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The OBBBA: A New Car with a Hidden Leak

Post author By Carson Ralphs
Post date August 22, 2025
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What if one day, the government delivered a brand new car to your driveway? Of course, you’d be pretty excited. The car looks really nice, and comes with some impressive features. But after you take it out for a few drives, you notice the temperature gauge slowly creeping higher and higher.

It turns out, the car has an irreparable coolant leak. Early on, the drip is manageable and you’re able to add new coolant as needed. But as you continue to drive the car, the coolant starts to drain faster and faster.

Eventually, the engine overheats to the point that it seizes up and breaks beyond repair. Leaving you stranded on the side of the road.

From our perspective, that’s what the One Big Beautiful Bill Act (OBBBA) has the potential to be. It offers shiny new benefits like permanent telehealth access, expanded HSA flexibility, and funding for rural hospital transformation. But underneath, it’s leaking through Medicaid cuts, Medicare spending caps, and millions of vulnerable people losing their health insurance. And if we ignore that leak, however slow it may be at first, the long-term damage could be devastating.

In this article we’ll discuss some of the major pros and cons of this bill, and what it means for healthcare leaders today. Our hope is that by better understanding what this bill contains, we as a healthcare industry will be able to prevent or diminish the potentially negative consequences.

Pros

1. Increased HSA Flexibility

One of the brighter spots in the OBBBA is the expanded flexibility it brings to Health Savings Accounts (HSAs). Patients with high‑deductible health plans can now use HSA funds for telehealth and direct primary care before reaching their deductible. That means routine checkups and wellness visits are accessible from day one, with no upfront costs to delay care.

For hospitals, this ushers in a host of benefits. One of which is that fewer patients arrive later and sicker, which helps alleviate the avoidable admissions for chronic or acute conditions. Another benefit is that patients who feel financially supported by their insurance are more likely to keep scheduled outpatient visits, which helps stabilize a hospitals operations and revenue.

While it’s true that this aspect of the bill won’t be very impactful for those without an HSA, it can help ease the strain on emergency departments and transition routine care away from acute settings, which will be beneficial for everyone who’s ever had to wait in a hospital waiting room.

2. Deductible-exempt Telehealth Coverage

Similar to the first point, another impactful feature of the OBBBA is how it will make telehealth services permanently deductible-exempt under high-deductible health plans. In plain terms, this means patients will be able to access virtual care without having to pay out of pocket before meeting their deductible, essentially removing any financial barriers patients might have to virtual visits.

Consequently, its expected that the number of missed appointments will decline, especially among patients who had a difficult time attending visits due to cost and transportation concerns. As a result, chronic care management becomes smoother, enabling better triage, earlier intervention, and fewer in-person encounters.

This can be particularly valuable in rural populations where transportation or distance is a hurdle.

3. $50 Billion Rural Hospital Transformation Program

Perhaps the widest-impact provision of the bill is the proposed $50 billion Rural Hospital Transformation Program, a five-year investment administered through CMS approved state plans. The potential use cases are compelling: expanding telehealth capacity, recruiting critical staff, launching care coordination tools, or investing in local health promotion efforts. At first glance, it’s a lifeline. But a closer look reveals serious limitations that demand a smart, strategic response.

If the $10 billion annual allocation is divided evenly across the approximately 1,800 rural hospitals in the U.S. (1), that amounts to about $5.5 million per facility per year. That can certainly be helpful, but in the face of large scale Medicaid cuts, rising labor costs, and aging infrastructure, that money can be absorbed as fast as it arrives. And by 2030, this funding will end. That gives hospitals a narrow five-year runway to not only address urgent needs with this additional funding, but also build more enduring, self-sustaining models of care delivery.

So the best move for rural hospitals is to start planning now. We recommend engaging early with your state’s CMS health plan to begin developing the goals for your hospital’s share of the funding. It would be helpful to position your proposals with that funding to address projects that don’t just fill immediate gaps, but create new revenue pathways or reduce future costs. That could mean launching remote patient monitoring services, building chronic care clinics, or aligning with managed care organizations to pilot value-based care initiatives.

For further information on the details of how these transformation funds can impact rural hospitals, we encourage you to read this article (2) from the Kaiser Family Foundation.

Cons

1. Medicaid Cuts

An alarming side effect of the bill is the large-scale Medicaid cuts, with nearly $900 billion slashed over the next 10 years. Its estimated that 7.8 million Americans are projected to lose Medicaid coverage as a result of these reforms. (3) The reforms include tighter eligibility rules, new work requirements, and fewer federal dollars flowing to states.

This loss of coverage obviously doesn’t mean that patients will stop getting sick. Those individuals will still show up in emergency rooms, labor and delivery units, and pediatric clinics. For example, 41% of births in the U.S. in 2023 were funded by Medicaid, and it was 47% of all births in rural communities. (4) But now, without Medicaid covering less of those births, hospitals will be performing that life-giving care without being reimbursed for it.

The financial domino effect from that fallout will be real: if a facility is already operating on razor-thin margins, absorbing millions in unpaid services isn’t sustainable. This often leads to having to make impossible choices, like cutting back on community health programs, shutting down specialty units like maternity or mental health, freezing new hires, or delaying critical facility upgrades.

For rural hospitals, which typically have about 20% of their discharges covered by Medicaid (5), this could accelerate the already troubling trend of closures. And children’s hospitals, which serve large populations of lower-income families, could see entire patient populations lose access overnight. The previously mentioned provision to give more funding to rural hospitals is meant to help address this shortage, but will it be enough? And what will happen in 2030 when that funding runs out?

2. Medicare Spending Caps

Another concerning aspect of the bill is the introduction of Medicare spending caps. These caps essentially limit how much Medicare payments to hospitals can increase over time, regardless of real-world pressures like inflation, rising wages, or staffing shortages.

On paper, it’s framed as a way to control federal spending, but in practice, it shifts the financial burden onto hospitals already operating under tight margins. If reimbursement rates don’t keep pace with the actual cost of care, hospitals will be forced to make difficult financial decisions that may lead to diminished clinical outcomes.

And as labor costs continue to rise, the inability to match those increases with stable Medicare revenue may trigger staff reductions or increase reliance on contract labor, each of which undermines care continuity and staff morale. For rural and safety-net hospitals that depend heavily on Medicare reimbursements, these caps could mean reducing entire service lines like obstetrics, behavioral health, or outpatient rehab to keep the doors open.

The ripple effects won’t merely be financial; they’ll be felt in less patient access, clinical outcomes, and an erosion of community trust. At a time when hospitals are being asked to do more with less, Medicare spending caps lock them into a funding model that’s divorced from operational realities. It’s budgeting by algorithm, not by need, and patients ultimately pay the price. We know that money from the government to fund Medicare isn’t infinite, but with the Medicare population increasing steadily by the day, this is a leak that will need to be addressed.

3. Health Insurance Loss for Millions

The Kaiser Family Foundation wrote that: “The Congressional Budget Office (CBO) estimates that, taken together, these changes will result in 16 million more uninsured people in the year 2034 than would otherwise be the case, including:

7.8 million more uninsured resulting from Medicaid changes in the One Big Beautiful Bill Act (OBBBA)
3.1 million more uninsured from OBBBA provisions affecting the ACA Marketplaces
900 thousand more uninsured from codifying the recent Trump Administration proposed rule on the ACA Marketplaces. This accounts for only half the effect of the proposed rule; the remaining 900 thousand people becoming uninsured are included in the effects of ACA provisions in the reconciliation package.
4.2 million more uninsured with the expiration of the enhanced premium tax credits, relative to an estimate of a permanent extension of those credits” (6)

These numbers tell a story, but they don’t tell much of it. Truthfully, millions of people losing their insurance is a crisis waiting to unfold. Uninsured patients are more likely to delay care, skip medications, and ultimately show up in emergency rooms when conditions have worsened and treatment is more expensive. This creates a double burden: ERs become overwhelmed with avoidable cases, and hospitals are forced to provide care without reimbursement.

