Rising costs in healthcare are the paramount concern for hospitals and governments as it impedes achieving a sustainable goal for accessible and affordable care to maintain health and well-being.
Balancing the act of lowering costs without disturbing the quality of patient outcomes is a tricky and ongoing process for healthcare cost containment.
Costs can be attributable to factors that can be controllable and uncontrollable by hospitals in general. A few factors that are beyond the scope and control of a hospital that contributes to the inflated prices are:
- Aging population
- Technology developments
- Natural calamities and pandemics
All the costs that can be controlled without affecting the safety and quality of patient care should be reduced through effective steps. Let us discuss the various strategies that can be implemented in healthcare cost containment here:
- Streamlining administration process
Inefficiencies in administrative processes lead to a rise in costs associated with insurance claims. Currently, the administrative process is complex and results in duplications. Healthcare systems should have a unified interface for data storage and resourcing that is critical to patient care. For example, implementing modern radiology workflow solutions can be a game-changer and speed-up the process while saving costs. When standard forms are used in claims processing there is coordination between the healthcare facility and the insurance company. Streamlined processes yield a low-cost efficient model that improves provider-insurer claims transactions in claims processing.
2. Managed care with the guaranteed payment model
The healthcare capitation model reimburses a fixed payment to the care provider and helps in reducing costs through the capitation limit. If physicians are interested in profitability growth, they need to practice a cost-efficient model.
Under this model, the onus to manage medical supplies wastage is on the healthcare center as its accountable. As opposed to the fee-for-service model, only required diagnostic tests and medical supplies are used in a patient’s care. Healthcare providers are rewarded for delivering the right care and not more care in a capitation model. They promote early-stage detection and intervention for the upkeep of patient care and do not recommend services of high value that can be eliminated.
3. Promotions of public health programs
Prevention is better than cure in terms of safety and costs associated with cure. Public health programs promote awareness of safety and disease spread and prevention practices. A recent example of a public health initiative during a pandemic is the statutory warning to wear masks in public places and wash hands regularly to avoid the spread of the coronavirus. Public health campaigns are drivers of change in how the larger masses perceive safety measures and avert threats to their overall health. The government’s initiatives to reduce tobacco consumption, and taxes on foods and beverages with low-nutritional value are examples of ongoing public health programs.
4. Group wellness programs
Wellness programs sponsored by employers promote health at the office. The advantage of this program is that people follow their peers and try to step up their psyches toward a healthy lifestyle. They start practicing mindful exercise and nutrition to stay fit. Behavioral changes that reduce the incidence of health episodes like quitting smoking help workplace employees to lead a better life. In a way, it involves the employees and improves their engagement and experience in an organization. With a healthy workforce costs incidental to insurance are lowered.
5. Telehealth services
Monitoring patients remotely through RPM devices and telehealth services are evidence-backed steps that have reduced healthcare costs. Engagement and self-care practices implemented through telehealth services increase proactive participation from patients to manage their health through regular intake of medicines, diet, and exercise.
6. Fraud-control
Unethical healthcare practices like overbilling are examples of medicaid fraud that lead to billions of dollars in loss for health insurance companies. Concentrated efforts to detect and avert fraudulent practices in billing for treatment plans through vigilant audits have helped the healthcare system from losing money.
Conclusion:
An iterated healthcare system should aim at reducing costs that can be controlled at their end. Loss and mismanagement of processes will eventually increase the cost and pressurize the healthcare system. Over time, when healthcare becomes unaffordable governments and people will find it difficult to implement basic preventive measures as well. Healthcare cost containment is not a one-time exercise but a continuous process that needs to dynamically adapt to changes that will be purposeful.
