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Rural Health Reimbursement Pain Points – Part 2

This is the second part of our three-part series on rural health reimbursement pain points.

Last month, we explored a number of operational related issued that rural health providers face and which have an impact on the organization’s revenue flow. We continue to review common challenges faced, focusing on revenue related issues.

Shift in Payments to Patient Responsibility

In recent years there has been a shift of payment responsibility from third-party organizations to patients due to high deductible plans. Patients are now the third largest payer for a number of organizations. Along with the shift has been a growth in bad debt. To balance this, providers need to ensure they are appropriately identifying the patient’s insurance as part of the registration process as well as the patient responsibility. Then, effective up-front patient collections are critical.

Increasing Payor Rates Not Keeping Pace with Cost

Providers nationwide are seeing an increase in payer rates, but unfortunately, these rates do not align with the increase in costs. This variance is an issue for rural health providers, as historically, they, on average, maintain a lower patient volume than urban providers. This lower volume makes the negotiation process with payers all the more difficult. It is important to remember in tough negotiations to focus on geographic coverage. While the number of patients may be low, illustrating the geographic coverage of your organization can be a good point to leverage.

Capital Funding Constraints as a Result of Low Margins

Rising rates and costs as well as other factors contribute to the low margins experienced throughout the healthcare industry. Such margins also make it difficult for providers to secure capital funding. Making strategic cost decisions and analyzing your organization’s service offering can be a good place to start as you work to secure available funds. Also, look for what funding is available to you.

Rural Health providers are faced with a number of unique reimbursement challenges. It is important to remember that you are able to take strategic actions to combat many of these points of concern. If you have the pain points highlighted in the series so far, please reach out to our Rural Healthcare Reimbursement Manager, Caren Puvalowski. 

Stay tuned for part 3 of Rural Health Reimbursement Pain Points, coming to you next month.

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