As we mentioned previously, these kinds of cuts lead to a surge in uncompensated care that further strains already tight budgets. For many safety-net and rural hospitals that rely heavily on Medicaid and ACA-subsidized patients to stay solvent, this could mean cutting service lines, laying off staff, or even shutting down entirely. Maternity wards, mental health services, and chronic care clinics often disappear first, leaving the most vulnerable with nowhere to turn.

It also jeopardizes federal and state goals around population health, prevention, and chronic care management. Simply put, stripping insurance from vulnerable populations doesn’t just harm patients; it destabilizes entire care ecosystems. As administrators, this calls for advocacy, innovation, and preparing for a future where the safety net may be weaker than ever. The OBBBA may deliver cost savings, but it risks transferring those costs, both fiscal and human, directly onto the shoulders of hospitals and their patients. Hospital leaders should brace for that impact and begin planning for it now.

Summary Table

	Pros	Cons
Expanded HSA use	Lower-cost access to preventive and telehealth care	Only helps those with HSAs
Telehealth coverage	Boosts access to care for rural and mobility-limited patients
$50B rural fund	Provides some financial relief to rural hospitals	Expires in 2030
Medicaid cuts	Reduces federal spending	Harms coverage and care access, with thousands of projected deaths
Medicare spending caps	May help control healthcare expenditures and encourage efficiency across the system	Could force hospitals to delay needed upgrades, reduce service lines, or downsize staff
Coverage losses		Millions will lose their health insurance, negatively impacting the most vulnerable patients

How to Navigate the Road Ahead

Going back to our car analogy, the OBBBA looks like an upgraded vehicle with new features like expanded telehealth access and greater HSA flexibility. It even offers rural hospitals a hopeful injection of funding, like a fresh set of tires for a long drive ahead. But under the hood, there’s that hidden coolant leak of Medicaid cuts, Medicare spending caps, and widespread coverage losses. At first, everything may seem to run fine, until the engine overheats, seizes up, and breaks due to the loss of coolant.

For healthcare organizations and policymakers, this means the benefits must be weighed against the hidden risks. Yes, telehealth is here to stay, and HSAs are more useful, and rural hospitals will get more funding. But that won’t matter if millions lose their insurance and hospitals collapse under the weight of all the additional uncompensated care.

Consequently, states will need to implement the rural transformation funds quickly, wisely, and equitably. Hospitals will need contingency plans for lost Medicaid and Medicare revenue, and patients with chronic conditions will require stronger outreach, navigation, and support to keep them from falling through the cracks.

A quote from Hubert H. Humphrey (a former Vice President of the U.S.) is inscribed in the entrance of the Health and Human Services Administration headquarters in Washington, D.C. It says,

“The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.” (7)

No matter where we stand in this field of healthcare, that quote is a reminder to all of us about where the priorities must be in our work.

In the end, the OBBBA may look like progress on the surface, but if we ignore the leak beneath, the engine of healthcare in our country will overheat, and the very people it aims to help will be the ones left stranded on the roadside when it breaks.

Sources:

Tags Future of healthcare

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Would You Tape the Bank Vault Code to the Door? Rethinking Password Security in Healthcare

Post author By Carson Ralphs
Post date June 2, 2025
No Comments on Would You Tape the Bank Vault Code to the Door? Rethinking Password Security in Healthcare

Close up of businessman hand showing key to success

Imagine this: A group of professional bank robbers sneaks into a high-security vault late at night. They’ve spent weeks planning, studying security footage, bypassing motion sensors, and hacking into the surveillance system. They’re ready for a serious challenge. But when they finally get to the vault, they stop dead in their tracks.

There, taped right onto the outside of the steel door, is a yellow sticky note. It reads: “Vault Code: 123456.”

At first, they think it’s a joke. But when one of them enters the code, the vault opens without resistance. No heavy lifting. No sparks flying. No nail-biting seconds ticking down. Just like that, they’re in. The gold, the cash, it’s all theirs.

It sounds absurd. Who in their right mind would leave the key to everything taped to the door?

And yet, in healthcare organizations across the country, this is happening every day. Not with gold bars or diamonds, but with patient records, financial data, and critical medical systems. When employees use weak, recycled, or easy-to-guess passwords, they’re essentially taping the combination to the vault right where anyone can see it.

Why Passwords Are the Weakest Link in Healthcare Cybersecurity

Hackers no longer need to be shadowy figures pounding keyboards in dark basements. Today’s cybercriminals have sophisticated tools and strategies, but they often don’t need them. And that’s because too many people are still using passwords like “Password123,” “123456,” or even “admin.”

According to a recent study, over 80% of data breaches are caused by compromised passwords (https://jumpcloud.com/blog/password-statistics-trends). And healthcare, unfortunately, is a top target.

When you combine EHRs containing a treasure trove of sensitive data with overworked professionals who often prioritize speed over security, and then layer in systems that are shared across multiple departments and facilities, you can see why hackers see healthcare as an easy target.

And we’re not just talking about identity theft or stolen credit cards, cyberattacks in healthcare have real-world consequences. When hackers gain access to hospital systems, they can:

Lock providers out of critical patient records
Halt operations through ransomware
Leak or sell patient information on the dark web
Disrupt care and even endanger lives

How to Lock the Vault: Password Security That Actually Works

So how do we fix it?

In case you’re thinking that your passwords aren’t included in the “weak” category, here is a list of the top ten most commonly used passwords in 2024 (https://jumpcloud.com/blog/password-statistics-trends):

123456
admin
12345678
123456789
1234
12345
password
123
Aa123456
1234567890

So if your password is any kind of variation of those top ten, it’s time to make some new passwords.

To apply this to our work, let’s take it from both angles: what individuals can do, and what healthcare organizations must implement to defend against these modern-day digital robbers.

For Individuals: Start With Smart Habits

Use Strong, Unique Passwords
A good password isn’t just long—it’s complex and random. It should contain a mix of uppercase and lowercase letters, numbers, and symbols. Avoid using names, birthdays, or words found in the dictionary.

Bad: Doctor123
Better: Trx!9pLw&28Bv

Don’t Reuse Passwords Across Accounts
If your work email and personal Netflix account share the same password, and Netflix gets hacked—guess what? Your professional life is suddenly at risk too.

Use a Password Manager
Tools like 1Password, Bitwarden, or LastPass can generate and store strong, unique passwords for every site or system you use. They’re encrypted, secure, and save you from sticky notes on monitors.

Enable Multi-Factor Authentication (MFA)
MFA adds an extra layer of protection by requiring something you know (your password) and something you have (a code sent to your phone or a hardware key). Even if someone guesses your password, they still can’t get in without that second factor.

For Organizations: Build a Culture of Cyber Hygiene

Create and Enforce Strong Password Policies
Require complex passwords, prohibit password reuse, and set expiration timelines. Don’t leave it up to chance—build the rules into your systems.

Invest in Employee Training
Your team can’t follow best practices if they don’t understand them. Offer cybersecurity training that’s simple, engaging, and specific to healthcare. Help them understand why strong passwords matter—not just what to do.

Regularly Audit and Update Systems
Schedule frequent checks for dormant accounts, weak credentials, and software vulnerabilities. Deactivate old logins immediately when employees leave.

Limit Shared Access and Accounts
Everyone should have their own login credentials. Shared usernames like “reception1” or “nurse_station” are dangerous and untraceable. Hold users accountable with individual access points.

