A Look at Medical Billing Profits in 2021. Who Earned & Who Suffered?

The healthcare business is continuously changing. How hospitals and health systems respond to these changes can make all the difference in their ability to maintain a healthy bottom line and continue serving their communities.

The factors that will drive revenue cycle market momentum in 2022 and beyond are technology, investments, efficiency, patient experience, underpayment recovery, and coding automation.

We are witnessing a new surge of consolidation, inventiveness, and innovation following a lengthy period of struggle due to COVID-19 and an already challenging economic situation for hospitals and healthcare organizations.

Here are some critical medical billing statistics – 

• 75% of patients are searching up the cost of medical treatments online.
• 62% of patients said knowing their out-of-pocket expenditures beforehand of service impacts the possibility of pursuing care.
• 49% of patients said having accurate information on expected out-of-pocket costs before receiving treatment affects their decision to use a healthcare provider.

According to a new study, patients’ average out-of-pocket expenses increased by 11% in 2017, advancing from $1,630 in 2016 to $1,813 in 2017. The analysis also showed that in 2017, on average, 49% of patient out-of-pocket expenses per healthcare consultation were below $500, 39% were $501-$1,000, and 12% were more than $1,000. In addition, the entire hospital revenue of patient financial responsibility after insurance rose 88 percent between 2012 and 2017.

• 69% have a budget process that takes over three months from initial implementation to board presentation (the methodology takes more than six months for 9% of these institutions)
• 41% use rolling forecasts to supplement or to substitute an annual financial plan (31% have plans to implement rolling forecasts)
• 50%+ CFOs want access to more straightforward report creation, better dashboards and visuals, and enhanced ability to delve into reports to understand innate details (2/3 struggle to pull data from multiple resources).

If you have an in-house medical billing team or are looking for help in a specific area of expertise, we at 24/7 Medical Billing Services are here to assist you. We recognize the hectic schedules of medical professionals and services, which is why we are committed to taking on duties to assist you in maintaining a healthy work-life balance.

COVID-19 pandemic has altered the dynamics of the healthcare industry; here are some highlights of who is profiting and who is losing on margins:

Omnichannel payments are impacting healthcare.

• 68% of consumers prefer electronic payment methods to pay their medical bills
• 80% of consumers prefer online payment channels to pay their health plan premiums
• 20% of online healthcare payments are made on a mobile device 

Healthcare data is under attack.

• 2016 saw more healthcare data violations and breaches than any other year on record
• 90% of providers report that payment security is critical when collecting patient payments
• 59% of consumers have significant concerns regarding the security of making payments for both their medical bills and health plan premiums

Consumers are demanding more from healthcare.

• 92% of consumers want to know payment responsibility before a provider visit
• 74% of consumers are confused by EOBs and medical bills
• 73% of providers report that it takes one month or longer to collect from patients

Let’s look at 2021 profit earners who benefited from the pandemic and earned the top spot in the latest trends – 

According to forecasts, the medical billing outsourcing market will reach almost $16.9 billion in 2021. As a result, many significant business groupings, including healthcare software businesses and other companies that service the healthcare industry somehow, are invited to participate in the multibillion-dollar merger. Regardless, many organizations adopt an offshore business strategy through captive centers or partnerships, either directly or indirectly.

Most healthcare professionals are willing to outsource their revenue cycle management services because of the ability to maintain and circumvent changes in healthcare revenue payment regulations and the ability to hire and train office staff; compliance issues, in addition to operational factors, are too risky.

There will be an increase or growth in regulatory compliance as patient responsibility increases. Therefore, medical billing businesses should take on the task of acquiring the ability to detect and remedy revenue leakage.

It generates and gives the optimum performance ecology using KPI, essential in revenue cycle management. Medical billing trends for 2021 aim to build a strong path for revenue reimbursements while also encouraging collections service.

Let’s take a look at the processes that suffered in 2021 –

By the end of 2021, according to Kaufman Hall, hospital operating margins will have fallen by 80% from pre-pandemic levels. With hospitals operating on razor-thin margins, forecasting cash flow and the ability to maximize revenue cycle efficiency is more important than ever. As revenue cycle executives and managers strive to improve business outcomes, key technological and process innovation will be driven.

Finally, Some Key Takeaways:

• Reduced patient appointments and walk-ins due to apprehensions of catching COVID-19 in the waiting room cause lower patient service revenue in medical practices.
• It makes sense to outsource medical billing services to a third party if you compute a higher flow of revenue by leaving the task to experts.
• While it can cost more for Revenue Cycle Management Outsourcing than for the work in-house, the more increased success rates on insurance claims offset the higher fees.
• Healthcare organizations can concentrate on their core competencies to deliver high-quality healthcare by taking their billing functions beyond the office to third parties.

The conclusion regarding whether to outsource your healthcare billing services to a third party deserves careful consideration.

Read more : Medical Billing Services In 2022 – Changes To Expect