Get the real deal on the top 7 medical industry business challenges and some ideas on how to overcome them. These are universal healthcare industry challenges like regulatory issues, how to accept payments and send bills the most cost effectively, technology challenges and more.
1. Regulatory issues – According to a recent article on Managed Healthcare Executive online, “When asked about the biggest challenge healthcare organizations face, a whopping 36.3% of survey respondents cited complying with new government mandates and requirements. Among these regulations, is the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which industry experts predict will be one of the biggest hurdles… Furthermore, healthcare executives are struggling with lower reimbursement rates for services rendered under Obamacare plans. “The exchanges often have high deductibles, leaving patients to shoulder more of the upfront costs of care,” Miro says. “When patients can’t afford to pay their deductibles, providers are often not paid for services and patients may not seek preventive care that could avoid future disease escalation.” All of this adds up to less patient visits to avoid paying high out of pocket costs and therefore less business for medical industry merchants.
2. Rising pharmaceutical costs – Increasing pharmaceutical costs are a big problem facing the medical industry and it’s being driven by several factors:
- Unit cost inflation
- The mix of drugs in the market (skewing increasingly toward high-cost biologics, cancer treatments, and other specialty drugs)
- Benefit designs that allow for consumption if a drug is available vs. if the drug is effective (in an era when more drugs are coming to market for a broadening range of issues)
- The complex system that rewards providers, pharmacy benefit managers, and pharmacies for volume
3. Technology challenges - Another challenge is the actual implementation of technology that’s used to organize and drive processes for healthcare providers. These can include EHR (electronic health records), hospital management, home health care, scheduling software, customer retention, bookkeeping, CRM, etc. Due to the complexities and HIPPAA requirements in the healthcare space, projects can take months to fully implement and require the project team to answer questions about how the software will work and where it will gather and disseminate data without fully understanding the implications of the decisions made. The other challenge is that no single software system can likely meet all the various needs so instead organizations are trying to pick two or three and then sync them up or just use them independently, often with a high rate of error because of the various system users having to move information from one system to another.
4. Payments issues – Invoicing/collections and handling the insurance reimbursement portions of the payments is a big stumbling block for healthcare merchants. Our full-circle electronic bill presentment and payment system can be integrated into other back-end management systems to provide the invoicing and collections and record-keeping piece of the puzzle. Learn more now.
5. Loss of market share – Because of the new healthcare marketplace many private insurers have lost market share which also moves patients from one healthcare provider to another who fits into their new insurance bucket. Here's what many healthcare providers are doing to attract new members and expand market share:
- 60% are expanding their customer experience improvement initiatives
- 53% are increasing consumer outreach initiatives
- 43% are expanding consumer relationship management capabilities
- 34% are focusing on improving cost transparency
- 17% are providing more financial counseling
6. Need to improve patient experience – Along with the above challenge of a loss of market share comes the increased need to improve the patient experience at every point of interaction to make them more loyal to the practice. Here are some key ways providers are improving patient satisfaction and retention:
- Maintain a tight schedule – don’t make patients wait more than 15-min for their appointment
- Offer text and email reminders instead of just phone calls
- Provide a welcoming office environment that is both clean and nice to be in. Offer a beverage station and magazines and have books/games for kids when applicable.
- Greet each patient by name and make sure the staff does the same, this creates a more personalized patient experience that they will remember.
- Follow-up by phone after a patient has had a procedure – this brief touch shows the physician cares and is willing to go the extra mile.