Widening the Scope: Healthcare Cybersecurity Threats Beyond Passwords

Unfortunately, weak passwords are just the beginning. Let’s zoom out and look at other digital threats plaguing the healthcare sector, and how you and your organization can fight back:

Ransomware Attacks
In a ransomware attack, hackers encrypt critical systems and demand payment to unlock them. In 2022 alone, 66% of healthcare organizations were hit by ransomware. These attacks delay care, force emergency rerouting, and in some cases, have even contributed to patient deaths.

Prevention Tip: In addition to strong passwords and MFA, regular data backups and offline storage are critical. Train staff to spot phishing attempts (explained below), the most common ransomware entry point.

Phishing Attempts
It will seem like a legitimate email, containing a link that invites immediate action. But if an employee clicks that link, malware is now inside the system. Phishing attacks will mimic trusted sources to trick employees into clicking malicious links or providing login credentials.

Prevention Tip: Conduct routine phishing simulations. Teach employees how to hover over links, identify strange senders, and report suspicious messages.

Outdated Software and Devices
Many healthcare facilities run legacy systems, equipment or software too expensive or complex to replace. But these are often unpatchable, unsupported, and full of exploitable vulnerabilities.

Prevention Tip: Perform regular vulnerability assessments and patch updates immediately. If a system can’t be secured, it should be segregated from sensitive networks.

Third-Party Vendor Risks
Hospitals rely on many outside vendors, from billing services to telehealth platforms. If a vendor doesn’t secure their own systems, attackers can use them as a backdoor into your network.

Prevention Tip: Vet vendors thoroughly. Demand evidence of security practices, and set up access controls so third-party breaches don’t spill into your core systems.

Internet of Things (IoT) Devices
From remote patient monitoring to connected insulin pumps, IoT devices improve care. However, many of them lack robust security features, and some don’t even allow password changes.

Prevention Tip: Inventory every connected device, change default settings, and ensure all devices are on a secure, segmented network.

The Takeaway: Protecting Patients Starts With Protecting Passwords
Healthcare workers are everyday heroes, all doing high-stakes work under pressure. But in the digital age, protecting patient data is just as important as providing quality care. The tools we use to protect that data, like strong passwords and authentication protocols, are the modern equivalent of armored doors, motion sensors, and surveillance cameras.

With a few simple changes like stronger passwords, multi-factor authentication, and a team that takes cyber hygiene seriously, we can keep our healthcare data vaults locked tight.

Your patients trust you with their lives. Let’s make sure their data is just as safe.

Healthcare

Don’t Ask Hospitals How Much Your Care Will Cost, Ask Your Insurance

Post author By Carson Ralphs
Post date May 9, 2025
No Comments on Don’t Ask Hospitals How Much Your Care Will Cost, Ask Your Insurance

Imagine you’re planning a cross-country road trip. You know you’ll hit toll roads along the way, but here’s the catch: every toll booth gives you a different answer about how much you’ll pay in total. Some give you an average, others offer a wide range of options, and some just shrug. You’re told to get the final total price from the road construction crew because they built the road. However, they have no idea the route you will be taking, how much gas your car will burn, or which roads your car qualifies to drive on. It’s frustrating, inefficient, and ultimately the wrong source for a straight answer.

This is exactly what happens when new regulations require hospitals to give patients an exact price for their healthcare before treatment. It’s a well-meaning regulation, but it targets the wrong party. Hospitals are not the ones who determine final out-of-pocket costs for most patients, health insurers are. Forcing hospitals to provide exact pricing for insured patients is like asking the road builders how much your trip will cost when they don’t even know what route your navigation system will take. The system is asking the wrong expert.

Let’s break down why this matters, and why patients deserve accurate cost information from the only source who can truly provide it: their insurance company.

What the Regulation Gets Right (and What It Gets Wrong)

On February 25, 2025, the current administration issued an Executive Order which says, in part:

“The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services shall take all necessary and appropriate action to rapidly implement and enforce the healthcare price transparency regulations issued pursuant to Executive Order 13877, including, within 90 days of the date of this order, action to: require the disclosure of the actual prices of items and services, not estimates…” Whitehouse.gov

The intent behind this Executive Order is applaudable, people want to know how much their medical care will cost before they receive it. No one likes surprise bills, and financial transparency is essential for trust in our healthcare organizations.

But here’s the problem: the exact price a patient pays depends almost entirely on their insurance company, not the hospital. There are many factors that go into how much an insurance company asks patients to pay for their healthcare. That list includes:

Deductibles
Copayments
Coinsurance rates
Out-of-pocket maximums
Network status of the provider
Whether pre-authorization or referrals are required, and more.

Hospitals can estimate the gross cost of a procedure, but they have limited visibility into a patient’s current insurance status or how much of their deductible they’ve already met.

So, when the government requires hospitals to provide an exact cost for a surgery, MRI, or lab test, they’re being asked to do the impossible. For insured patients, only the health insurance company knows what the patient will finally owe at the end of the day.

When Hospital Estimates Work, and When They Don’t

To be clear, there are situations where hospitals can and should provide exact prices upfront: when the patient is self-pay.

In those cases, the hospital is both the service provider and the billing party. There’s no third party in the middle, so the hospital can offer a fixed rate or cash-pay discount and stick to it. In these situations, price transparency works exactly as intended.

However, once a health insurance policy is involved, the picture gets more complex. Different insurers negotiate different reimbursement rates for the same procedure. What Blue Cross pays is not what Aetna pays, which isn’t what Medicare pays. And patients with the same insurance company can owe vastly different amounts based on their individual plans.

For example:

Patient A has a $2,500 deductible, and they’ve already met $2,000 of it. Their knee surgery will cost them $500.
Patient B has a high-deductible plan and hasn’t met any of it yet. They’ll pay the full cost of the procedure.
Patient C has hit their out-of-pocket max for the year. They pay nothing.

The hospital has no way of knowing this without direct access to each patient’s up-to-the-minute insurance data. That data lives with the insurer, and not all insurers share that data in a timely or efficient manner.

The Administrative Burden and Risk of Inaccuracy

Not only is this regulation misdirected, it’s also wasteful and potentially harmful. When hospitals inevitably give an incorrect price for care, patients feel confused, angry, and misled, even if the hospital did its best with the information they had.

By putting the burden of pricing on hospitals instead of insurers, the system guarantees patients will get incomplete or inaccurate numbers, damaging the very trust the regulation was meant to build.

Insurance companies, not hospitals, have the full blueprint of a patient’s financial responsibility:

They know the network status of the provider.
They know how much deductible is left.
They know the exact copay, coinsurance, and out-of-pocket max for that individual.
They know if pre-authorization or tiered coverage applies.
They know what negotiated rate has been established with that particular hospital or clinic.

In other words, insurers are the only party capable of giving a reliable, exact cost to the patient before care, yet the current regulation doesn’t require them to do so. That’s like asking the road builders what the tolls cost when only the navigation app knows what route you’re on, how many tolls you’ll hit, and what kind of car you’re driving.

What Should Be Done Instead?

If we want patients to have real price clarity, here’s the smarter approach:

Require insurance companies to provide exact cost breakdowns to members for common procedures based on network provider, location, and plan details.
Have insurers create integrated price estimate tools that hospitals can pull from.
Have hospitals focus on transparent list pricing and cash-pay rates for uninsured patients, which they can accurately provide.
Enforce clarity around patient financial responsibility from both sides, insurance must share the exact cost breakdown, and hospitals must confirm what services are being rendered.

If you need to know how long your flight will take, you don’t ask the baggage handler. If you want to know how much your mortgage payment will be, you don’t ask the home builder. Instead, you ask the person who would really know.

In healthcare, the right expert on out-of-pocket costs is the insurance company, not the hospital.

