The Soaring Cost of Healthcare & What Providers Can Do
Healthcare is essential and can define your life and the quality thereof. However, the cost of healthcare is at an unprecedented high and continues to skyrocket. While the healthcare industry brings in large amounts of profits, it’s the massive sums of healthcare dollars spent every year that raise eyebrows.
How come healthcare expenditures continue to rise, forcing physicians to invest more of their hard-earned money back into their medical offices?
The truth is, many of our healthcare processes lack efficiency and solely focus on addressing pressing needs, right now. While trying something new can be utterly time-consuming and strain your already limited staff and energy, you can reap great benefits down the road.
From implementing highly effective workflows, automating processes, and shifting to novel tools and technological applications, planting the seeds now can lead to growth later because ironing out kinks in our healthcare system and addressing inefficiencies can not just help your staff but also reduce the cost of healthcare.
Let’s find out how.
Healthcare Growth & Profit
Healthcare profit pools are expected to grow to $790 billion in 2026 at a 4% compound annual growth rate (CAPR).¹ The growth will be more profound in certain areas of the healthcare sector, such as ambulatory surgery centers, specialty pharmacies, and applications paving the way for higher patient engagement and supporting clinical decisions.¹
According to the American Family Care Centers, significant growth can be observed in mental and behavioral health services, which are expected to grow by $40 billion by 2027, as well as home healthcare, projected to grow by 7.96% by 2030, in addition to remarkable growth in retail pharmacies and urgent care facilities.²³
The Cost of Healthcare: What Are We Spending Our Healthcare Dollars On?
While pandemic-related government expenditures have ceased, the cost of healthcare is soaring. According to the Commonwealth Fund, healthcare spending rose from 8.2% in the 1980s to 17.8% in 2021.⁴ National health expenditures are further expected to increase from $4.4 trillion in 2022 to $7.2 trillion in 2031.⁵
With the healthcare industry consuming chunks of our GDP (gross domestic product), where does all this money go?
The American healthcare system certainly holds a unique foothold in the healthcare landscape, spending over 31% of the total healthcare spending in 2021 on hospital care alone.⁶ Other dominating categories included physician services, other personal health care, prescription drugs, and clinical services.⁶
The leading cost of healthcare, hospital care, for example, constitutes any type of service rendered to patients within the hospital setting. This ranges from the cost of patient rooms to physician charges to in-house pharmacies, and home health services.
Hospital expenditures increased by 4.4% in 2021 and 5.6% for physician and clinical services respectively.⁷ The latter category comprises any services rendered by physicians and/or provided in a clinical setting, ranging from evaluations, anesthesia services, treatment planning, and screenings to chronic disease management.
In addition, healthcare costs continue to rise due to generally increasing prices for medical products and healthcare services, with social factors like population aging and the exponential population increase further raising costs.
Inefficiencies That Play Into Increasing Healthcare Costs
Some of the contributors leading to an increase in healthcare costs cannot easily be manipulated and require decision-makers to adopt effective planning strategies. However, some healthcare expenditures are a direct result of inefficiencies that lead staff to follow time-consuming policies and ineffective workflows and cause unnecessary repetition and tedious manual labor.
While implementing change can take time, a period of learning and trial-and-error can lead to an improved new path with innovation presenting significant solutions to existing issues.
Training staff can be tedious and time-consuming, and can further cause a reduction in patient-facing interactions — at first. Nonetheless, policy or strategy changes should be assessed for their end goal and the growth potential they can yield.
So what can YOU as a provider do?
Below are some common inefficiencies observed at healthcare organizations that might be unassuming but can increase the cost of healthcare.
Administrative Inefficiencies
Many primary care providers note a substantial administrative burden when handling everyday operations within their healthcare organization. From scheduling appointments and following up on patients to providing post-visit care, sending in prescription drugs, and handling lab reports.
Given the nature of the healthcare industry and the hectic workdays healthcare professionals face regularly, getting caught up in your tasks now can be easy. However, long-term strategic goals and revenue outcomes should be weighed in as well.
For instance, primary care practices reported that 30% of their medical appointments ended in no-shows,⁸ despite the time-consuming effort to speak with patients — in person or on the phone — to find a suitable time and date, potentially rescheduling a few times, before ultimately receiving a cancelation.
