The healthcare industry is undergoing fundamental transformation on many levels. Banks are playing an increasingly central role in helping organizations navigate not only the numerous financial challenges, but also develop larger transformative paths forward. CommerceHealthcare® is directly involved in many of these industry efforts.
Rick Heise, Senior Vice President, Specialty Healthcare Services, recently shared his insight and elaborated on the growing mandate for banks as well as the specific roles CommerceHealthcare® is assuming for its healthcare clients.
What are healthcare’s biggest challenges today?
The issues can be separated into two categories: short-term and long-term. For the former, hospitals, health systems and physician groups alike are heavily focused on recovering the revenue and profitability lost in 2020. The numbers are staggering. Total hospital losses were said to exceed $300 billion.1 Nearly half had negative margins during the pandemic. Physicians reported substantial volume decreases, and some practices chose to close. Beyond the financial hit, the heavy staff furloughs and shift to a remote work environment created operational dislocation and disrupted workflows.
Despite these challenges, long-run trends remain intact. Two of the most powerful are:
- The ongoing shift to value-based care that rewards new models that “bend the cost curve.”
- The accelerating consumerism that places a premium on delivering convenient care, competitive with emerging non-traditional retail providers.
Where do banks fit in healthcare’s solution equation?
The traditional banking functions have proven their value over the past year. From facilitating Paycheck Protection Program (PPP) loans to setting up or expanding credit lines quickly, Commerce has helped providers nationwide weather the financial storm. Cash and asset management services are also vital, given these tight cost controls and investment needs.
Faced with today’s complex matrix of problems, healthcare organizations are seeking banking partners with strength in core financial competencies as well as the ability to provide innovative technology and services. The financial industry has developed sophisticated automation that the healthcare industry can adopt to gain substantial administrative efficiencies. These results are optimized when a financial institution is well-resourced, offers deep healthcare experience and is capable of enterprise-level deployments.
What specific kinds of value does CommerceHealthcare® provide?
CommerceHealthcare® delivers a spectrum of resources specifically tailored to help healthcare providers. This includes a dedicated team consisting of both bankers and former healthcare leaders. While banks can bring many valuable benefits to health systems, hospitals and physician practices, there are three primary reasons an increasing number of providers are turning to CommerceHealthcare®.
- Improved patient financial experience. Patient financing programs can address the care affordability issue by allowing providers to offer no- or low-interest lines of credit. A highly flexible program is one that can be customized, requires no patient credit checks and leverages an open line of credit that can be offered to patients at any point in the billing cycle. This approach to financing greatly reduces patient stress by replacing the financial uncertainty associated with many medical procedures or hospital encounters with a known fixed, affordable monthly payment. Patients can focus on care, not finances. Some programs offer the added benefit of immediate full funding to the patient account as well as utilization of payment technology that enables online loan payments and electronic refunds. These features enhance patient access and deliver patients a better overall financial experience.
- Efficiencies that create cost savings and support a remote workforce. The recent CAQH Index calculated that cost savings of 42% could accrue from adopting completely electronic healthcare administrative transactions.2 Workflows throughout revenue cycle management continue to be significantly manual, paper-based and dependent on multiple financial systems. Opportunities abound to apply cloud-based technology and process automation to traditional financial processes such as lockbox services, insurance and patient payments posting and reconciliation, patient financing and many more. This proven innovation drives cost reductions and supports a dispersed or fully remote staff.
- Enhanced Revenue. Electronic transactions can likewise unlock new revenue opportunities. Key to this effort is expanded use of automated payment rails, particularly ACH and virtual card payments. It is also critical for healthcare providers to align themselves with a bank that has built a large supplier network. These vast networks enable providers to maximize revenue-sharing features offered by a card program and earn much-needed incremental income while also reducing operational expenses.
Can you elaborate on the opportunities that automation can provide?
CommerceHealthcare® delivers cost-saving automation through technology and services platforms in three important revenue cycle processes:
- Remittance processing. A unified insurance and patient receivables technology platform can provide paperless, exception-based workflows such as automatic payment posting, unbundling aggregated remittances with posting to the proper system and automated reconciliation. The conjunction of cloud-based technology and automated remittance processing establishes a strong foundation for remote/hybrid workforces and is a powerful generator of high-efficiency.
- Patient financing. A growing number of health systems, hospitals and physician practices are adopting automation that promotes a frictionless processing cycle for patients, helping to improve their financial experience and remove economic uncertainty regarding medical encounters. Electronic application and enrollment, plus lender-managed rather than internal loan servicing, contribute to a consistently efficient operation. Streamlining can be further accelerated by concentrating on the pre-service phase, where issuing flexible credit lines based on estimated charges offers considerable speed-to-financing.
- Invoice automation. Managing thousands of supplier payments can get complicated and confusing. A single automated platform can optimize payables across payment types (credit card, EFT, check), information systems or banks, as well as scheduled or one-time payments. The system can also generate accurate reconciliation files, reducing manual processes, speeding cash flow and eliminating some operational costs.
How do you foresee the role of banks going forward?
Effective financial management is a critical success factor and potential differentiator for healthcare organizations. Banks occupy a unique space for CFOs and their staffs. Banks can bring a blend of earned industry experience and a flexible range of solutions to tailor programs to a provider’s specific needs and bolster resilience to meet future turbulence. For those reasons, CommerceHealthcare® is ready to play an even larger role in healthcare in the years to come.
- American Hospital Association, “Hospitals and Health Systems Continue to Face Unprecedented Financial Challenges Due to COVID-19,” May 2020.
- CAQH, “2020 CAQH Index,” 2021.