Healthcare organizations will face these 23 risks next year, analysis says

Revenue cycle issues such as denials management and patient access are among the risk areas for healthcare organizations next year, according to an analysis from Crowe, a public accounting, consulting and technology firm.

The analysis is based on assessments of nearly 3,000 risks in 2018 for more than 250 hospitals, health systems, physician practices and other healthcare entities. To determine top risk areas, Crowe examined how often a risk was included in assessments by healthcare entities. Researchers said they also considered each risk's effect on the healthcare entity and how likely the risk will negatively affect patient care, regulatory compliance and other critical goals.

Rather than ranking the risks, Crowe put them under five categories, although top risks may be relevant to multiple categories. The top risks based on likelihood of occurrence and their effect on organizations are:

Compliance

  • 340B Drug Pricing Program
  • HIPAA
  • Nonphysician contracts
  • Physician contracts and compensation
  • Pharmacy

IT

  • Business continuity and disaster recovery
  • IT governance
  • Cybersecurity
  • Systems access management
  • Systems implementation

Operations

  • Case management
  • Financial performance
  • Health information management
  • Joint ventures
  • Physician practices
  • Third-party vendor management

Patient care

  • Quality and safety
  • Telehealth and telemedicine

Revenue cycle

  • Billing and collections
  • Charge capture
  • Coding
  • Denials management
  • Patient access

 

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