Appointment reminder software and policies for no-show patients can easily alleviate additional administrative burdens, all while maintaining better health outcomes and achieving financial goals.
Third-Party Interactions
The cost of healthcare can further be impacted by interactions with third parties that demand a lot of effort, time, and manpower. For healthcare providers, most such interactions include insurance vendors, pharmacies, and lab facilities — requiring not just additional staff but also countless hours that need to be invested in a labor-intensive back-and-forth with the provider’s office.
The vast majority of phone calls include requests about prior authorizations for prescription drugs and referrals to specialty providers, billing inquiries, as well as verifying eligibility requirements.⁸
Many practices report that training staff specifically on tasks that comprise insurance interactions helped address their workload more effectively, in particular, when the same staff members were dedicated to conducting such phone calls.
However, physicians also noted that investing in a reliable EHR was worthwhile as it supported the accurate coding and billing of medical services rendered.⁸
Manual and Repetitive Tasks
The epitome of inefficiencies that can suck your healthcare budget dry is made up of the thousands of little but tedious daily tasks that are still done by hand in many offices today. Unfortunately, the cost of healthcare can increase rapidly if this ineffective practice is maintained long-term.
From manually keying in blood glucose results instead of utilizing applications that can download the data to chasing medical records from other providers through countless faxes and emails to communicating ineffectively with your patients — such inefficiencies can strain your medical staff and decimate the time you urgently need for more important tasks.
The solution? To embrace innovation, particularly in the face of a high-tech world that is shifting to digital platforms steadily anyway. Automation and reliable technological tools are helping the healthcare system progress, provide higher-quality care, and improve workflows in the process, while alleviating the pressure your staff feels while tackling their daily workload.
Vivlio Health® Was Designed to Address Inefficiencies
At Vivlio Health we understand that the soaring cost of healthcare can have a profound impact on physicians and medical providers. The last thing your healthcare organization needs is for inefficiencies and redundant tasks to drain your time and money.
Vivlio Health was designed to address inefficient workflows head-on by providing clinicians with their patients’ complete medical history — quickly, securely, and without any hassle. It’s a cloud-based tool that can extract clinical records instantly and helps doctors provide better quality care to their patients.
It’s time to revise outdated office policies and update processes that no longer work. Your staff will thank you for more efficiency in the workplace.
Want to learn more about Vivlio Health and what we offer? Sign up for a free demo and let’s provide better more efficient care today.
References:
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“US healthcare developments in 2023 and beyond.” McKinsey, 9 January 2023, https://www.mckinsey.com/industries/healthcare/our-insights/what-to-expect-in-us-healthcare-in-2023-and-beyond. Accessed 3 December 2023.
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“The Hottest Healthcare Sectors for Investment: 2023.” American Family Care Franchise, https://afcfranchising.com/blog/the-hottest-healthcare-sectors-for-investment-2023/. Accessed 3 December 2023.
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“Home Healthcare Market Size, Share & Trends Report, 2030.” Grand View Research, https://www.grandviewresearch.com/industry-analysis/home-healthcare-industry. Accessed 3 December 2023.
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“U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes.” Commonwealth Fund, 31 January 2023, https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022. Accessed 6 December 2023.
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“Healthcare Spending Will be One-Fifth of the Economy within a Decade.” Peter G. Peterson Foundation, 27 July 2023, https://www.pgpf.org/blog/2023/07/healthcare-spending-will-be-one-fifth-of-the-economy-within-a-decade. Accessed 6 December 2023.
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“Trends in health care spending | Healthcare costs in the US | AMA.” American Medical Association, 20 March 2023, https://www.ama-assn.org/about/research/trends-health-care-spending. Accessed 6 December 2023.
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“NHE Fact Sheet.” CMS, 6 September 2023, https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet. Accessed 6 December 2023.
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“Inefficiency in Primary Care: Common Causes and Potential Solutions.” Katherine A. James et al., Fam Pract Manag. 2015;22(2):18-22, https://www.aafp.org/pubs/fpm/issues/2015/0300/p18.html. Accessed 7 December 2023.