Six tips to help maximize revenue

By Advis Staff 

Agility, Alacrity, and Creativity are buzzwords we live by. That’s because the Healthcare industry must live by them as well. Be nimble. Be quick. Stay alert. Guard your sources of revenue and always be on the lookout for new opportunities. Sometimes opportunity is truly new. You feel your way while pursuing your goal. Other times, new opportunities are dressed in old clothes. It merely requires recognition of what it is. The trust factor is a given.

So it is with the six revenue enhancement tips below. One may be new to you or all of them quite familiar. Either way, Advis recommends that you maximize these opportunities to help maximize revenue. 

• Telehealth is a Revenue Generator:  As the pandemic continues, telehealth will remain a revenue generator while addressing capacity needs for various services. Although the future regulatory climate is uncertain, providers would be well-served to begin developing a post-pandemic, comprehensive telehealth strategy, which figures to be a key revenue component.

• Establish Greater Control of Pharmacy and PBM Networks: Hospitals continue to struggle to negotiate and compete with payers and PBMs relative to their pharmaceutical networks. This leads to lost revenue opportunities, limitations for patients, lack of drug access, and more. Over the past several years, hospitals and health systems that have established integrated retail pharmacy models with their own health plans and local employers, have seen success in competing at more favorable rates for patients while maintaining a robust and effective service line. As pharmaceutical prices continue to rise and payer/PBM access continues to limit providers, a robust retail program presents a significant opportunity for expansion and growth.

• Specialty Pharmacy and Infusion Clinic Coordination: Combining the two service lines of specialty pharmacy and infusion services are complementary. Specialty drugs currently account for nearly 40% of pharmacy benefit spend, and the number of patients who need specialty drugs are on the rise. Hospitals with 340B pricing can also experience additional savings. The hospital-based infusion services will also ensure patients continue to experience a seamless continuum of care and allow for the hospitals to utilize its existing nursing, pharmacy, dietitian, and physician services to increase revenue and increase patient satisfaction.

• Maximize FQHC relationships: The patient-centered focus of FQHCs, opportunities for specialty-care referrals, and management of low-income high-cost patients make these networks a unique partner for hospitals. Establishing, fostering, and growing connections between hospitals and FQHCs can reap benefits by ensuring patient care management is optimized across the care continuum.  By ensuring patients access to care in the right setting at the right time, hospitals and FQHCs can drive cost savings and increase revenue.

• Optimizing the Patient Experience and Maintaining Your Ability to Pivot: The silver lining of this past tumultuous year is the expansion and acceptance of telehealth throughout various healthcare venues and the flexibility that healthcare operators championed. That being said, as vaccinations continue and the pandemic gets under control, patients will still have lingering anxiety about seeking healthcare services and they will also have choices in their healthcare providers. With virtual services available now, accessibility beyond their immediate communities is a reality. They will look for the optimum patient experience. The focus of 2021, should be on optimizing the patient experience to set your organization apart from the rest. They need to feel they are safe when entering your facility. The virtual experience should be user-friendly and when onsite, promote contactless processes where ever possible. Now is the time for your facilities to review the patient journey and make necessary improvements while maintaining the ability to pivot when necessary. Take a look at improving this journey through state-of-the-art automation, improving flexible workflows, implement online or mobile scheduling, registration and check-in. And most importantly, optimize the experience by making the cost competitive in the market.

• Vendors, Emergency and Ambulatory Service Providers Should Consider Entering the Rural Market with the implementation of Rural Emergency Hospital Classification: The new Rural Emergency Hospital classification recently announced by CMS opens the door for emergency physician organizations, staffing agencies, and ambulatory service providers to enter rural markets by partnering or contracting with existing rural hospitals who may need expertise or additional specialized staff to meet the requirements of the classification. The financial incentives for this new classification is projected to assist struggling rural hospitals to promote much needed services in these communities and shift the focus to emergency and outpatient services from inpatient care.

Advis is a national healthcare consultancy made of legally trained consultants, financial experts, clinicians, hospital executives and business strategy and communication experts. Our team has hands-on experience partnering with hospital systems, community hospitals, physician groups and other providers across the country. Our services span the spectrum of needs from regulatory and compliance issues, to operations, financial, and new revenue stream analysis and implementation.