For U.S. hospitals and healthcare systems, the byproducts of healthcare reform significantly impact not only a healthcare entity’s business model and strategy, but how it delivers care, tracks patient care, ensures patient satisfaction and safety, and even how much it is paid.
Perhaps more than any other sector, healthcare organizations will be largely dependent on their healthcare workers to implement these changes, and reliant upon them to achieve revenue-based performance measurements as dictated by the Affordable Care Act (ACA). Simply put, for hospitals and health systems, profitability is contingent upon a skilled, engaged and satisfied workforce.
Healthcare Reform Creates Closer Link between Profitability and Employee Performance
It is fair to say that healthcare reform law changed the way hospitals get paid for providing health care. Specifically, two mandates within the ACA: one penalizes hospitals if patients are re-admitted to the hospital within one month of a visit for a condition that should have been dealt with on the first trip; the other redistributes higher Medicare payments to hospitals that are delivering better care. Both are part of an effort to fundamentally transform the health care system in the U.S. by moving it from a system that pays for value rather than volume.
As part of the national healthcare overhaul, patient satisfaction and experience dictate revenue generation. Federal payments to hospitals are tied to surveys that gauge patient attitudes and happiness – happier patients equal more money. Nationwide, about $1 billion in payments will be based on patient satisfaction scores and other clinical quality measures.
Healthcare HR Professionals Face Many Hurdles
The pressures upon healthcare HR professionals have increased over the past several years, given the relative upheaval of the healthcare landscape. Not the least of which is the ongoing need to recruit and retain workers to meet hiring demands. In the US, the healthcare industry is growing at a rate far outpacing most other sectors. In 2015 and 2016, according to the Bureau of Labor Statistics, the US added nearly 900,000 healthcare jobs, or an average of 37,000 jobs per month. This represents nearly 20% of the total job growth in the US over the same period. In 2016, US Healthcare spending exceeded $3.4 trillion, which is more than $10,000 per person and 18% of total gross domestic product.
Demand alone is making it very difficult to fill vacancies with qualified candidates. Furthermore, a satisfied and engaged healthcare staff is essential in today’s landscape if healthcare HR departments are to hit the goals of improving patient satisfaction and safety—and obviously extended vacancies do not support this effort.
Findings from a 2016 McKesson study identified these six priorities for hospitals and healthcare facilities.
- Value based care: Transitioning from concept to execution. Aligning resources and services to improve patient care, quality, outcomes and revenues.
- Patient access to support staff: Improving HCAHPS scores will require people and technology improvements at each touch-point for the patient.
- Medical coding and payment: Another transition requiring staff and management to monitor and track each claim, identify errors and bring disconnects to the payers’ attention.
- Capture charge: educating and safeguarding that all codes are entered, and entered correctly to optimize revenue and mitigate risk.
- Patient self-pay collections: starting with improved patient communication and ending with collection efforts, hospitals need policies, technology and people to manage revenue and avoid bad debt.
- Financial reporting and analytics: using data and insights to continue to improve all areas of your organization. Requiring well-trained people and technology, unbiased data and qualified interpreters can turn analytics into meaningful, sustainable results.
As research continues to demonstrate, engaged workers perform significantly higher than disengaged ones. The fact that employee satisfaction and engagement levels now impact revenue-generation has caused HR leaders in the healthcare sector to focus on key HR initiatives to drive important business objectives. And, patient safety, patient satisfaction and cost containment all arguably hinge more than ever on worker satisfaction.