How Providers Can Improve Revenue Amid Staff Shortage

Amid the pandemic and increased provider burnout, the ongoing staff shortage has placed strain on health care organizations.

In this interview, Matt Seefeld emphasizes measuring staff effectiveness and optimizing data and workflows, strategies he says will allow provider organizations to thrive despite the shortage.

Can you comment on how the pandemic has impacted staffing in health care organizations?

It is the Great Resignation. Everybody is fickle when it comes to where they work nowadays, and we have high turnover. People are not necessarily looking for careers anymore—they are looking for jobs, often short term.

It has impacted health care on both the clinical side as well as the financial side. High staff turnover can be very detrimental to the margins of health care providers.

How do you retain effective staff? The hard part is objectively identifying who is effective at their job and who is not. The last thing we can afford to do in this day and age is lose effective people.

We also have sent everybody home. When I asked at a conference how many administrators had sent their entire business offices home, or at least most of them, 95% of people raised their hands. Work from anywhere is here to stay. How do you monitor remote labor and make sure they are being effective?

How has fewer staff affected providers, patients, and the health care system more generally?

Although we are a financially focused firm, I continue to read how the clinical side has been impacted.

A lot of medical assistants are not showing up to work. They are resigning, and that is now disrupting operating rooms. Physician assistants and physicians are starting to retire early because they are burned out. There are a lot of macroeconomic things impacting the ability for patients to get services, whether it is an elective surgery or emergent care.

I equate it to when you walk into a restaurant and see 15 tables open, but they tell you it is a 30-minute wait. You ask why it is 30 minutes, and they say, “We don't have the staffing to cover those tables.” It is the same concept.

In the business office, lack of staffing is also detrimental. When people do not show up to work, it can impact cashflow for provider organizations. How are you going to ensure your claims billed to the insurance company are paid?

How can organizations leverage data to alleviate these challenges?

Data is the key. The challenge in health care is the billing systems and electronic medical records do not capture all the structured data required to understand revenue cycle effectiveness. From the point of scheduling the service, to billing the insurance company, to being paid for that claim, organizations must capture data for every single person working in that revenue cycle.

I am glad you brought up data because that is where we, as a company, have had to focus. We developed a workflow automation tasking system that is used by all full-time equivalents along the revenue cycle.

This system makes employees warrant their work, and then we can measure the outcome and the work effort it takes to get that outcome. We call it effective intelligence. That allows us to zero in on who is or is not effective.

A client asked how his revenue cycle is going, and I was able to tell him only 48% of his claims go out the door and are paid without any human interaction. It should be more than 48%. Not only do you have a labor shortage, but too many people are involved to get the outcome. That is a double-edged sword. How do we touch workflows less, get paid correctly, and do it with fewer people?

You need effective intelligence and the structured data that tells that story. It is a huge gap in this industry. I have worked on this for 22 years, and I have had to design four workflow management systems to make up for the inadequacies of practice management.

What do you think practices and providers should keep in mind when selecting a vendor to improve their analytics?

How are you automating many parts of your revenue cycle? Are you capturing the data necessary to tell the story of employee effectiveness?

When I start my messages with potential clients, I ask what their business objectives are. Nine times out of 10, people say, “I want to improve my margin.” Pretty simple, right? If there is no margin, there is no mission.

Then I ask how organizations are holding their people accountable for the work they are or are not doing. I ask about the work effort it takes for them to get an acceptable outcome. That is where clients say they do not know, and where we say, “Let me tell you a story. Let me show you a pathway to get that result.”

But we must return to the fundamental business objective of a margin. Providers must understand that changes to people, process, and technology must be made. This industry, historically, does not like change. But the bottom line is, you cannot say you want a better margin and then be unwilling to make a change and adopt software that holds your people accountable for their work.

With this labor shortage, high staff turnover, and work from home culture, if you do not have effective labor monitoring tools in place, you will not be successful. You may survive, but you will not thrive.

Thank you for that insight, Matt. Is there anything else you would like to add today?

When I speak at conferences, people ask me, “What do you see as the biggest systemic problems? Where do you see the next three years going?” I think I would be remiss to not bring that up for your readers.

High-deductible health plans are not going away. Patient liability is going to continue to grow. There must be flexible but proactive ways to collect from the patient. I see too much free care, especially in the elective surgical market. Patients keep coming back without paying their bills, but providers keep seeing them repeatedly. You have to drive accountability on the patient.

This work from anywhere culture is also not changing. We have been lucky that such technology exists so we can have our folks work from anywhere. It allows me to recruit over state lines, too. Three years ago, I recruited people in Arkansas to go into my company’s office. Now, I am recruiting the best people I can, regardless of where they live. Organizations need to understand the whole business world has changed, for all of us.

With data warehousing and virtuality, you cannot be held hostage to your provider management system and electronic medical records. Your data is going into a database, and you must have access to that database. More organizations, large and small, are starting to build out data warehousing. We do that for our clients, so they have real-time access and insights.

The last thing I will add is about real-time access. There is still too much reliance on bad data, and too much average or inconsistent data out there. Data need to be surfaced and analyzed. You should know whether you have opportunities to improve. If you do not, stop stressing, and go worry about all the other fun things in health care. But if you do have opportunities, you need to know why and what to do about it, quickly.

A lot of that comes back to labor and holding people accountable for the work that you are paying them to do. If they are highly effective, you will have a very, very good margin. That is where we have to live in the business world nowadays, especially in health care.

About Mr Seefeld

Matt Seefeld is the executive vice president at MedEvolve, where he oversees the sales and marketing departments, data science and workflow automation development teams, and revenue cycle services.

Mr Seefeld also founded a free app called myLifeLink, which is a sober community for those looking for human connection to combat physical, emotional, and behavioral addiction. The app can be downloaded on Apple or Google.

Mr Seefeld lives San Diego, California. He loves to surf, has two young children, and coaches youth sports.