#USA #Boca Raton #Knowtion Health #HFA #Payer Denial

New Insights on Hospital Financial Health

A recent study conducted by Knowtion Health in collaboration with the Healthcare Financial Management Association (HFMA) reveals alarming trends in hospital revenue cycles, particularly regarding payer denials. This report, titled Keeping Pace with Payers: Hospital Survival Strategies for a Shifting Reimbursement Landscape, presents findings based on a comprehensive survey of 147 revenue cycle leaders from various healthcare organizations across the nation.

The study indicates that nearly half of these leaders view payer denials as the most significant threat to their financial viability. This marks a critical turning point for hospitals, elevating what was once considered a back-office issue into a pressing concern at the forefront of financial strategy. Jayson Yardley, CEO of Knowtion Health, emphasized the need for hospitals to rethink traditional denial management strategies. “The old ways of managing denials simply aren’t sustainable anymore,” he stated.

Key Findings

Several striking statistics emerged from this report:

• - Denial Volume Surpassing Other Revenue Threats: A staggering 48% of leaders reported that the volume of payer denials exceeds other financial threats, such as declining reimbursement rates and labor shortages.
• - Increased Appeal Delays: Statistics show that appeals are now taking significantly longer, with 47% of respondents noting that the timeframe for appeals has more than doubled in the last three years.
• - Information Overload: Nearly half (50%) of the respondents indicated that they have experienced a drastic increase in requests for information from payers, complicating their ability to effectively manage billing and collections.
• - Operational Challenges: The survey revealed that 38% of leaders struggle to prioritize denials based on their potential revenue impact, underscoring the need for more strategic approaches in managing these challenges.
• - Staffing Difficulties: Hospitals are facing greater challenges in recruiting skilled workers for critical roles, such as appeal writing and denials analytics, further hindering their operational efficiency.

These findings suggest that hospitals must innovate their approaches to not only address the rising volume of denials but also to reclaim lost revenue effectively. Smart automation, rethinking processes around niche areas of funding, and adopting aggressive appeal strategies are imperative steps for hospitals looking to safeguard financial health.

A Call for Courage and Action

This moment calls for bold actions from revenue cycle leaders. As Yardley noted, it’s essential for healthcare organizations to abandon outdated processes and invest in the necessary tools and insights to adapt to the evolving landscape of payer behaviors. By doing so, hospitals can improve their chances of collecting properly reimbursable claims and preserving cash flow, particularly in this increasingly complex environment.

This comprehensive report is available for complimentary download on Knowtion Health’s official website, providing detailed insights that can help leadership teams strategize effectively in response to these emerging trends.

About Knowtion Health

Knowtion Health is recognized as a leading provider of technology-enabled revenue cycle management services. By leveraging AI technology and deep industry expertise, Knowtion aims to reduce denial rates and improve patient experience. The company is awarded for its rapid growth, indicating a commitment to the healthcare sector's evolving needs. For further information, visit Knowtion Health's website.