It has been widely reported that independent medical practices across the United States are suffering serious economic hardship as a result of the COVID-19 outbreak and the subsequent reduction in elective and non-urgent care procedures. It only goes to follow that industries servicing these practices will experience similar repercussions. In order to quantify the current and projected impact on medical billers who provide revenue cycle management services to independent practices and to better understand what measures these billers are taking to cope with the changing business dynamics, Inbox Health surveyed a diverse group of billers during the month of April 2020.
Billers representing approximately 1,200 medical practices responded to the Inbox Health survey. The responding billers support over 22 specialties, including family medicine (50%), Physical Therapy (41%) and Internal Medicine (48%). The practices which these billers support are spread fairly evenly across the United States: West (34%), Southeast (34%), Northeast (32%), Midwest (24%) and Southwest (17%). The responding billers ranged in size with many (54%) supporting 10 or less practices, 35% supporting between 10 and 50 and approximately 11% supporting over 50 practices.
Key takeaways from the survey include:
General Impact on Medical Billing
Approximately 55% of respondents to the Inbox Health survey on the impact of COVID-19 on medical billing see it as a serious threat, with another 30% recognizing it as a minor threat. Less than 8% of respondents see COVID-19 as no threat at all to medical billing. 36% believe COVID-19 will greatly impact their business over the next 6 months while 50% believe it will somewhat impact their business over the same period.
Almost 65% of respondents state that they have not had to, nor do they plan to, lay off any employees as a result of the pandemic. Just over 20% state that they have had to or expect to lay off between 1% and 10% of their employees, with almost 8% of respondents stating that they have, or plan to, furlough 25% or more of their employees.
Impact on Medical Practices
54% of respondents say that none of their practices have closed or plan to close over the next 6 months, while 21% see 10% to 25% of their practices closed or they believe will close over the next 6 months. Almost 18% of respondents see the impact of COVID-19 being much more severe, planning for 25% to 50% of their practices to close over the next 6 months.
Part of the stress on medical practices should be relieved as a result of the disbursement of the $100 billion that Congress allocated to hospitals, physicians, and other health care providers in the Public Health and Social Services Emergency Fund in the Coronavirus Aid, Relief and Economic Security (CARE) Act, also known as the Provider Relief Fund. The CARES Act was signed into law on March 27, 2020.
Impact on Patient Interactions and Collections
As the chart below illustrates, many respondents have seen a significant reduction in their patient interactions:
While some of this reduction can be explained as a result of a drop in elective and non-urgent care treatment, another explanation is that billing staff are now working remotely, away from many of their typical communication tools.
This reduction in patient interactions correlates with the 10% to 25% drop in patient collections reported by 27% of the survey respondents, and 25% or more of a drop reported by almost 24% of respondents. Patient collections, always a challenge for medical billers, has become even more difficult now as many patients are also suffering economically from the forced shut-down of much of the economy.
Responding to the Crisis
Medical billers tend to be run by experienced entrepreneurs who are used to adjusting quickly to changing business dynamics. Many of the billers Inbox Health surveyed are not only focused on bringing their own businesses through these challenging times but also providing any support they can to help independent medical practices survive as well.
Not surprisingly, almost 86% of respondents are increasing their telehealth support to better prepare their business to weather the COVID-19 storm. The chart below highlights other approaches medical billers are taking to adjust to the new business dynamics:
Many of the strategies being deployed by medical billers in these challenging times center around automation and finding more effective ways to interact with their patients in an effort to improve patient billing.
Clearly the medical biller community is struggling. However, like many other industries, they are demonstrating grit and creativity in adjusting to the new reality that COVID-19 has established. As the financial heartbeat of many independent medical practices, it is critical that the thousands of independent medical billers and hundreds of thousands of medical biller employees receive the support and appreciation they need in order to keep the U.S. healthcare system healthy and vibrant as we emerge from this pandemic.