Karen Fitzsimmons
Assurance Principal: Healthcare Industry Co-Leader, BDO USA
Patient Access & Experience
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Patients are responsible for navigating their own care and bridging the gap between different providers and sites of care. Care coordination is especially challenging for patients trying to navigate large institutions. As a result, patients often experience disruptions in their care, which can lead to diminished health outcomes.
Relationships between patients and providers continue to weaken as demand for care outpaces the availability of clinicians. In particular, the primary care relationship has suffered significantly, with patients increasingly reporting they have no primary care physician.
While many healthcare organisations have deployed patient portals, these platforms are rarely used to their full capabilities. Explore ways to enhance your patient portal’s function — for example, by implementing automated scheduling — to reduce the strain on providers and give patients more control over their care.
Site-of-care transitions can lower the cost of care while maintaining or even improving the quality of care. Evaluate the capacity and services of the facilities in your network to determine which services should be shifted outside of your facilities into community settings and how to best invest in these facilities.
Explore ways to offer support to patients and care coordinators in navigating care. Review existing technology and infrastructure to identify ways to improve the referral process and maintain continuity of care.
While inflation has cooled slightly, costs and expenses remain high, and reimbursements have decreased. Underperforming hospitals are costing taxpayers money. In some cases, state healthcare institutions are being pressured to take on underperforming hospitals to keep them afloat, which means taxpayers will ultimately be financially responsible for these organisations.
As financial pressures and the need to deliver high-quality patient care push providers away from fee-for-service models, value-based care (VBC) is growing in popularity. Providers who have yet to make the shift to VBC will likely need to in the near future.
Healthcare organisations can likely take advantage of new credits offered such as credits related to sustainability. These credits may be of particular interest to organisations engaging in clean energy projects.
Develop an understanding of where it makes sense to continue investing and where to divest by assessing the profitability and outlook of service lines. Understanding the needs of the patient population is crucial to avoid divesting from critical services
Explore ways to apply technology to revenue cycle management. For example, automated billing can help streamline and improve revenue capture, while offering more cost-efficient staff models.
Continued supply chain disruptions and their impact on patient care have shown that supply chain management in healthcare is still insufficient. Supply chains are especially vulnerable to unpredictable events like natural disasters, as there is limited opportunity to prepare for them. Other large-scale events, like geopolitical conflict, can be more predictable but still exert pressures on supply availability and cost.
High costs and inflation combined with lower reimbursement continue to cause margins to decline, which can impact an organisation’s ability to fund critical investments.
Certain drugs — especially rare drugs — are in short supply, causing issues for vulnerable patient populations. The problem may be exacerbated by inefficient drug distribution, for example, drugs being prescribed to patients without a medical need for them.
While most healthcare organisations have already deployed basic cost-saving measures, additional cost containment tactics have yet to be explored. These tactics include considering alternate energy sources, testing new waste disposal management tactics.
Some financially strapped or small organisations, such as rural or standalone hospitals, may not have sufficient in-house resources to support all necessary supply chain infrastructure. Rather than hiring full-time staff, consider a co-sourcing arrangement for functions like purchasing.
Augmenting the knowledge of front-line staff with the analytical capabilities of technology can help organisations better understand supply trends, predict shortages, and forecast demand. These insights can also guide purchasing and vendor decisions.
Relying too much on artificial intelligence (AI) to inform decision-making can lead to suboptimal decisions, particularly if the underlying data informing the AI algorithm is of poor quality.
Poorly integrated EHR systems can make it difficult for clinicians to do their jobs by adding to their administrative burden, worsening burnout and turnover rates.
Many healthcare organisations are paying for numerous tools and applications that have the same or overlapping capabilities, which can create confusion and frustration.
As adoption of AI and other advanced technology increases, many healthcare organisations have discovered their current methods of structuring and managing data are insufficient to support new technology. As a result, these legacy technologies perform poorly and make it difficult for healthcare organisations to accomplish key goals and meet new reporting requirements.
Cyber attackers continue to take advantage of healthcare organisations’ cyber vulnerabilities to steal patient data and disrupt care in order to secure hefty ransom payments. In addition, cyber attackers are leveraging AI to sophisticate their attacks, making them even harder to prevent, detect, and combat.
Automation and AI can help lower costs by automating manual tasks, streamlining workflows, and mitigating resource waste. AI can also help offer data and insights that organisations can use to secure better outcomes when renegotiating vendor contracts, seeking new vendors, rationalising service lines, and more.
Integrating existing technology and retiring redundant tools allows healthcare organisations to create true interoperability and increase cost savings — which can then be reinvested in the organisation.
Patient demand for self-service capabilities has increased dramatically. To satisfy patient expectations and offer more accessible, streamlined service, providers need to increase their use of both adoption and self-service applications.
While most healthcare organisations have started investing in AI and analytics, many aren’t using them to their full potential. Explore new use cases like predictive staffing and diagnostic capabilities to get the most out of your investments.
Integrate virtual and in-person care and explore ways to dispense more care during in-person visits to reduce the need for return visits. Make greater use of advanced practice providers (APPs), medical assistants, and other ancillary providers.
With older doctors and nurses retiring and fewer entrants into medical school, most OECD countries are facing a serious clinician shortage. At the same time, the overall population continues to age and require more care for chronic conditions.
After several years of deferring care, patients are back to seeking care, causing volumes to far outpace expectations. The years of deferred care have also resulted in greater patient acuity, further straining existing resources.
BDO’s 2023 Clinician Experience Survey found that 61% of healthcare leaders cite burnout as their top clinician morale challenge. Heavy workloads and poorly integrated technology make clinicians’ jobs increasingly difficult.
AI has the power to support and streamline multiple critical functions within healthcare organisations, including clinical, staffing, finance & accounting, revenue cycle, and more. Consider where AI can automate administrative tasks driving burnout, expand the capacity of clinical staff, and increase patient throughput.
Consider partnering with medical schools to create feeder programs to grow your talent pipeline. These programs should cater to more than just clinicians and should also target pipeline development for ancillary providers like physician assistants.
Involve your staff in discussions about their working environment and needs to discover what solutions will improve their quality of life and work-life balance. Discussing these decisions can help staff feel more engaged and in control of their working environment and unlock actionable solutions, which can help reduce burnout and turnover while increasing productivity.
High malpractice premiums make it difficult to service needs because the risk is so high. Certain organisations may remove some service offerings in response, potentially leading to care gaps in the surrounding communities.
While there is currently no comprehensive regulation around AI, countries and states continue to roll out their own AI rules and enforcement mechanisms. Healthcare organisations will need to become familiar with all applicable local regulations.
Organisations that fail to comply with pricing transparency regulations could be subject to expensive fines — an added financial burden that many organisations can’t afford.
Robust documentation is necessary to fulfil reporting requirements and secure incentives. Consider ways to improve and centralise your documentation for ease of use and what internal controls should be implemented to support these practices.
To account for regulatory uncertainty and trailing reimbursement rates, healthcare organisations should budget for their worst-case scenarios. This approach provides built-in protection regardless of the outcome of regulatory questions and changes to reimbursement rates.
Karen Fitzsimmons
Johannes Hohenauer
Frank van der Lee