Well-meaning transparency regulations are important, but to be effective, they must be targeted correctly. Otherwise, patients will continue to be misled by numbers that may never be accurate to begin with.

When it comes to government intervention and encouragement on the journey towards price transparency in healthcare, we need to stop asking the road builders how much the tolls cost. In healthcare, that means putting cost responsibility where it belongs for most patients: in the hands of the insurer.

Tags Price Transparency

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Heroes In Healthcare: Edith Cavell

Post author By Savannah Wixom
Post date January 9, 2025
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The Forgotten Hero Who Saw No Borders in Humanity

In times of conflict, whether on a personal or global level, it can be easy for interactions between people to devolve into divisions of who is on which side, and a contagion of us-versus-them thinking can spread broadly and quickly.

That’s why the story of Edith Cavell is like a breath of fresh air. It’s a reminder that even in times of the deepest conflicts, humanity can still shine through.

The Roots of a Life of Service
Born in 1865 in Norfolk, England, Edith grew up with a strong sense of duty and faith. She worked as a children’s teacher before pursuing a career in nursing, a decision that would ultimately define her legacy.

After training in London, Cavell moved to Belgium, where she became the matron of a pioneering nursing school in Brussels. Her leadership helped elevate nursing standards and expand professional opportunities for women, and she gained a reputation for being not only skilled but deeply compassionate.

When World War I began, Edith chose to stay in Belgium, right in the thick of the conflict. That’s when her story became a legend.

Nurse Edith Cavell

Healing Beyond Borders
The hospital where she worked quickly became a refuge for the wounded, regardless of whether they wore Allied or German uniforms. Cavell’s belief was simple yet profound: a soldier’s humanity did not change based on the flag he served. She treated each patient with the same care and dedication, a decision that put her at odds with the occupying German authorities.

As the war raged on, Cavell became involved in a secret network that helped Allied soldiers and civilians escape to neutral Holland. Her hospital became a sanctuary not only for the injured but also for those seeking freedom. In just over a year, she is credited with aiding the escape of more than 200 Allied soldiers.

In August 1915, Edith Cavell was arrested by German authorities and charged with treason for aiding the enemy. During her trial, she remained composed, admitting to her actions but standing by her belief that she had simply done her duty as a nurse and a human being. On October 12, 1915, Cavell was executed by firing squad. Her death sent shockwaves across the world, galvanizing public opinion against the German occupation and immortalizing her as a symbol of courage and compassion.

What made Edith Cavell remarkable was not just her willingness to risk her life but the spirit in which she did so. She viewed every wounded soldier as a human being deserving of care and dignity. “Patriotism is not enough,” she said. “I must have no hatred or bitterness towards anyone.” Her words and actions challenge us to rise above division and to see the humanity in those we might otherwise consider adversaries.

A Legacy We Can Learn From
Edith Cavell’s story isn’t just something inspiring to think about; it’s a mirror. It forces us to ask ourselves how we’re treating the people around us, especially those we don’t agree with. Edith didn’t see “enemy soldiers”; she saw human beings who were scared, hurt, and in need of help. How often do we let labels like political affiliations, cultural differences, or opposing opinions cloud our ability to see someone’s humanity?

It would’ve been easier for Edith to play it safe, to only care for those she was expected to. But she didn’t. She took risks because she knew that compassion isn’t about convenience, it’s about doing the right thing even when it’s hard.

Acts of Kindness Have Ripple Effects
Every life Edith saved was a ripple. Those people went on to live, love, and create futures in their respective homelands that wouldn’t have existed without her courage and kindness. Our small actions, like listening to someone, offering help, or simply being kind, can all create ripples we might never see but that matter deeply.
As we reflect on Edith’s life, we’re reminded of something powerful: we don’t have to be in the middle of a war to make a difference. Every day and every interaction gives us opportunities to choose connection over division, understanding over judgment, and action over apathy.

Maybe it’s reaching out to a coworker who’s struggling. Maybe it’s finding common ground with someone you strongly disagree with. Or maybe it’s just taking a deep breath and refusing to let a feeling of contempt (looking down on someone with disdain or disregard) take root in your heart.

A Choice We Can Make Every Day
Edith Cavell’s story is proof that courage is about making the daily choice to do good, no matter the cost. Her ability to rise above the fear and hatred of her time challenges us to do the same.

What if we approached the world like Edith did? What if we saw people as people, not as sides or labels? What if we let compassion guide our decisions, even when it’s inconvenient?

Her story reminds us that at the end of the day, it’s not about who was right or wrong in the moment. It’s about the lives we’ve touched, the good we’ve done, and the humanity we’ve upheld.

We hope to let Edith Cavell be a reminder that every choice we make can tilt the scales toward hope and healing. Her legacy calls us to be better, to see beyond differences, to recognize the humanity in everyone, and to act with courage and compassion no matter the circumstances.

Healthcare

Level Up Your Patient Engagement: What Healthcare Can Learn from Video Games and Social Media

Post author By Carson Ralphs
Post date November 13, 2024
No Comments on Level Up Your Patient Engagement: What Healthcare Can Learn from Video Games and Social Media

What if managing your health was as addictive as your favorite video game or as engaging as scrolling through social media? Imagine a world where your healthcare app celebrated your progress, rewarded your healthy habits and connected you to a supportive community, all with the sleek, intuitive design of the digital platforms you use daily.

This isn’t just a far-off fantasy, it’s the key to unlocking a new era of patient engagement, and many healthcare organizations are implementing these concepts with impressive results. They’ve shown that by borrowing proven strategies from the gaming and social media worlds, healthcare providers can turn patient portals from overlooked tools into must-use resources that empower, motivate, and inspire healthier living.

Join us in this blog post as we explore five ideas that reveal this untapped opportunity to better bridge the gap between patients and their healthcare.

1. Leveraging Gamification for Deeper Engagement

The gaming industry has long been the benchmark for sustained user engagement. Gamification, or infusing game-like elements such as rewards, progress tracking, and challenges into non-game settings, has proven to be an effective way to keep users motivated. So why shouldn’t healthcare adopt this model?

Think of a patient portal where every interaction is an achievement. Whether it’s scheduling an appointment, tracking daily physical activity, or logging vital stats, each completed task earns a digital badge or progress point. Imagine a dashboard that celebrates small victories, like a week of consistent exercise or maintaining a prescribed diet, with virtual rewards.

Actionable Insight: Take Kaiser Permanente’s Thrive Game as an example. This game rewards patients for engaging in healthy activities like step-counting or attending screenings, effectively mirroring the strategies of popular wellness apps.

2. Creating Personalized and Social Experiences

If you’ve ever been hooked by a social media feed tailored to your interests, you know how powerful personalized content can be. Healthcare portals have the potential to tap into this same allure by curating content that speaks directly to each patient’s unique needs.

A personalized portal could go beyond generic annual check-up reminders, offering tailored notifications that consider age, medical history, and health goals. For a 45-year-old patient with a family history of diabetes, this might mean specific nudges about lifestyle choices or timely blood sugar monitoring. Additionally, social features like patient forums or condition-specific support groups could build a sense of community, making users feel supported in their healthcare journey.

Actionable Insight: Central Valley Medical Center’s use of our Redde platform is a prime example, using patient data to send individualized reminders and health updates that make patients feel seen and cared for.

3. Ease of Use and Frictionless Design

The seamless interfaces of video games and social apps make it easy for users to keep coming back. Unfortunately, many healthcare tools are bogged down by clunky design and complex navigation, discouraging use.

Healthcare systems should focus on mobile-first, intuitive designs with streamlined processes for tasks like appointment scheduling and bill payment. If patients can manage their health as easily as they manage their social media accounts, they’re more likely to engage consistently.

