation was concerning prior to the pandemic; it is now unsustainable for a significant number of providers, particularly as this report shows the most common ways to address the issue rely on increased labor costs. Turnover, hiring, and training staff are constant for these organizations, without an end in sight.
Sample findings:
100% of respondents indicated that staffing shortages have impacted revenue cycle management and/or patient engagement efforts.
96% of respondents indicated that payer reimbursements, patient collections - or both -- were impacted by staff shortages.
More than 8 out of 10 respondents say the patient experience is worse due to staffing shortages.
92% of respondents say new staff members make errors that negatively affect claims.
Healthcare organizations have struggled to address staff turnover, vacancies and the overreliance on agencies for the past three years.
This white paper outlines how one of the top academic medical centers in the nation used innovative enterprise workforce management approaches to address these challenges, including establishing an internal agency pool. See how the organization optimized its use of external agencies and travelers while achieving an 86 percent registered nurse fill rate consistently over the course of 2022.