Surviving Fitch’s new ratings and large employer primary care clinics

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As if it wasn’t bad enough, life is about to get much harder for hospitals, particularly nonprofits. Disruptive moves such as Amazon setting up telemedicine services, getting into pharma and CVS buying Aetna are going to strain already tenuous market shares. And the newest blow: Fitch’s announcement of its new ratings criteria will affect revenue defensibility and make money more expensive.

Let’s start with market share. Protecting yours is going to get tougher with news that CVS plans to buy Aetna. If that deal goes through, all of Aetna’s members will be routed to CVS clinics, and you can be sure that other retailers and payers will follow suit. Then there’s the trend of major employers opening their own primary care clinics in markets where they have significant numbers of employees, according to Darryl Linnington, director of financial planning and analysis for McAlester Regional Health Center. Linnington was recently interviewed by Becker’s Hospital Review, and asked about attention-getting disruptors. His answer:

“We have recently learned that some major employers, in an effort to reduce health benefit costs for both them and their employees, are starting their own primary care clinics in the markets where they have a significant employee headcount. If local health systems do not engage these employers to alternatively provide a private value network, offering quality and cost-competitive healthcare services, they may see their volumes diminish. We have recognized that direct communications with employers — even branch plants of national companies — and helping them to evaluate their health plan design and costs is essential to maintaining and improving our market position.”[1]

Then there’s the problem of money. As bad debt increases for nonprofit hospitals, it will likely become much more difficult to borrow money, based on Fitch’s rating changes. According to an article in Becker’s Hospital Review, Fitch Ratings new criteria “focus on the following rating drivers: revenue defensibility, operating risks, financial profile and asymmetric additional risk considerations.”[2]

Disruption is hitting you from all sides. How are you going to compete with retailer-payer mergers? With large employer private clinics? How are those employees going to know about you and decide to choose you beyond primary care? What are you going to do about your debt service and how it’s rated by Fitch? How are you going to defend your revenue and ensure your debt doesn’t go up?

What is your plan?

To compete and survive you must disrupt the disruption and create a brand so powerful that people choose you. And not just choose you, but flock to you. What better way to create a brand that demands attention than to create a medical marketplace that drives consumers your way and promotes your brand in the process? Create a marketplace like other industries that are winning. The Amazons and Expedias of the world. You can do this in healthcare and disrupt the market to your advantage.

As a provider, you can do more than defend your market. You can strategically control it with a compelling marketing strategy that will help you dominate. HealthQRS has it ready for you. Right now.

A simple, yet powerful, e-commerce platform is the strategic marketing tool needed for every hospital and clinic. Just as simple, online retail shopping attracts consumers, a simple online medical retail experience will draw patients to you. We can help you win consumers with a retail application that allows people to easily find you, schedule services and procedures and pay with a few finger taps on their smartphones. HealthQRS has a complete retail application ready to help you market yourself. Our solution is a software as a service (SaaS), so you only pay a low monthly fee, with no capital investment.

HealthQRS has developed the only complete e-commerce medical marketplace platform on the market. We essentially created the “Amazon platform” for healthcare that gives consumers exactly what they need without the white noise. Our solution can be used for virtually any healthcare model including hospitals, clinics, outpatient surgery centers, behavioral health and freestanding imaging centers.

We also offer a pre-scheduling/collection service to help providers collect patient out-of-pocket expenses upfront. This solution interfaces with existing practice management or hospital management systems. Our new pre-scheduling/collection service provides a call center staff to you and can handle your claims submission, claims status inquiry, ERA processing and online claim corrections. If you want to perform the functions with your own staff our point of service/pre-scheduling solution has all this functionality plus medical necessity included (except the claims services). If you use our point-of-service solution for all registrations, then you receive our e-commerce medical marketplace solution at no additional cost.

It’s important to note that an e-commerce platform is not just a revenue cycle solution, but is the strategic marketing tool that is needed for every hospital, clinic and service provider. Now is the time to provide true prices along with an easy-to-use shopping experience for consumers, businesses and their employees. Disrupt the disruption.

We invite you to learn more about HealthQRS and our e-commerce medical marketplace and how we can help you be the disrupter. We have over 12 years of experience developing healthcare retail experiences for consumers and our founders have over 50 combined years of e-commerce experience. Why not  contact us right now for more information or click here to schedule a demo? Or watch our point-of-service video to see how we can help you.

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[1] Jessi Young, “Becker’s 9th Annual Meeting Speaker Series: 3 Questions with Darryl Linnington, Director of Financial Planning and Analysis at McAlester Regional Health Center,” Jan. 5, 2018, https://www.beckershospitalreview.com/hospital-management-administration/becker-s-9th-annual-meeting-speaker-series-3-questions-with-darryl-linnington-director-of-financial-planning-and-analysis-at-mcalester-regional-health-center.html–

[2] Ayla Ellison, “Fitch finalizes new rating criteria for nonprofit hospitals: 5 things to know,” Becker’s Hospital Review, Jan. 9, 2018, https://www.beckershospitalreview.com/finance/fitch-finalizes-new-rating-criteria-for-nonprofit-hospitals-5-things-to-know.html

 

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