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Summit Insights
Nov, 21

Operational and Compliance Considerations for 2022

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Steps to Take Now Heading Into the New Year (Article 4/4)

Concluding our series for healthcare services companies, I highlight some operational and compliance considerations. 

Here are four things to consider, some common observations and challenges we’re seeing with companies:

1. Did you receive payment through the CARES Act or other reimbursement (e.g. PPP, PRF or ERTC)?

  • Many companies received, or are in the process, of receiving forgiveness on such funds. Do you have the resources in place to meet the reporting requirements, both now and in the future? 
  • Companies that received multiple rounds of PRF will have future attestations. Is your team continuing to track and report the related expenses? 

2. How are your patients utilizing your telehealth solution?

  • A recent study from McKinsey concluded that “Telehealth utilization has stabilized at levels 38x higher than before the pandemic.” Currently, over 15% of all E&M services are being delivered with a Telehealth solution. For certain specialties, such as behavioral health, telehealth may represent over a third of all patient visits. 
  • During the pandemic, many states permitted limited platforms such as FaceTime. Have you upgraded to a comprehensive software that integrates with your EMR? Is your current set-up (i) compliant and (ii) delivering the best patient experience? 

3. How does your 2022 budget consider:

  • Potential staffing shortages and rising labor inputs. Common concerns we see are (i) clinic staff turnover, (ii) rising wages and (iii) the impact of vaccine mandates. At the same time, a stronger telehealth platform could help mitigate these risks to deliver patient care with less overhead. 
  • Supply chain issues securing medical supplies. Is your team effectively managing inventory and exploring secondary suppliers? Do you have sufficient working capital if new vendors require pre-payment? 

4. How has your revenue cycle team performed over the past year?

  • Have you experienced an increase in denials and/or delay in reimbursement from payors? 
  • With the additional work, is your team effectively managing patient responsibility, including refunds owed? 
  • Have you fully utilized stimulus programs such as supplemental reimbursement through CARES (e.g. uninsured patients, Covid vaccinations, etc)? 

If you’re a business owner, we encourage you to consider how your team is addressing the items we highlighted in this series. Does your team respond, rather than react, to a changing environment? Do you have a trusted advisor working inside the business, asking the right questions around the future health and growth of the Company? We celebrate our healthcare heroes in yet another difficult year, especially those working in underserved markets. 

Brian Ford is a FocusCFO Area President based in Nashville, TN.