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Cost Optimization Tactics for Healthcare Businesses

The global healthcare services industry was valued at $7,975.87 billion in 2023, marking a compound annual growth rate (CAGR) of 6.3% from 2022. It’s expected to grow to $9,816.85 billion in 2027 at a CAGR of 5.3%.

Healthcare tech is a significant contributor to that growth. Sometimes referred to as healthcare IT, this market alone was valued at $663 billion in 2023, and is expected to see significant growth of CAGR 15.8% by 2030.

The growing use of smartphone and demand for remote patient monitoring are among the top reasons for this double-digit growth forecast.

As one of the largest and most vital industries around the world, it’s no surprise the healthcare industry is one that struggles with rising costs. It’s not just inflation that impacts the cost of healthcare and medical services, although they are a major contributor, but as technology advances so do the procedures and patients’ medical needs.

Research by Definitive Healthcare found that salaries and surgical supplies represent the biggest share of costs for medical institutions. This makes it difficult for healthcare facilities to reduce their expenses without impacting quality.

However, cost optimization allows hospitals and healthcare businesses, in general, to reduce their cost, streamline their operations, and find new ways to generate revenue.  

First Step: Operational Audits

Before a healthcare organization can begin cost optimization, it needs to conduct a detailed operational audit. This audit analyzes more than the organization’s various expenses. 

The auditing process examines the entire patient journey, the procedures taken at every step, and the performance of the different teams involved.

  • Time wasted is one of the key elements that contribute to the leakage of costs. The sequence of a given checkup
  • The quality of the doctors’ reports 
  • Insurance and claim procedures, as well as contract terms with insurance companies

Internal audits are designed to help hospitals and medical institutions evaluate their operations, systems, and spending. They help them find ways to make them more efficient, while maintaining patient safety and confidentiality as well as ensuring compliance with local laws and regulations.

For example, an internal audit may review the patient’s journey from the moment they book an appointment until they receive their discharge papers. This may include the time invested by receptionists and medical staff all the way to accounting, insurance, and follow-ups.

For a healthcare institution, it may be helpful to conduct several internal audits, each dissecting a part of the healthcare process.

For example, a hospital may audit its process from the moment a patient enters the building to the moment they leave. It may conduct a parallel audit of doctors’ and nurses’ processes for seeing and treating patients.

An audit may uncover miscommunication, a needlessly-long process for patients to be seen by doctors, among other areas where value and cost can be optimized to serve both the healthcare entity and its patients.

Moreover, a hospital may conduct an audit to review its marketing and sales as well as its processes and negotiations with healthcare insurance providers. Such an audit may offer insights into areas of fraud, wasted revenue, or simply opportunities to optimize spending.

By conducting this series of audits, a medical institution may uncover ways to re-negotiate better contracts with health insurance providers, reduce and optimize spending, and increase revenue streams by providing new services to patients.

New Revenue Sources

Offering new complementary services using your existing resources—without overextending them—is a great way to generate higher revenues from the same cost.

For example, providing home care or at-home visits by doctors can reduce the number of patients, pressure, and chaos in hospital waiting areas. It also offers opportunities for elderly patients to get the medical attention they need and pay for it from the comfort of their homes.

Adding clinic services to a hospital or additional care services to a polyclinic are other examples.

Second Step: Optimizing Costs

The results of the audit will show the gaps and potential areas where a healthcare entity can optimize, reducing its cost and increasing its efficiency. The next step is to implement a cost-optimizing strategy. 

One of the essential tools that help optimize your operations is technology. Streamlining operations with AI can improve the speed of delivery and accuracy in providing a medical service. 

For example, healthcare professionals can use AI algorithms to analyze medical imaging data and deliver quick and accurate diagnoses. Similarly, Automatic Speed Recognition software can be used to document medical information more accurately.

Auditing and improving the quality of patient care can help hospitals and medical centers increase patient retention and forecast revenues.

Using technology can improve operational performance through the use of booking apps to capture more patients and track their journeys and experiences, automating billing and scheduling to reduce paperwork and expenses, and so on.

Healthcare service providers should use data and analytics to improve decision-making across day-to-day activities, business, operations, spending, recruitment, or any other area. Data can vary from incoming revenue sources, number of health insurance partners and how they contribute to a hospital’s annual revenue, among others.

The healthcare industry is a fast-paced one. One way to optimize costs in healthcare is to help teams adapt to new changes and regulations. Whether these are internal changes or external ones like new laws or legislation.

Regularly upskilling healthcare teams and professionals helps hospitals optimize spending by increasing employee retention and reducing turnover and layoffs. Doing so also reduces recruitment costs and ramp up time for new employees such as nurses, doctors, or even admin roles.

Outsourcing non-core functions such as human resources, recruitment, facilities management, and some financial operations can help optimize healthcare costs.

Conducting regular assessments of your entity’s financial situation along with financial forecasts can offer a clearer picture of where your business is and what you should do to improve.

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