The Trends in Healthcare Payments Annual Report focuses on the latest trends in the healthcare industry and provides key information to inform decision-makers on the changes underway. This report is intended to promote change and better efficiency through education. It uses data from the InstaMed Network, qualitative survey data from consumers and independent sources to examine the market from all stakeholders’ perspectives. To learn more about the latest trends in the healthcare industry, read the full report.
According to a report released by the American Medical Association, telehealth is a growing industry, with nearly 85% of physicians currently using it to provide care. Of those, 70% plan to continue to offer such services in the future. Furthermore, 60% of physicians felt that telehealth improved access to care and allowed for higher quality care. And over 50% of physicians indicated that telehealth had improved their working environment. As a result, telehealth will likely play a significant role in healthcare payments in 2022.
However, the potential for fraud and abuse of telehealth should be analyzed. In addition to expanding access to telehealth, the HHS Office of Inspector General has warned against fraudulent practices involving telehealth. These schemes use sham phone calls to prescribe expensive durable medical equipment. Further, they often combine telehealth with telefraud schemes. However, the risks associated with telehealth are higher than those associated with other types of fraud, including combining sham phone calls with fraudulent prescribing.
Real-time bill payments
The COVID-19 crisis continues to dominate headlines, but its massive impact will continue into the year 2022. Meanwhile, other, long-standing issues continue to demand attention. CommerceHealthcare recently completed a comprehensive market scan and analysis of leading issues in finance, revenue cycle management, and RCM. The results of that study were presented in a new report, “Healthcare Finance Trends for 2022.” The report analyzes eleven trends, including the potential impact of COVID-19 and the potential of electronic payment solutions.
The law sets federal protections against surprise medical bills from out-of-network providers. This protection is intended to prevent consumers from being shocked by large medical bills, which are often from out-of-network providers. According to the federal government, nearly 9% of hospitalizations are accompanied by surprise bills. It also requires health plans to provide key information to uninsured patients. The new rules are part of President Joe Biden’s push to increase competition in the health care market.
Value-based payment options
The private sector accounts for the largest share of health care spending, yet commercial insurers have been slow to move to value-based payment. To make the shift a success, APMs must be aligned across payers, service lines, and health plans. The federal government can help lead the charge by establishing the foundation for value-based payment by aligning it with public and private programs, as well as Medicare and Medicaid managed care.
Although the Affordable Care Act was passed 10 years ago, few value-based payment initiatives have achieved the goals of reducing costs and improving quality. While the number of value-based payment programs continues to rise, adoption of advanced forms of value-based payment is still well below the threshold required for widespread practice transformation. A significant barrier to broader adoption of full risk-bearing contracts is the administrative complexity of the models.
Costs of care
In 2022, US healthcare systems will be paying for more expensive illnesses, thanks to the pandemic. For instance, cancer will go undetected for years and patients will suffer from worse illnesses because their symptoms were missed. Blood pressure will increase without treatment, and prediabetes will turn into Type 2 diabetes. The health care system will also be struggling to deal with the costs of COVID-19, which is expected to persist into 2022.
The COVID-19 pandemic, which killed millions of people, also increased the use of urgent care facilities and virtual-care visits, and resulted in fewer emergency room visits. An emergency room visit can cost close to $1,900. In contrast, an urgent care visit costs about $165. In October, insurance company Aon released its health plan cost forecast, predicting a five percent increase in 2022 for large employers. That means health care costs will reach $13,000 per employee, a 5.2 percent increase from 2021.
The continuing labor crunch in the healthcare industry is a certainty for the next year and beyond. But there are ways for stakeholders to address this crisis. Here are five factors that could help mitigate the labor crunch in 2022:
If nursing homes had staffing levels equal to those of other health care facilities, the study could prevent 4,370 deaths in Medicare recipients over the next four years. It would reduce cumulative patient stays by 388,160 days and save hospitals $720 million. If we had a 4-to-1 staffing ratio, it would prevent at least 4,370 deaths among hospitalized Medicare recipients from 2019 to 2020. And it would decrease readmission rates and save hospitals $720 million over the next five years.
Costs of care after pandemic
In the United States, the COVID-19 virus quickly spread across the country. Many experts predicted high medical costs after the pandemic. Hospitalizations were expected to be expensive in hotspots. But the numbers are different than they were predicted, and non-COVID expenditures have declined sharply. While some of this care will still be provided later, it is not urgent and patients are likely to be reluctant to seek non-urgent care.
Health insurance spending decreased by 1.2% from the beginning of the pandemic to the end of 2020, accounting for 28% of national health expenditures. The decline in private insurance enrollment may be attributed to the reduction in elective procedures and services during the early stages of the COVID-19 pandemic. The resulting higher medical spending will also further reduce the affordability of care for the nation. The effects of COVID-19 will be felt for years to come.