Accelerating COVID-19 Revenue Recovery with Analytics

By Kaylee House

Hospitals continue to struggle to regain baseline inpatient and outpatient volumes following the COVID-19 outbreak—and many anticipate that volumes won’t return to normal until July 2021, an American Hospital Association analysis shows.

It’s one reason why leading hospitals are using analytics to understand the financial impact of COVID-19 and predict their recovery curve. At The SSI Group, we’ve created a COVID-19 dashboard to give healthcare revenue cycle leaders the tools they need to clearly understand the effect COVID-19 has had on revenue and take the right actions to strengthen their financial health.

Diagnosing Financial Pain Points

The SSI Group developed the COVID-19 dashboard for hospital revenue cycle leaders to use not just to spot trends in financial performance during the pandemic, but also forecast future payment trends during the pandemic. Launched in August 2020, the dashboard analyzes pre- and post-COVID data from SSI clients, ranging from small to large organizations. This data includes billed charges and current and historical data related to claim payment.

With the dashboard, hospitals gain payment forecasts by facility and day as well as an all-encompassing view of payment across the organization by week and by month.

EXHIBIT ONE:

Modeling the Financial Impact of COVID-19

The most exciting aspect of this tool is a COVID-19 Recovery Curve Calculator that enables hospitals to determine what it will take to meet their financial recovery goals (with recovery defined as the total loss reaching zero or less than zero). It also projects the date the health system will “return to normal,” defined as the date at which the forecasted claim volume is equal to or greater than the pre-COVID-19 trend.

For example, if the organization’s goal for recovery is Dec. 31, 2020, leaders can plug this date into the calculator to determine the rate at which it will need to increase claim volume (in dollars) each month to meet its goal. The calculator also estimates the total loss to the organization if recovery is achieved on the projected date.

Depending on the organization’s goal for recovery, the rate of improvement and calculated loss will change accordingly. The tighter the recovery date timeline, the higher the monthly rate of increase in claim volume needed to support the hospital’s goal; the farther the recovery date, the lower the monthly rate.

EXHIBIT TWO:

Predicting Your Organization’s Path to Recovery

To arrive at this view, we analyze three years of pre-COVID claim payment data for each organization and then compare this analysis to the trends we are seeing during the pandemic. With this information in hand, we can estimate a hospital’s COVID-19-related losses since March 1. We can also project a hospital’s losses from March 1, 2020, through the end of 2021.

For hospital leaders, the projected recovery rate provides the basis for determining whether a hospital’s goals are achievable. It also offers a road map for a return to financial health.

Removing the Mystery from COVID-19 Financial Trends

The ways in which COVID-19 has disrupted financial performance vary by organization. Some hospitals were hit hard by a surge in coronavirus cases and associated delays in elective procedures. Others never experienced significant hikes in COVID-19 volumes.

That’s part of why numbers around average losses during the pandemic are less meaningful for hospitals than organization-specific data. Additionally, long-range forecasts may exaggerate losses when the forecast value is less than a hospital’s pre-COVID-19 trend.

What is needed is organization-specific data that tells hospital leaders:

• How the pandemic has affected their own organization’s revenue and cash flow
• What their timeframe recovery is likely to look like, based on an analysis of pre-COVID and post-COVID trends
• The steps their hospital will need to take to meet its financial goals in the year ahead

The more clarity that revenue cycle leaders gain related to pandemic payment trends, the better equipped they will be to respond in ways that make a substantial difference.

The COVID-19 dashboard is available through SSI’s existing claims analytics product. For more information, contact us.

bio:
Kaylee House, MBA, CSBI, CRCR, is Product Manager for The SSI Group. Kaylee has worked for The SSI Group since 2018. She has experience as a patient navigation specialist; an office manager for a dental group; and a surgical assistant/patient care coordinator.