How technology brought essential efficiency to UAB Selma
The organization was facing perils typical of rural providers, but automation brought dramatic improvements enabling patient-centered care.
Quality, affordability, availability and equity have been top concerns across the healthcare industry for decades. The COVID-19 pandemic and economic instability have only exacerbated those concerns in recent years. Patients want to know that when they seek medical care, whether preventative or reactive, they can find the help they need, but that isn't always the case.
More than 80 percent of counties in the United States contain "healthcare deserts," lacking access to adequate healthcare infrastructure, including pharmacies, hospitals, primary and trauma care, and affordable care options. Considering that 12.4 percent of the US population lived below the poverty line in 2022, an increase of nearly 5 percent from 2021, it's not financially feasible for millions of individuals to travel long distances for expensive healthcare options.
Unfortunately, a lack of financial stability has hurt hospitals and healthcare systems' ability to support patients. From 2019 to 2022, overall hospital expenditures grew 17.5 percent, with labor costs increasing nearly 21 percent, drug prices surging almost 20 percent and supply expenses climbing 18.5 percent. One contributing factor is inflation, which hit a record high in 2022 and continues to impact businesses and consumers. Another factor is a significant workforce shortage; by 2031, the Bureau of Labor Statistics estimates a nurse shortage of more than 195,000 and a physician shortage of 124,000, including as many as 48,000 primary care physicians. Without adequate staffing, healthcare systems struggle to meet patient care demands and face average per-person turnover costs of $50,000 to $75,000.
The University of Alabama Birmingham Selma Family Medicine Practice (UAB Selma) is the primary provider for the UAB Health System in Central Alabama and one of the oldest practices in the area. But recently, we identified a problem, which is, "How do we maintain sound financials while maintaining a high level of patient care?" Here’s how technology helped put UAB Selma on a long-term road to success.
The importance of rural healthcare
Selma serves as the county seat of Alabama’s Dallas County. Though its population is slightly more than 38,000, Dallas County has two healthcare deserts – a provider shortage and a trauma care shortage. UAB Selma is essential to central Alabama, considering the six neighboring counties have a combined 22 healthcare deserts, and Montgomery, the capital, is nearly an hour away.
The system serves a diverse range of patients, from infants to senior citizens, with a patient-centered approach that addresses whole-body health. In addition to its work caring for patients of all ages, UAB Selma is a primary training location for 18 family medicine residents. For more than four decades, UAB Selma has provided one of the few rural family medicine residency programs in the U.S.
The significance of healthcare in rural areas cannot be overstated. There are 46 million individuals living in rural areas, approximately 14 percent of the nation’s population. Several factors contribute to poorer health and higher death rates for rural residents, compared with their urban counterparts, including age (17.5 percent older than 65 years old, compared with 13.5 percent in urban areas), smoking rates (19 percent, compared with 11 percent) and obesity (34 percent, compared with 28.7 percent). As a result of these and other socioeconomic and environmental factors, rural residents face a higher risk of death from preventable ailments, including heart disease, chronic lower respiratory disease, cancer, stroke and unintentional injury.
Avoiding another healthcare desert
In early 2022, UAB Selma had a difficult decision to make — it faced financial challenges like numerous other healthcare systems and was on the verge of closure without significant changes, potentially leaving Dallas County with another gap in care.
UAB Selma found multiple culprits: accounts receivable delays, high claim denial rates and an inefficient billing system that took time away from the focus of patient care and wasted valuable financial resources. However, with a decreasing staff and increasing operational costs, what could be done? Having previously successfully implemented an electronic health record (EHR) system, leadership again turned to technology for support.
UAB Selma chose to integrate an administrative and financial management platform that was plug-and-play with the existing technology stack. This platform was fast, reliable and accurate, and had low technical barriers to entry. UAB Selma wanted a system that could augment human tasks in specific areas, including claim and statement submissions, claim denial navigation, claim error management, payer follow-up, credential identification and training program development.
Without assistance, UAB Selma risked joining more than two dozen hospitals that closed their doors in 2020 and 2021. With the help of technology, UAB Selma was able to achieve a 78 percent reduction in accounts receivable days, from 164 to 36; a 39 percent higher gross collection rate; and a 64 percent increase in payments per encounter.
Technology: The path forward
Healthcare still has systemic issues, and there's work left to do. Workforce shortages show no signs of slowing; millions of patients live far from affordable, high-quality care; and equity remains a challenge, as many underserved and marginalized communities are still distrustful of the system.
However, despite the underlying issues, technology offers a light at the end of the tunnel. It's time to take advantage of the tools available to address these problems and improve healthcare for everyone. There is no more time to waste.
Jeff Denney, MBA, MSHA, is the administrative director at UAB Selma Family Medicine Center in Selma, Ala. He is a results-oriented executive with 20 years of progressive experience in business administration, executive management, healthcare administration, healthcare operations and academic medicine.