As anyone who has visited a hospital recently can attest, facility fees and other expenses can quickly accumulate and inflate the cost of treatment. Care facilities, faced with added pressure from shrinking federal reimbursements and patients with high-deductible plans, have been forced to try to protect their cash flows by new means.
Scientific American recently explored one former MacArthur grant winner's proposal on how to deliver better care and cut down on expensive emergency room visits. Six years ago, after noting that seeking treatment in the emergency room for a relatively common upper respiratory infection could cost more than $1,000, Jeffrey Brenner began scouring billing data from hospitals across the nation. Together with a team of social workers and medical professionals, he learned that those provider who made regular house calls offered some of the most efficient care.
He brought others to his cause, and started offering other innovative caregiving solutions to help reduce spending. He offered one particular story that gives insight into his actions in the years since:
"There is a patient in Trenton, N.J., who went 450 times to the local hospitals in a single year," he explained. "She was chronically homeless and alcoholic, and she had a lot of physical and sexual abuse in her history. Through a collaboration with the local hospitals and social agencies, she was able to get into a special housing unit and worked with a multidisciplinary team like ours that got her down to 18 visits a year."
It is this kind of outside-the-box thinking that is necessary to address the many inconsistences that exist in our current health care system. Until others like Brenner offer innovative cost-reduction solutions, some care facilities may continue to experience a need for health insurance claims follow-up help. The decision to outsource receivables management can reduce the number of dollars released to bad debt and protect cash flow.