Actionable Insight: Apple’s iPhone is a standout example, offering a user-friendly experience where User’s can intuitively navigate the platform with ease.

4. Real-Time Feedback and Progress Tracking

Immediate feedback is a powerful motivator. It’s what keeps players glued to their screens and social media users constantly checking for new interactions. Healthcare tools could harness this by providing real-time data updates and progress feedback, boosting patient motivation.

Wearable tech like Fitbit and Apple Watch already demonstrates the potential of real-time data to drive behavior change. Healthcare portals could build on this by integrating wearables and offering insights tailored to the data collected. For instance, if a wearable notices a drop in daily activity, a portal could suggest light exercises and reward compliance with motivational points or new “milestone” badges.

Actionable Insight: Platforms like Livongo provide immediate health feedback paired with actionable tips, offering patients instant support and increasing their engagement with their health data.

5. Continuous Engagement Through Notifications and Reminders

Push notifications have become a staple in keeping users tied to their digital lives. While healthcare must tread carefully to avoid overwhelming patients, well-crafted, personalized notifications can make the difference between engagement and disinterest.

The key lies in relevance. For example, notifications could be strategically timed to remind patients to take medications, view test results, or schedule preventive care. Ensuring that these alerts are actionable and align with patient preferences helps maintain a balance between helpfulness and intrusion.

Actionable Insight: Wearables like Fitbit, pair health tracking with notifications to help drive behaviors and making health management an ongoing part of a patient’s day.

Conclusion: Unlocking the Power of Patient Engagement

If healthcare systems begin to incorporate lessons from the gaming and social media industries, they can transform patient portals from passive tools into interactive health companions. By blending gamification, personalization, social features, real-time feedback, and streamlined design, healthcare can evolve from a reactive system to a proactive, patient-centered ecosystem.

With deeper engagement, patients are more likely to become active participants in their health, driving better outcomes and fostering stronger, more connected relationships with their providers. It’s time for healthcare to not only inform but inspire, turning patient care into an experience that’s as compelling as it is empowering.

Visit us at Wixcorp.com

Tags Future of healthcare, Patient Experience, Revenue cycle

Healthcare

Striking the Right Cord

Imagine a symphony conductor who spends all their time perfecting the timing of the percussion section. Every beat is flawless, each drum hit is precisely on cue, and the cymbals crash with exacting precision. The conductor becomes an expert in the intricate rhythms and nuances of the percussion instruments, ensuring they never miss a note.

However, in this meticulous focus on one section, the conductor neglects the others. Eventually, the violins begin to fall out of harmony, the flutes play off-key, and the trumpets lose their synchronization. Despite the impeccable percussion, the overall performance falters, lacking the harmony and balance necessary for a truly captivating symphony.

This scenario mirrors the challenges faced by healthcare organizations that overly prioritize certain revenue cycle metrics. Metrics like Days Outstanding or Cost to Collect offer needed insights, much like the precision of the percussion section. However, concentrating too much on these can lead to neglect of other crucial aspects, such as patient satisfaction, coding efficiency, and overall revenue health. The result is a disjointed performance, where some areas excel while others suffer, impeding the organization’s overall success.

Just as a conductor must balance all sections of the orchestra to create a beautiful symphony, healthcare leaders must discover how to interpret and focus on the various metrics to ensure a thriving, efficient, and integrated revenue cycle. Understanding that each metric, like each instrument, plays a vital role in a broader picture is essential.

This article will explain the pros and cons of the following Key Performance Indicators (KPIs), and, at the end, introduce a novel method that not only illustrates the current status of various metrics but also illuminates precisely how healthcare organizations can achieve financial harmony and operational excellence, leading to a performance that resonates with both patients and stakeholders.

Days Outstanding (Net Days in Accounts Receivable)
Days Outstanding is a critical metric that provides insight into the efficiency of a healthcare organization’s collection processes. It measures the average number of days it takes to collect payments after services are rendered. Rating agencies often use this metric to assess the financial health of an organization. A lower number of Days Outstanding typically indicates a more efficient revenue cycle, which can lead to better credit ratings and lower borrowing costs.

While Days Outstanding is a useful indicator of collection efficiency, it does not give a complete picture of revenue and cash collection leakage. This metric does not account for the revenue that is never collected due to various reasons, such as denied claims, underpayments, or write-offs. As a result, relying solely on Days Outstanding can provide a misleading sense of security regarding the overall effectiveness of the revenue cycle.

Cash to Net Revenue (Net Collection Rate)
The Net Collection Rate is an essential metric that compares actual cash collections to the net revenue expected. This ratio provides a clear picture of how well an organization is converting its net revenue into cash. It helps in identifying potential issues in the collection process and ensures that the organization is maximizing its revenue potential.

Despite its usefulness, the Net Collection Rate can sometimes obscure the true net revenue opportunity. This is because net revenue is often based on historical collection rates, which may be underperforming. If an organization consistently underperforms in its collections, the net revenue figures might be artificially low, masking the potential for improvement and leading to complacency in addressing collection inefficiencies.

Gross Denial Rate
The Gross Denial Rate is a critical metric that indicates the rate at which initial and secondary claims are accepted or denied by payers. A lower denial rate generally suggests that claims are being submitted accurately and in compliance with payer requirements, which is essential for maintaining a steady revenue stream.

However, the Gross Denial Rate does not always reflect the accuracy of denial code mapping or account for denials caused by payer errors. As a result, this metric can sometimes misrepresent the true state of an organization’s revenue cycle, leading to misguided efforts to reduce denials without addressing the root causes.

Cost to Collect
The Cost to Collect metric is vital for ensuring that the expenses associated with the collection process are kept within reasonable limits. By monitoring this metric, organizations can identify inefficiencies and areas where costs can be reduced, ultimately leading to improved financial performance.

On the other hand, focusing solely on the Cost to Collect can be detrimental. This metric does not take into account the efficacy of the collection process, service standards, or the overall revenue yield. An organization might achieve a low cost to collect by cutting corners or reducing service quality, which could lead to lower patient satisfaction and higher long-term costs due to lost revenue opportunities.

Pre-Registration
The Pre-Registration metric measures the completeness of demographic information collected before services are rendered. This metric is essential for ensuring accurate billing and reducing claim denials due to incomplete or incorrect patient information. A high pre-registration rate can lead to smoother billing processes and faster payments.

With that said, Pre-Registration does not always reflect demographic and payer denials that arise from incorrect data entered and subsequently cleaned up in pre-claim editors. This limitation means that while the metric indicates completeness, it may not fully account for the quality and accuracy of the information collected.

Patient Payments – Pre to 7 Days Post Service
This metric measures the amount of patient payments received before and shortly after services are rendered. It is a good indicator of a healthcare organization’s ability to collect payments upfront, reducing the risk of bad debt and improving cash flow.

But focusing on this metric alone can be misleading. It does not indicate the total patient liability or account for increases in patient credit balances. As a result, organizations might not get a complete picture of their financial position and patient payment behaviors.

Patient Satisfaction
Patient Satisfaction is a vital metric that reflects patients’ perceptions of both clinical and administrative services. High patient satisfaction scores can lead to increased patient loyalty, better word-of-mouth referrals, and overall improved financial performance for healthcare organizations.

And yet, patient satisfaction metrics can be challenging to interpret. They often do not differentiate between various service areas, making it difficult to pinpoint specific areas for improvement. This lack of granularity can hinder targeted efforts to enhance patient experience and satisfaction.

Discharged Not Final Billed (DNFB)
The DNFB metric is a vital indicator of coding efficiency within a healthcare organization. It measures the amount of revenue tied up in accounts that have been discharged but not yet billed, highlighting potential bottlenecks in the coding process. By focusing on DNFB, organizations can improve their coding workflows and reduce delays in billing.

