Becker's Hospital Review

24 CFO / FINANCE One-third of US hospitals' average denial rates are in 'danger zone,' survey finds By Katie Adams T hirty-three percent of hospital execu- tives said their organization's average rate of insurance claims that are de- nied is in the "danger zone," meaning it is more than 10 percent, according to survey results released June 1 by consulting firm Harmony Healthcare. e firm surveyed 131 hospital executives via LinkedIn between April 27 and May 20. e survey's findings on American hospi- tals' average denial rates: 1. irty-three percent of hospital execu- tives said their average denial rates were more than 10 percent. 2. Sixteen percent of hospital executives said their average denial rates were between 8 percent and 10 percent. 3. Twenty percent of hospital executives said their average denial rates were between 5 percent and 7 percent. 4. irty-one percent of hospital executives said their average denial rates were less than 5 percent. Four top concerns hospital executives have regarding denials, followed by the percent- age of respondents who listed them as their top concern: 1. Coding (32 percent) 2. Medical necessity for acute inpatient stays (30 percent) 3. Front-end processes (20 percent) 4. Clinical validation denials (18 percent) n Physician wealth & debt: 6 takeaways By Kelly Gooch T he average primary care physician's salary amounts to $242,000, while specialty physicians make an average $102,000 more annually, according to a June 11 report from Medscape. For the report, researchers examined survey responses of 17,903 physicians in more than 29 specialties between Oct. 6, 2020, and Feb. 11, regarding physician wealth and debt. Five more takeaways from the report: 1. Forty-four percent of physicians reported a net worth of less than $1 million, compared to 50 percent in Medscape's report last year. 2. The highest percentages of physicians with net worth under $500,000 were in family medicine, internal medicine and pediatrics. 3. Fifteen percent of physicians said they had a financial loss last year because of business problems, changes in practice situation, or reimbursement chang- es, and 5 percent said they had a financial loss because of a job loss (either themselves or their spouse/partner). 4. Sixty-four percent of physicians said they are paying off the mortgage on their primary residence; 37 percent said they are paying off car loan payments; and 25 percent said they are paying off their college or medical school loans. 5. Five percent of physicians said they live above their means, and 47 percent said they live within their means. n 1 in 3 Americans skip care due to cost concerns, survey shows By Katie Adams C ost was a bigger factor driving Americans to skip recommend- ed healthcare than fear of contracting COVID-19, according to a report released June 1 by Patientco, a revenue cycle management com- pany focusing on patient payment technology. Patientco surveyed 3,116 patients and 46 healthcare providers, finding 34 per- cent of female patients and 30 percent of male patients have avoided care in the past year citing concerns about out-of-pocket costs. Three more notable findings from the report: 1. Healthcare affordability is not an issue that affects only Americans with low in- comes, as 85 percent of patients with household incomes greater than $175,000 are less likely to defer care when flexible payment options are offered. 2. Across all ages, income levels and education levels, most patients said they struggled to understand their medical bills and what they owed. Nearly two- thirds of patients said they did not understand their explanation of benefits, did not know what they should do with the information in their explanation of benefits, or waited too long to obtain their explanation of benefits. 3. Forty-five percent of patients said they would need financial assistance for medical bills that exceed $500, and 66 percent of patients said the same for medical bills that exceed $1,000. n

• Cover