The healthcare industry has been struggling recently to provide adequate, timely care without breaking the bank or the insurance company, but areas of the south have been faced with the most challenges. There are a few key factors that have contributed to the struggling healthcare industry in the south.
Most problems come from a lack of adequate support for both patients and healthcare organizations. This has shown up in the form of lack of adequate coverage with insurance and providers, as well as in the tasks required for those providing healthcare.
1. Low Level of Health Insurance Coverage
One of the biggest challenges facing the healthcare industry in the south is the lack of adequate health insurance for much of the population. With the debate over expansion of Medicaid services always being brought up, the southern states tend to provide the least for their populace. People in the southern states tend to have less reliable private insurance options as well. With these problems, it is difficult for hospitals and doctors to receive proper compensation for their work and can lead to medical billing issues.
2. New CMS Regulations
The Centers for Medicare and Medicaid Services (CMS) requires certain protocols and documentation that can be difficult for provides and healthcare organizations to achieve. The amount of work that must be provided to stay compliant can become very costly for hospitals and private practices, many times to the detriment of the patients. Practices that do not stay compliant with CMS risk losing that source of revenue.
3. Low Insurance and Medicare/Medicaid Reimbursements
Even when healthcare practices stay up-to-date with CMS standards, they often do not receive adequate reimbursement for their services. As medical billing continually changes, new codes must be implemented correctly or insurance companies will also refuse to reimburse for services. Obtaining insurance reimbursement has become quite a hassle for providers, especially in the southern states. People in the south are more likely to have low quality insurance with complex guidelines.
4. Lack of Physicians
The southern states have been struggling with a lack of adequate health coverage and an increased need due to numerous chronic health problems, especially in rural areas. The availability of physicians to care for the general population has not been able to keep up with the current healthcare demand. Providers have been pressured to take care of more patients than they can handle, leading to burnout and lower quality of care. Although this problem is seen nationwide, the need for healthcare providers has increased greatly in the south.
5. Changes in Health Information Technology
The rapidly advancing field of information technology has provided many excellent innovations, but it has also put pressure on the healthcare field to keep up. Health information technology, which involves the management of patient health records, has struggled to implement necessary changes in a timely manner. The lack of proper implementation of electronic health record systems can cause errors in patient care management and medical billing, along with other issues. The need to manage health records safely and efficiently can become too much of a burden for many healthcare organizations.
By understanding these challenges, the healthcare industry may be able to see some much needed reform. Providing better training for healthcare workers and allowing for improved reimbursements in medical billing can be major factors in overcoming most problems. As a whole, the healthcare industry has been faced with certain challenges, but these issues have been most prominent in the south.