On the downside, an overemphasis on DNFB can lead to a focus on the coders themselves rather than the underlying causes of delays. Issues such as late charges, incomplete documentation, or the need for additional queries to accurately capture procedures and Case Mix Index (CMI) may be overlooked, resulting in a narrow approach to resolving billing inefficiencies.

Net Denial Write-Offs
Net Denial Write-Offs provide valuable insights into the revenue lost due to preventable errors. This metric highlights areas where improvements can be made to reduce write-offs and increase revenue capture. By focusing on preventable errors, organizations can implement targeted interventions to enhance their revenue cycle processes.

Even though it is important, the Net Denial Write-Offs metric does not track the amount and trend of other adjustments, such as contractual allowances, charity care, and bad debt. This limitation means that organizations may miss out on understanding the full scope of their revenue adjustments, leading to an incomplete picture of their financial performance.

Late Charges
Late Charges is a metric that measures the timeliness of charge entry from the service date. This metric helps organizations identify delays in charge entry, which can impact cash flow and revenue recognition. By monitoring late charges, healthcare providers can improve their billing processes and ensure timely revenue capture.

The drawbacks of the Late Charges metric include not capturing the accuracy of the charges entered, or identifying any missing charges. As a result, focusing solely on this metric can lead to an incomplete understanding of the overall billing accuracy and completeness, potentially leaving revenue on the table.

Bad Debt and Charity Write-Offs
The metric of Bad Debt and Charity Write-Offs provides insights into the financial burden of uncompensated care. Trending these write-offs as a percentage of gross revenue helps organizations understand the impact of bad debt and charity care on their financial health.

Conversely, these metrics can sometimes obscure key details, such as the number of repeat patients and the volume of patients written off to bad debt. Additionally, high gross charges invariably understate actual trends when compared to net revenue or total patient liability leading to a potentially skewed understanding of financial performance.

A New Approach

In the dynamic world of healthcare, where financial stability and patient satisfaction must harmoniously coexist, the concept of Tension Metrics™ emerges as a groundbreaking approach to managing complex revenue cycle processes.

Returning to our analogy of the conductor, we can clearly see how each musician’s peak performance is needed, yet the overall success of the symphony relies on the conductor’s ability to balance every note and tempo seamlessly. Tension Metrics™ acts as this conductor, orchestrating a perfect balance between critical KPIs to create an environment where revenue, performance, service, and quality are in constant, productive interplay.

Tension Metrics ™ are not just numbers on a spreadsheet; they are strategic tools that align focal points across various dimensions of healthcare operations. By creating the right tension between essential KPIs, they ensure that no single aspect of the organization overshadows another, fostering a holistic approach to revenue cycle performance improvement. This alignment is crucial for engaging operational teams, who can see the direct impact of their work on overall outcomes, fostering a culture of transparent communication and accountability.

The power of this approach lies in its ability to minimize disruptions and errors through effective monitoring, ensuring that every step of the patient journey is meticulously managed and optimized. This results in not only a superior patient journey but also impressive, sustainable outcomes for the organization. As Tension Metrics™ guides healthcare providers toward balanced excellence, they yield results that resonate far beyond immediate financial gains, driving long-term success and patient satisfaction in an ever-evolving healthcare landscape.

Welcome to the era of Tension Metrics™, where strategic balance and meticulous oversight converge to create a healthcare environment that thrives on precision, transparency, and excellence.

To learn more about Tension Metrics™, please contact us at:

ERIC SUMMERS
VP of Business Development/Channel Relationships – Wixcorp

Eric.Summers@wixcorp.com

608-628-2315

MARK PULCZINSKI
President – Momentum Revenue

Mark@MomentumRevenue.com

434-422-2527

* TENSION METRICS™ is cobranded by Wixcorp and Momentum Revenue, LLC

Healthcare

Beyond Broken Promises: How to Rebuild Trust in Healthcare

Post author By Carson Ralphs
Post date April 23, 2024
No Comments on Beyond Broken Promises: How to Rebuild Trust in Healthcare

Businesspeople joining their hands in the sign of unity

Remember that time when someone broke their promise? Or the time when someone didn’t do what they said they would do? Or that time when someone deceived you into thinking something that wasn’t true?

Violations of trust have a way of being sticky in the worst ways. We tend to remember the people and organizations that violate our trust, and rebuilding that trust doesn’t happen overnight.

One example occurred to Matt and Lucy, parents of a middle-school-aged boy named Tommy who loved to play games. This love of video games grew so much that Matt and Lucy came up with a rule that he could only play video games on the weekend.

One day, not on the weekend, they found Tommy playing video games. Disappointed, they removed the device from his room and told him how sad they were that he had lost their trust.

About an hour later, Tommy contritely approached them and asked: “What do I need to do to regain your trust?”

Matt and Lucy were pleasantly surprised by their son’s words, and together they all came up with a plan of action items that would lead to a restoration of trust and a reinstitution of video game privileges.

While some violations of trust are universally more serious than a boy playing video games when he shouldn’t, there are still actions that can be taken to restore that trust.

In healthcare, patient trust in healthcare organizations is falling. According to one study, 68% of patients say their trust in healthcare has declined in the last two years. The top reason patients feel trust has eroded comes from the feeling that the “healthcare system acts out of their own self-interest rather than mine as a patient”. ¹

Unfortunately, healthcare as an industry has provided countless reasons to justify that lack of trust.

From criminal research practices that violated human rights, to pharmaceutical executives raising prices excessively, to re-writing of legal contacts to justify not having to pay severance packages right before massive layoffs, to the opioid pandemic fueled by unethical and deceptive marketing practices, to negligence in patient care that has resulted in lost limbs and lost lives, and adding on top of all that history the distrust of the oft-misaligned financial incentives that permeate healthcare as a whole, one doesn’t need to look far to identify why patients might have a time placing trust in healthcare organizations and professionals.

The Trust Triangle

In the Harvard Business Review article titled “Begin With Trust”, the authors describe how they helped Uber rebuild it’s reputation by focusing on what they called the Trust Triangle. ²

The Trust Triangle has three points: Authenticity, Logic, and Empathy. When trust is lost, it can almost always be traced back to a breakdown in one of the tree points of this triangle.

Authenticity is described as whether or not people feel they are experiencing the real you. Logic is how much people can trust you to do something well. And the Empathy triangle point is explained as other people believing that you care about them and their success.

Applying this to healthcare, we can see how Authenticity can be equated to Transparency, Logic can be represented by Quality, and Empathy can be reinterpreted as the Patient Experience.

The article goes on to explain that organizations don’t always recognize how the information they’re broadcasting through their operations and policies may undermine their own trustworthiness. With that said, most organizations produce a “stable pattern of trust signals”, which means that even small improvements can lead to meaningful change.

At times when trust is lost, it’s usually the same triangle point that goes “wobbly”. Or in other words, this is the point of the triangle of trust that you’re most likely to fail on. According to the article, everybody and every organization has a “trust wobble”, and a key to building or restoring trust is identifying what your particular “trust wobble” is.

The article then explains how helpful it can be to look at a pattern of “wobbles” across multiple incidents where you can identify that trust was compromised. By picking three or four interactions that stand out to you, for whatever reason, ask yourself the following two questions for each interaction:

What does your typical “wobble” point seem to be, Transparency, Quality, or the Patient Experience?
Does the pattern change under stress or with different kinds of stakeholders? For example, do you “wobble” on one trait with your staff but on a different one with patients?

If you’re like most healthcare leaders, you’ve experienced or heard about how healthcare organizations have “wobbled” on each of the three Trust Triangle points.

Gratefully, as mentioned above, even small improvements in Transparency, Quality, and the Patient Experience can rebuild trust. There are even some simple practices that can be instituted quickly with little or no cost that bring substantial and almost immediate results.

