Becker's Hospital Review

135 Executive Briefing Sponsored by: I n recent years, hospitals and health systems in the United States have largely been focused on three fundamental pillars: improving patient access, making care more affordable and enhancing quality. The COVID-19 pandemic has underscored the need to achieve these three aims and exacerbated existing financial challenges experienced by health systems around the nation. Becker's Hospital Review recently spoke with Matt Hawkins, CEO of Waystar, about the outlook for healthcare organizations as winter approaches. Many worry that pockets of the country that have already seen declines in COVID-19 cases may experience latent surges of the virus this fall and winter. The good news is that technological innovations can help healthcare organizations deliver services safely, as well as streamline billing and reimbursement processes. Now is the time to embrace modern billing and telehealth solutions As the pandemic gained momentum in the United States, demand for elective health procedures and preventive care plummeted. This contributed to significant revenue losses for health systems. At the same time, administrators were grappling with rising costs for personal protective equipment as providers turned their attention to treating patients infected with the novel coronavirus. Additionally, during the first few weeks of the pandemic, payers struggled to update billing codes and policies. This prolonged the reimbursement cycle, creating additional financial concerns for health systems. Although payers have now published reimbursement codes, the financial effects of the pandemic can still be felt across the healthcare industry. A recent survey by the American Hospital Administration suggests that around half of all U.S. hospitals are now in the red financially and many will operate at a loss in the second half of 2020. Waystar works with over 800 hospitals and health systems nationwide. At those organizations, reimbursement is top of mind for healthcare executives. Organizations using up-to-date technology systems have fared the best. "Providers that have embraced the new billing codes, updated billing software and new approaches to care, like telehealth, have tended to weather the storm better than those that did not," Mr. Hawkins said. "Those providers were reimbursed more quickly. We've seen time and time again that organizations who adopt and use modern technology tend to adapt more easily to a shifting environment." In fact, claims for telehealth visits on the Waystar platform have been reimbursed 40% faster—and COVID-19- related claims 37% faster—on average, than other claims. These claims are largely clean, with 98.99% of telehealth claims and 97.92% of COVID claims being free of errors and rejections. Moving forward, it will benefit all healthcare organizations to evaluate their billing software and integrate telehealth into their care delivery strategy. The pandemic presents healthcare organizations with valuable improvement opportunities Acknowledging the many losses associated with COVID-19, this is an important time in the healthcare sector. Although the environment is challenging, it offers healthcare organizations the chance to update payment processes, improve the patient financial experience and take the next step toward modernizing healthcare. "There are some silver linings to be found in our current situation," Mr. Hawkins said. "We have the opportunity to create more effective interactions between providers and patients. Imagine a world where a patient can access preventive and other important health services via a telehealth visit. Whether pre-visit or immediately post- visit, patients can understand price for the healthcare service, insurance eligibility and coverage, and payment responsibility. Modern technology, like Waystar's, makes simplifying healthcare payments a reality. We believe a re-imagined healthcare payment experience is good for patients, providers and payers." Health systems and providers may also want to use this time to prepare for the inevitable demographic shifts occurring in the United States. As the American population ages, CMS has become the largest healthcare payer in the country. By 2030, experts predict there will be more than 80 million Americans on Medicare. From a reimbursement perspective, providers must be prepared to work with Medicare as a major payer, as well as with commercial payers. To do this in an efficient Don't let a crisis go to waste — Insights on modernizing critical technology platforms in preparation for future COVID-19 surges

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