How small community hospitals are making big digital transformations

Hospitals are the lifeblood of their communities. That’s particularly true for community hospitals, and ones located in rural areas. Often the sole providers for the complex healthcare needs of their area, they also serve as their major employers. In 2020, rural hospitals supported one in every 12 rural jobs in the U.S. and $220 billion in economic activity in rural communities.

It’s easy to understand why the stakes are high for community and rural hospitals to deliver on their mandates. But operating in today’s complex healthcare environment –one that includes changing reimbursements, workforce shortages, higher costs and much more – can be particularly difficult for smaller hospitals. Financial challenges mount as a result, and every year, dozens are forced to shutter their doors due to financial issues. An average of 21 hospitals closed each year between 2010 and 2015 – with 47 closing in 2019, a Harvard Kennedy School analysis found. There were 19 rural hospital closures across the country in 2020 alone.

But accepting continued financial struggle as a rural, small and even medium-sized hospital doesn’t have to be a foregone conclusion. And while the factors that must come together to ensure they can continue to serve their communities are complex, one of the contributors to success is to be on equal footing technologically with the largest hospitals in the U.S.

Enter Oracle Cerner and Flywire. Through its CommunityWorks program, the enterprise and now EHR software giant puts its flagship Millennium EHR software into the hands of smaller and often rural hospitals, partnering with Flywire to provide a digital-forward patient engagement and payments platform. CommunityWorks, a cloud-based version of Millennium software for hospitals with less than 250 beds, can be implemented in as little as six months on a fixed fee implementation at a discounted fee.

With EHR and payments technology comparable with some of the largest healthcare systems in the U.S. – sans the large IT staff to support and maintain it – smaller hospitals can ditch disparate and oftentimes legacy systems, and consolidate patient and financial data in a single database. And they have the functionality to use that data in innovative ways to improve patient care and hospital management. As a chief medical information officer told Cerner: “We’re a small, rural-based hospital. Unfortunately, those are closing left and right. If you don’t do things to keep yourself on the edge of both current medical technology, electronic health record technology and actual care for those patients, you’re going to become lost as well. Our partnership with Cerner has really been able to put us out in front, and I think that is one of the main reasons why we have continued to be successful.”

EHR plus payments software boosts patient collections in community hospitals

The reasons for any one hospital’s financial issues are complex, and somewhat dependent on where they are located. But to oversimplify, there’s just not enough money coming in to cover what goes out, or at least, not fast enough.

Collecting on medical bills is a challenge for hospitals of all sizes – but particularly for small and rural hospitals. Many community hospitals have a heavy reliance on public payer revenue, and receive low rates from commercial payers.

There are many reasons patients don’t pay medical bills on time, in full or at all. Bills can be hard to understand, they’re not easy or intuitive to pay, or patients don’t have the financial means to pay them all at once. According to a recent Flywire survey of 2,000 patients , 85% of patients are concerned about the rising cost of medical care, and nearly half said they can’t afford to pay for an unexpected illness or treatment in one lump sum.

With a solid EHR system and payments platform in place, hospitals have the foundation needed to drive greater consumerism into the financial process, creating patient payments experiences that contribute to higher rates of patient satisfaction while increasing collections and reducing bad debt.

It’s the marriage of these two technologies that makes it possible to meet the complex needs of the healthcare consumer today. With some of community hospitals being system-affiliated, EHR systems are needed to provide a single view of all of a patient’s care across a healthcare system. But they can’t always consolidate these charges and push this information into a bill that makes sense to the patient. That means often a patient who receives care across several parts of that system can also receive several disjointed bills for care.

This not only creates confusion, but can lead to lost revenues for providers. In that same patient survey mentioned above, 37% of patients admitted to missing a medical bill because they found the system too complicated. Payments software can be integrated with the EHR to deliver the patient a much more intuitive billing experience – from receiving the bill, through actually making payments on it.

By partnering with the right EHR and payments platform, many rural hospitals are gaining access to newer technologies such as machine learning to help inform the billing and payments process. From adapting to each patient’s communication preferences, to better understanding a patient’s capacity to pay the billed amount and automatically presenting financial options to pay (such as customized payment plans or integrated financing), community hospitals are more easily bringing their financial processes in line with what consumers have come to expect from other industries.

In its annual report on rural hospitals, American Hospital Association authors write that: “Despite facing ongoing challenges, a number of pathways exist for rural hospitals’ financial sustainability.”

More than 70% of new CommunityWorks clients beat baseline A/R 180 days post implementation, according to Cerner. With a robust EHR platform in place, there’s a foundation to implement leading technology that helps improve patient collections and puts paying for care within reach – which helps to make healthcare more accessible.