Transparency

One method to increase Transparency would involve healthcare organizations publishing their prices in a way that makes it easy for patients to understand. Unfortunately, many healthcare organizations still try to bury their prices on the website in hard to find locations, and they often don’t provide the pricing in an easily consumable fashion. Both practices build frustration for patients in place of trust. To remedy this, utilizing tools like a Cost Estimation tool can make it easy for patients to understand their costs before their visit or procedure.

Quality

In regards to Quality, there are many factors and resources and institutions that can support efforts to improve the quality and safety of healthcare organizations. The Leapfrog Group even has a website that gives out free safety grades for hospitals in your area that can be helpful when deciding where to receive healthcare. ³

When it comes to improving the quality of healthcare, utilizing tools like a safety checklist before surgery have shown to produce a significant reduction in both morbidity and mortality and decrease the amount of surgical errors. ⁴

Here is an example checklist created by the World Health Organization:

If these safety checklists were more frequently utilized, medical errors resulting in additional pain, the loss of life, or other tragic events could be better avoided. The horrifying case of a hospital performing an abortion on the wrong pregnant woman is a recent and devastating example of how vitally necessary these safety checklists are. ⁵

Patient Experience

A low-cost tool championed across multiple healthcare organizations around the country is called “Rounding on Patients”, as popularized by the healthcare consultancy Studer Group. This includes having nurse leaders round on individual patients asking them about what is going well and what could be going better. This feedback is then relayed to employees to help identify where and how the patient experience can be improved in their department.

Studer Group has said that “Nurse leader rounding on patients has proven to be the number one most important tactic in determining [clinical] patient experience. When nurse leaders round, patients feel important and leaders can review first-hand the outcomes from nursing behaviors to identify opportunities for coaching and recognizing top performers.” ⁶

It is also important to note that while providing clinical care is the reason the healthcare industry exists, only 4% of patient complaints are related to Quality of Care, 96% are from Customer Service. ⁷ While we are providing exceptional care, it’s often the processes accessing and paying for that care that impact a patient’s overall experience the most.

The Road Ahead

Trust is a delicate yet vital component in any relationship, whether it’s between individuals or between healthcare organizations and their patients. As illustrated by Matt and Lucy’s experience with their son Tommy, trust can be broken by even minor transgressions, but it can also be rebuilt through genuine effort and commitment.

The current state of healthcare, as highlighted by declining patient trust, calls for urgent action, and a renewed focus on the three Trust Triangle points of transparency, quality, and the patient experience.

While the road to rebuilding trust may be challenging, even small improvements can yield meaningful results. By identifying and addressing their own “trust wobbles,” healthcare organizations can take concrete steps towards regaining the trust of their patients and ensuring a brighter, more trustworthy future for everyone.

Learn More about Patient Expereince at Wixcorp.com

Tags Future of healthcare, Patient Experience

Healthcare

Protecting Your Digital Healthcare Castle

Post author By Carson Ralphs
Post date January 9, 2024
No Comments on Protecting Your Digital Healthcare Castle

El Morro fort located in Old San Juan Puerto Rico.

Centuries ago, preventing an enemy from attacking your castle was fairly straightforward. Typically, there were limited methods that opposing forces could breach the walls. Those vulnerabilities could be protected in a fairly straightforward way, by a moat, a drawbridge, or guarded under constant surveillance.

But now, we live in a very different world of malware, social engineering, cyberattacks, and hackers. For healthcare organizations, these digital foes threaten from every side. Not only do healthcare organizations face financial pressures from the government, insurance companies, and others, but they are also threatened by an average of 203 hacking attempts across the healthcare industry daily. When these hackers are successful, valuable financial resources are siphoned away instead of being used to better serve and care for patients. ¹

A recent report found that nearly 93% of healthcare organizations have experienced a data breach in the past three years, and 57% have had more than five data breaches during the same timeframe. ¹

The stakes are incredibly high in healthcare due to the sensitive financial and medical nature of the data, and the consequences of falling victim to ransomware attacks can be devastating. These include operational disruptions, financial losses, and potential harm to patient care are all on the line, not to mention the negative impact on the organization’s reputation within the community.

This can be even more devastating for small and rural health organizations. One report found that ransomware attacks on smaller healthcare organizations are more harmful, resulting in median damages of $15.2 million, with a loss of 30 percent of estimated operating income. This includes financial losses linked to revenue decline, remediation expenses, brand impairment, and legal charges that may confront healthcare entities. Aside from monetary setbacks, healthcare organizations could undergo operational disturbances and jeopardies to patient safety due to a cyberattack. ²

In their 2022 Cybersecurity Survey, HIMSS found that should ransomware attacks occur, roughly 42% of healthcare cybersecurity leaders assert that their organizations would not pay the ransom in the event of a ransomware attack, but more than 55% of respondents say they are uncertain about their organizations’ stance on ransom payment, and only a small fraction expressed that their organizations would definitely comply with the ransom demands (1.89%). ³

Gratefully, there are steps that healthcare leaders can take to prevent and mitigate the damage of these cyberattacks. One beneficial and increasingly popular tactic is the use of third-party vendors. HIMSS emphasizes the importance of collaboration and information sharing in enhancing cybersecurity practices. They found that 42.7% of healthcare organizations are seeking assistance from external data security vendors. By teaming up with vendors, revenue cycle leaders can tap into a wealth of expertise and tools, bolstering their security defenses against evolving threats. ³

The HIMSS survey included the following action items for organizations to consider: ³

More frequent, practical cybersecurity training for everyone
Broader awareness training for everyone
Hiring and retaining qualified cybersecurity professionals
Passwordless multi-factor authentication
Robust incident response teams
Digital forensics (post-incident)
Third-party vendors – leveraging third-party expertise to reduce organizational risk
Information sharing about threats and mitigations with peers
Insider threat detection

Following these recommendations can help healthcare leaders better protect their digital healthcare castle. By doing so, they can ensure the security of financial and operational data and, above all else, the safety and privacy of their patients’ information, thus allowing the crucial mission of providing care to continue uninterrupted.

Reviewing what data you have housed with third-party vendors is also a good practice. Sharing protected health information (PHI) with a third party is another source of a potential data breach. Ensure you have a current record of what data you have stored across your and your partner’s systems. This will help you maintain strong and consistent security across your digital ecosystem and be a source list of places to draw on in case of data loss.

One of Wixcorp’s client partners was struck with a ransomware attack a few years ago. The medical group lost access to not only their EMR but also all their backups. Fortunately, their interface with the Redde platform stayed secure, and they were able to restore 100% of their billing data from the Redde system within hours of the attack.

It would take weeks before their EMR was fully up and running again. However, during that time, they were able to continue to process patient and digital insurance payments through the Redde platform, ensuring ongoing revenue during an extremely difficult and costly time for the organization.

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If you’re looking for assistance or have any questions about how to better secure your financial data and payment processes in the case of a cyberattack, you can contact us at info@wixcorp.com for a free consultation.

Learn more

Visit Wixcorp.com

References:

Tags Revenue cycle

Patient Experience

The Transformative Impact of Patient-Driven Revenue Cycles on Hospital Revenue, Staffing, and Operations

Post author By Carson Ralphs
Post date December 18, 2023
No Comments on The Transformative Impact of Patient-Driven Revenue Cycles on Hospital Revenue, Staffing, and Operations

In the vast sea of healthcare, patients and providers often find themselves adrift in a complex financial landscape. Billing and payments can be turbulent waters to navigate, leaving many patients feeling lost and overwhelmed.

However, there’s a beacon of hope emerging on the horizon—the patient-driven revenue cycle. Beyond improving the patient experience and increasing revenue, this approach to the revenue cycle can also play a pivotal role in reducing staffing and operational costs.

