Hospital-at-home programs, RSV, and Medicare reimbursement rates are just a few key trends that are taking the healthcare industry by storm. Here are a few predictions for 2023 as well as some solutions.
Declining revenues and increasing expenses continue to stress health systems across the country. Many hospitals face insurmountable financial losses and negative operating margins.
According to Forrester, hospital, and health system, expenses are expected to increase by nearly $135 billion in 2023. On top of that, hospitals face substantial financial stressors, including increased labor costs, staffing shortages, and inflationary pressures. Forrester also highlighted that more than 30% of all rural hospitals are at current risk of shutting down due to a low financial pool.
In a September 16th article published in Fierce Healthcare, Mike Slubowski, President and CEO of 88-hospital Trinity Health reported that his organization has nearly 3,900 unfilled Registered Nurse positions and a 14% clinical support staff vacancy rate. The staff shortages "are like nothing we've ever seen before," he said, and have forced Trinity to take 12% of its beds, 5% of its operating rooms, and 13% of its emergency departments are offline.
The solutions aren't simple. Systems will be asked to provide as much care - if not more - with less revenue and fewer staff. Health systems must do more with less.
The answers require realignment around a cohesive strategy where cost-cutting and revenue-generating initiatives, large and small, require focused precision. Edgility's Revenue Enhancement and Cost Reduction (EdgeRECR) brings scalpel-like precision to operations. From system-wide care variation reduction, and redeployment of staff, to managing patient volumes, EdgeRECR brings a systemic approach to realizing short-term and long-term realignment goals. This brings us to our next trend of 2023.
Improve value in Medicare
Medicare pays for millions of patients’ care and influences providers’ business and clinical decisions. Medicare reimbursement rates refer to the amount of money that Medicare pays to doctors and other healthcare providers when they provide medical services to a Medicare beneficiary. Below are a few of the complex operating challenges and cost increases witnessed in the past year.
1. The first quarter of 2022 marked the most demanding performance period for U.S. not-for-profit hospitals and health systems.
2. High labor expenses are causing sustained operational hurdles and demands on cash flow combined.
3. Weaker investment market returns could reduce financial flexibility through the remainder of 2022 and into 2023.
4. Patients with limited coverage will use fewer healthcare services, reducing volume and price.
5. Employers may find it more palatable to cut back, knowing safety nets are in place, Less generous benefits could also depress utilization and revenue per case.
Institutional financial well-being depends substantially on market-level factors. The need for realignment around cohesive strategy is real and urgent. Health Systems are looking to be strategic in their cost-restructuring efforts. RECR, through a Smart Operations platform, provides just such an opportunity.
For example, EdgilityRECR was able to identify the level of care mismatches and orchestrated the ‘levers of action’ to realize a total of $1.23 million in savings in telemetry at a Cleveland-based Health System in just 12 months.
Care at Home is on the rise
Healthcare providers are rethinking models of care where they can safely deliver to patients in their homes. Today, Hospital at Home is an offering. Tomorrow, patients will expect it. This new and growing market has not gone unnoticed. Over the past year, companies including retailers like Amazon—have spent billions to stake a claim in the home healthcare market.
For health systems, Hospital-at-Home programs can be a blessing. Receiving care at home improves clinical outcomes, reduces recovery times, and increases patient and provider satisfaction. But safely relocating care from traditional brick-and-mortar facilities to a patient's home is no easy task. The mere job of identifying patients who will respond well at home is an overwhelming hurdle.
Edgility's Hospital at Home module identifies patients in real-time, taking into account constant status changes, socio-economic factors, and insurance parameters - constantly sifting through hundreds or thousands of patients. This job required multiple nurses in a slow-painstaking process - a luxury health system cannot afford.
Edgility's Hospital at Home platform helps orchestrate University Hospitals' (UH) Cleveland Hospital-at-Home program. Through this program, UH freed up 996 hospital bed days.
"This program allows us to reimagine hospital-type care at home and innovate future care delivery models with (Edgility's) technology, said Melissa Cole, Vice President of Integrated Delivery Operations at University Hospitals, Cleveland.
Due in part to vaccine burnout, flu vaccination rates are down, Covid-19 viruses continue to mutate and affect non-vaccinated patients, and sequestering populations, particularly children, have reduced natural immunity to otherwise manageable viruses.
The "tripledemic" of influenza, COVID-19, and respiratory syncytial virus (RSV) infections are overwhelming many pediatric hospitals. Physicians and healthcare leaders have likened the current situation at Children's hospitals to the early days of the COVID-19 pandemic.
Brian Peters, CEO of the Michigan Health and Hospital Association made that comparison in the CEO report.
"In short, it feels like déjà vu in Michigan's children's hospitals, but instead of a surge of COVID-19 patients stressing capacity to the limits, our facilities are strained by a high number of pediatric patients suffering from respiratory illnesses largely driven by RSV," Peters wrote. "Similar tactics that have been implemented in prior years, such as initiating incident command systems, have been in operation to ensure appropriate direction and communication is occurring throughout those systems impacted by this crisis."
Edgility has responded to this alarming concern by developing a Pediatric Lens. Edgility-powered Smart Operations Centers use our Pediatric Lens to orchestrate pediatric care plans by bringing real-time visibility into the critical components of care.
"As we respond to this unprecedented surge in critically ill children, the Edgility Pediatric Lens is an exceptional instrument for identifying patient conditions and appropriate levels of care," said Dr. Steven L. Shein, Chief of Pediatric Critical Care Medicine and the Linsalata Family Chair in Pediatric Critical Care and Emergency Medicine at UH Rainbow Babies and Children's Hospital, Cleveland.
According to Forbes, in 2023, we will see wearable medical devices acting as "edge" devices. These devices will be equipped with processors and capable of utilizing in-device analytics. This has two main benefits: The first is privacy, as sensitive patient personal data never has to leave the device. Secondly, there is speed – which is critical in the case of devices designed to detect and warn of potentially life-threatening conditions. At Edgility, we intentionally designed our platform to function as an OS for healthcare operations. The Edge Cognitive Platform (ECP) is, in part, a workflow engine designed for speed - ingesting - and displaying - data in real time.
Until recently, medical devices relied on hard-wired interlocks, trained personnel, or "air-gapped" installations to prevent intentional or unintentional misuse that might harm patients. Today, Edgility’s AI increases patient safety by monitoring inputs and identifying irregularities in medical devices.
To learn more about how Edgility is planning for 2023 check out the rest of our website.