4 Key Issues in US Healthcare That Leaders Must Address

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Healthcare service and delivery have improved tremendously over the course of the last few decades. Treatments for common ailments and diseases are now possible, life expectancy is continuously shooting upwards, and people have unprecedented access to a large amount of medical information.

But as the world progresses further into the 21st century, new challenges are springing up. On top of containing COVID-19, hospital managers, executives, and other healthcare leaders in the US already had their hands full on these 4 big issues.

Evolving regulations

Currently, the US is in the process of rolling back several parts of the Patient Protection and Affordable Care Act or ACA. Some changes include:

  • Individual mandate requirement – it compels all US residents to have health insurance or else pay a corresponding penalty. In 2017, the penalty was essentially removed.
  • Subsidies to insurers – Federal government’s payment to insurers encourage them to participate within the ACA. However, since 2017 the subsidies have stopped.

Constantly adjusting to changes to the ACA or changes introduced by new policies are a burden to management and staff across the healthcare industry.

Hospitals, clinics, private practices, or any other health facility, must comply with shifting reporting requirements in a number of regulatory areas (e.g. Health Insurance Portability and Accountability Act, Centers for Medicare and Medicaid Services, Joint Commission on Accreditation of Healthcare Organizations).

To be successful, healthcare organizations must engage relevant partners and share information seamlessly.  Additionally, integrating new technologies like electronic medical records and medical management software can eliminate tedious processes in documentation and auditing.

Rising costs

Experts have been forecasting increased healthcare spending, which will grow at an annual rate of 5.8 percent from 2015 to 2025. And by 2028, total healthcare costs in the US could reach over $6 trillion.

Combined with the increase in cost brought about by regulatory changes, this will exert tremendous pressure on both consumers and health providers.

While this is nothing new — the price of healthcare has been rising for decades — leaders must find ways to meet the challenge head-on.

One approach is to ramp up research on grants and other funding facilities. Additionally, health leaders can also collaborate with public officials and take part in shaping policies that can help make healthcare costs more bearable for all.

Processing payments efficiently

It’s one thing to worry about increasing costs and it’s another issue to ensure efficient payment processing. Serving an increasing number of patients presents challenges in payment collection. There’s a lot to keep track of, from following up on unpaid claims to processing denials and appeals.

Aside from making sure staff are getting paid for health services rendered, it’s also a matter of making the patient experience the highest forms of convenience. Without a user-friendly system, potential clients may end up looking for other providers who can provide a better experience.

  • Offer payment options – Patients should have multiple options when it comes to settling their medical bills. Don’t just accept credit cards, accommodate new platforms via e-banking and e-checks.
  • Adopt digital documentation – Going paperless has many benefits. For one, you avoid spending a lot on printing and you can minimize waste. Billings can also be sent directly to patients’ email or online accounts.
  • Use a payment processing system – You’ll find several software solutions that can help you efficiently keep track of payments and claims. Additionally, these new technologies also come with revenue cycle management services that provide technical support and resolve common troubleshooting issues.

Patient confidentiality comes to the forefront when it comes to adopting these internet-based platforms and technologies. Therefore, healthcare leaders must emphasize the importance of cybersecurity. To that end, new rules and guidelines must be developed to safeguard confidential information.

Countering misinformation

In recent years, the general public has been bombarded with misleading information and unverified research on key health matters. The ubiquity of smartphones and the rise of digital media haveplayed their part in this.

Movements initiated by anti-vaccine groups, for instance, are undermining decades of medical progress.

Not too long ago, measles outbreaks were reported in some parts of the US due to vaccine critics’ refusal to have their children immunized. More recently, many anti-vaxxers have downplayed the seriousness of COVID-19 and have outright condemned pharmaceutical companies’ efforts to develop a viable vaccine.

Healthcare leaders must spearhead awareness and information initiatives that can effectively counter fake medical news and information. Publishing in medical journals won’t be enough. Authoritative voices must meet audiences where they currently are — social media channels like Facebook, Instagram, Twitter, and many more. More importantly, medical jargon must be translated into familiar and easily digestible explanations that can be understood by the general public.

A way forward

There are many more issues and changes that decisionmakers and policymakers need to grapple with. In finding solutions, it’s important to remember that in the complex field of health, there is no silver bullet or one approach that trumps all the rest.

Cross-sector collaboration will be invaluable. Long-term partnerships in research and training will eventually lead to innovative breakthroughs. Ultimately, such efforts will enable the industry to usher in new systems that address the interests of both medical professionals and patients.

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