In the following blog post, we’ll discuss how patient-driven revenue cycles can streamline administrative processes, improve operational efficiency, and enhance patient care.

Streamline Administrative Processes to Decrease Collection Costs

Patient-driven revenue cycles begin with a fundamental shift in how healthcare organizations engage with patients financially. These cycles actively involve patients in understanding their financial responsibilities, implementing self-service tools for patients, and providing transparency in billing.

As a result, the administrative workload is lightened, requiring fewer staff to manage billing and collections processes. This streamlined approach directly contributes to fewer billing inquiries and substantial cost savings.

Improving Operational Efficiency

Reducing the complexity and workload associated with billing and collections operations has a ripple effect throughout the entire healthcare organization. This leads to a noticeable increase in operational efficiency.

Think of it as streamlining the processes within a well-oiled machine. Patient-driven revenue cycles enable hospitals to optimize their workforce, creating a leaner staffing model that helps reduce labor costs. This efficiency in staffing and operations allows hospitals to allocate their resources more efficiently and focus on what matters most – patient care.

Enhancing the Patient Experience

Perhaps the most significant benefit of lowering staffing and operational costs through patient-driven revenue cycles is the ability for hospitals to refocus their efforts and resources from managing patient issues to creating patient experiences.

This shift in focus towards patient experience and satisfaction is not only a benefit for patients but is also an essential strategy for hospitals to differentiate themselves in a competitive healthcare landscape. It leads to improved patient loyalty and word-of-mouth recommendations, further boosting a hospital’s reputation and success.

Conclusion

As healthcare staffing and operational costs continue to rise, it will become even more imperative for hospitals to transition their revenue cycles from admin-driven to patient-driven. These patient-driven revenue cycles are not merely an innovative approach to healthcare financial management but rather represent a paradigm shift that increases patient satisfaction and leads to substantial cost savings at the same time.

Patient-driven revenue cycles represent a win-win approach, where patients are more satisfied, and hospitals experience revenue growth and cost savings. They offer a path toward financial sustainability and success in a healthcare landscape that increasingly prioritizes patient-centered care.

Gratefully, hospitals nationwide are embracing this transformative approach and are setting sail toward a more prosperous and patient-focused future.

If you want to learn more about making your revenue cycle more patient-driven, you can contact us at information@wixcorp.com or by scheduling a free walkthrough of the digital solutions by clicking here.

Learn More at Wixcorp.com

Healthcare

Connecting Patient Needs with Local Resources: How Social Determinants of Health Enhance Healthcare Outcomes

Post author By Carson Ralphs
Post date November 16, 2023
No Comments on Connecting Patient Needs with Local Resources: How Social Determinants of Health Enhance Healthcare Outcomes

In an old fable, several blind men approach an elephant. They each touch different parts of the mighty beast and describe their limited perceptions. One grasps the trunk and perceives a snake; another feels the ear and senses a fan. They all make their unique contributions, but none of them grasp the full reality of the elephant.

This parable clearly illustrates the fragmented nature of the healthcare system, which often focuses on isolated parts of a patient’s health without considering the holistic picture. To truly advance public health and promote well-being, it is imperative that we embrace the importance of social determinants of health (SDOH), which are the factors that shape our lives and contribute significantly to our overall health outcomes.

In the realm of healthcare, our attention has historically fixated on the immediate and tangible aspects of illness and treatment—such as symptoms, medications, and surgeries. These components, analogous to the blind men’s perception of the elephant’s parts, are absolutely essential. However, they represent only a fragment of the intricate web of factors influencing an individual’s health.

Just as the blind men’s perceptions were limited by their focus on isolated parts of the elephant, a healthcare system that fixates solely on symptoms and treatments neglects the broader determinants that shape an individual’s health. Factors such as economic status, education, housing, employment, access to nutritious food, and even the surrounding community all play pivotal roles in health outcomes. Research has even shown that a patient’s SDOH contributes to 30% to 55% of their overall health outcomes. ¹

Source: Institute for Clinical Systems Improvement: Going Beyond Clinical Walls: Solving Complex Problems,
2014 Graphic designed by ProMedica.

To place added emphasis on the importance of identifying the SDOH in healthcare, CMS will require hospitals to screen for the following in all admitted inpatients in 2024: ²

Food Insecurity
Interpersonal Safety
Housing Insecurity
Transportation Insecurity
Utilities (electricity, water, A/C, phone, etc.)

Furthermore, The Joint Commission has added to the regulations by stating all of the following types of facilities must all also screen their patients for SDoH:

All critical access hospitals and hospitals
Ambulatory health care organizations providing primary care within the “Medical Centers” service in the ambulatory health care program (the requirements are not applicable to organizations providing episodic care, dental services, or surgical services)
Behavioral health care and human services organizations providing “Addictions Services,” “Eating Disorders Treatment,” “Intellectual Disabilities/Developmental Delays,” “Mental Health Services,” and “Primary Physical Health Care” services

They will also need to ask questions about:

Access to transportation
Difficulty paying for prescriptions or medical bills
Education and literacy
Food insecurity
Housing insecurity

While beginning to track and record the SDOH of patients is important, even more so is the ability to do something to address these needs. Some healthcare organizations may balk at the challenge of stepping in to influence a patient’s life outside of the hospital walls, but others will begin to see the whole elephant, and recognize this as an opportunity to bring long-lasting improvements to not only their patients’ health, but the health of their communities as well.

How can The Community Initiative and Wixcorp empower hospitals to successfully address a patient’s Social Determinants of Health?

Wixcorp is excited to partner with The Community Initiative (TCI) to provide hospitals with community resources that can help improve the social determinants of health for patients across the country. TCI leverages real-time interfaces with a dedicated team of analysts to maintain a comprehensive and accurate database of resources that can be targeted and personalized to meet individual patient needs.

Through this partnership, hospitals can now not only collect and report on patient SDoH, but can also automatically correlate individual patient needs with local community assets that can be beneficial.

Most health systems have processes in place to collect information from their patients regarding their health-related social needs and notify Social Workers and Case Management departments. Unfortunately, those processes are often subject to the pitfalls of manual data entry and can be very time-consuming for hospital staff.

To help improve SDOH tracking and trending, a new class of codes was added to the ICD-10 database in 2015. More recently, CMS released its recommendations on how the industry can leverage this new code set to help healthcare providers better identify the SDOH needs and outcomes of their patients. You can view CMS’s recommendations here.

To help connect patient needs with resources, The Community Initiative has built out a list of 500,000+ local and national resources that match SDoH needs. When connected with Wixcorp’s patient engagement engine, Redde, institutions can have access to intuitive texting and digital forms tools to help patients quickly and easily complete their own screening questions and be matched to personalized community resources from TCI. Patient responses are recorded with the appropriate Z-codes for easy reporting and billing.

Hospitals will also have access to real-time data to show the impact of the efforts you are putting into the community. For example, if a hospital donates a significant amount of resources to a local food bank, they can then track the data over time to track the impact of that donation on the food insecurity levels of the target patient population.

This new partnership between TCI and Wixcorp will allow hospitals to streamline patient access, track population health specifically, and incorporate community resources with discharge processes like never before. These technologically empowered solutions will not only meet the new SDOW compliance standards from CMS, but will, more importantly, quickly connect patients with personalized resources that will better support them on their road to better health.

Visit this site to learn more about how to successfully comply with this new CMS standard, and improve the SDOH metrics of your patients and community at the same time.

Learn more at Wixcorp.com

References:

World Health Organization – Social Determinants of Health
HIMSS – Addressing Social Determinants of Health (SDOH) in Healthcare Part 2

Tags Patient Experience