Across the US, nursing shortages are close to reaching a critical level. A McKinsey survey from May 2021 reported that 22% of the nurse respondents suggested they were considering leaving their current positions driven by factors that have developed during the pandemic. To make a bad scenario even worse, over half of these nurses are looking at alternate career paths or leaving the workforce entirely. Of those considering leaving their current positions, 59% reported that insufficient staffing levels were a primary factor, while 56% said the intensity of their workload was a key factor, as well. This turnover is costly for health systems and hospitals and exacerbates a pre-existing nursing shortage.
Pandemic-induced burnout has hospitals across the nation struggling to comply with nurse staffing requirements for two reasons: 1) Nurses are looking at alternate career paths, and 2) forgoing their full-time positions for travel positions.
Due to the nurses leaving for alternate career paths on top of the existing staffing shortage, nursing vacancies have increased dramatically over the pandemic. In California alone, those vacancies have increased 96% from August 2019 to August 2021. This impacts patient care accessibility; a nonprofit West Coast health system that treats over half a million patients annually, is being forced to consider closing some of its outpatient facilities and delay medical procedures as job openings continue to increase.
Nurses choosing to travel are motivated by demand, wage increases, and hopes to alleviate burnout. Nurses are paid premiums to travel to states with COVID surges, such as Texas. Aya Health, a large traveling nurse provider, reported they are paying up to $145 per hour for ICU nurses at facilities in dire need. This is causing nurses to leave their full-time positions to pursue traveling gigs, leaving their home hospital with insufficient staffing.
Some states have laws that cap the number of patients assigned to a single nurse or have committees responsible for setting staffing ratios. However, federal emergency waivers have been granted throughout the last year, allowing hospitals to work their nurses out of ratio. These emergency waivers allow that cap to increase, essentially putting more undue strain on the nursing staff.
A strong solution to alleviating medical burnout in nurses and physicians and to supplement a reduced workforce is outsourced concurrent reviews, whether partially, such as specific times of the day or specific days of the week, or in whole.
Engaging an outsourced staff to work on concurrent reviews decreases the clinical team’s workload. Nurses are no longer spread thin attempting to complete both their nursing and administrative duties. With the right partner, outsourcing enables your clinical team to have an ideal nurse-to-patient ratio and focus on high-quality patient care. It also provides the peace of mind that concurrent reviews are being given the attention they deserve for your organization to take a proactive, denial prevention-led position. During a time when increased demands are being placed on an already physically and psychologically strained staff, outsourcing concurrent reviews is a straightforward way to get your nurses back to nursing.
Outsourced concurrent reviews are also an immediately impactful tactic to utilize during staffing shortages. By supplementing your current team with experienced RNs to reduce administrative strain, outsourcing enables your organization to retain an attentiveness to thoroughness during admission to weed out registration errors. By reducing the extra work of potential appeals, your organization can realize increased revenue in a shorter time frame while also lessening the increased individual workload on your reduced workforce.
An effective concurrent review program is vital to health systems, both during and post-pandemic. It facilitates proper admission of patients, provides the opportunity to evaluate the medical necessity of care provided, decreases time to revenue, and increases reimbursement. Preventing denials can yield millions in additional revenue for a typical hospital, and their outsourcing is an effective and efficient way to immediately relieve pressure from the most cited factors behind nurse burnout today.
As the concurrent outsourcing partner to one West Coast health system, Advent Health Partners was able to recover $4.84 million from 2018 to 2020. Even as hospital denial rates across the country rose due to COVID, in 2020 alone, we reviewed 235 accounts and wrote 165 appeals that resulted in $1.14 million in revenue for them.
With a highly experienced clinical team, Advent’s reviewers step into your existing workflow, ready to start immediately. Our team becomes an extension of yours, reducing the administrative burden in whatever way is needed to help your nursing staff. Advent’s reviews are first-level utilization reviews performed in real-time through EMR access, and in the unlikely case of a denial, Advent defends our work throughout the life of the claim–at no additional cost. Our goal is to provide your team the support, knowledge, and resources right now to ensure appropriate reimbursement and reduce denials in the future.
Advent Health Partners can support your organization’s concurrent review process, reducing the administrative burden on your clinical team and reducing your time to revenue.