
Home healthcare organizations are continually looking for ways to reduce cost, ensure
compliance, and serve more patients, while maintaining the highest possible quality of
care.
Even though managing field-based expenses in home healthcare differs from other
industries, most organizations rely on traditional expense management solutions — or
manual processes — to get the job done. In fact, it’s estimated that 90 percent globally
depend on this manual process, making it extremely difficult, if not impossible, to gain
the visibility, control, and, the comprehensive data insight required to accurately
monitor this spend and to drive a positive change.
DIFFERENCE #1: MILEAGE TRACKING
Car travel and mileage reimbursement requirements are significantly different between
home healthcare organizations and other large companies.
For example, Fortune 1000 companies tend to be sizable employers with large geographic
footprints, with employees based domestically and internationally. Healthcare providers
are typically big employers within smaller geographic areas, servicing a specific
metropolitan area or region.
Thus, most of a healthcare organization’s travel is done by car, as providers travel
from one facility to another, or to patients’ homes to administer home healthcare or
hospice services within their specific regions. All of this movement adds up.
The amount spent on mileage varies from provider to provider, but it’s very rare to have
a healthcare organization where personal mileage is not one of the top three expenses
and, on average, healthcare providers spend twice as much on mileage reimbursements than
any other industry.
With the demand for mobile healthcare expected to increase from $103B in 2018 to $173B
by 2026 as the population ages, those mileage costs will only increase. Yet, most
healthcare organizations still rely on their staff to manually track and submit mileage
reimbursement requests – which compromises accuracy, increases costs, and adds
unnecessary complexity to the expense management process.
DIFFERENCE #2: EMPLOYEES IN THE FIELD
One of the biggest challenges of managing Expenses in a healthcare environment versus a
large corporation is the culture. Whereas other types of organizations can mandate – and
enforce – travel policies, per diems, and set firm boundaries around mileage, it’s not
so simple for healthcare providers.
Every organization in the world struggles with change management. The bad actors
continue their bad acting until it finally hits a breaking point where regulatory
agencies step in and force that change. We’ve already seen that happen in the
pharmaceutical industry, with the Sunshine Act and Stark Laws. I’m sure the pharma
companies, if they could go back in time, would have put some rules in place before they
had rules dictated to them.
While organizations might put tight controls on traveling sales teams and mid-level
managers, they are far more relaxed with healthcare workers. By being proactive and
gaining visibility into their spending habits, healthcare organizations can identify
areas of questionable spending and make changes themselves, rather than forced
compliance.
As a result, most healthcare organizations have a non-mandate culture. However, there is
risk not having an enforceable policy and a Healthcare-Centric Expense Automation
Solution in place next time the regulators show up for an audit.
CONSEQUENCES OF STAYING THE COURSE WITH MANUAL PROCESSES
Perhaps more than any other industry, healthcare providers and payers face a great deal
of scrutiny around fiduciary responsibility.
When fraud is uncovered, it makes the headlines, as the public expects providers to live
up to a higher standard. There’s also a false perception that healthcare payers and
providers are wasteful, so anything that can increase this perception is usually quick
to hit the news.
Without complete and immediate visibility into corporate spending, it’s practically
impossible to detect fraud and abuse, and difficult to prevent cost overruns due to
human error.
Another common area of unnecessary financial bleeding is continuing medical education
(CME) spending. Most of our clients are surprised to learn they spend approximately
forty percent of their total Expense budget on CME. Most clinicians get an annual
stipend for education, but, the actual spend often well exceeds that budget, something
that is not discovered until it’s too late.
BEST PRACTICES FOR SOLVING THESE CHALLENGES
The home healthcare industry is particularly vulnerable to processing errors, delayed
payments, and supply chain disruptions for a couple of reasons: 1) The sheer number of
moving variables that make up hospitals, home healthcare, visiting nurses, hospice,
palliative care, etc. 2) The sensitive nature of patient information and the ethical
considerations therewith.
For example, let us say you run a home health care service that employs 150 visiting
nurses. These nurses spend their days traveling from home to home caring for patients,
never going in to an office. Because their jobs are completely mobile, visiting nurses
must have any and all tools with them at all times, which can create additional out of
pocket expenses.
In addition, maintaining patient confidentiality is one of the most important duties of
a healthcare worker. Automation provides an extra layer of security through AI, OCR and
ML technologies and eliminating paper. Paper-based processing lacks these advantages. In
a paper-based system, the employee is responsible for filling out the necessary
paperwork, storing records properly, and manually keying the data into the company’s
system or Excel document.
In a field that works around the clock, it is easy for papers to be lost, forgotten, or
filed incorrectly. This can cause an accounting nightmare as it is estimated that
locating one lost invoice/ receipt can cost up to $700.
AI, OCR and ML technologies. Proprietary OCR technology matches the card data to imaged
receipts, while it also reads the receipt for charge types that are out of compliance
with your policies.
Document control. Receipts are immediately put into the system via APP, upload or email
and can be retrieved anytime, anywhere, from any device. All you need is an Internet
connection.
Mileage. Mileage tracking through integrated mapping features and full day logging
availability saves you 20-25% ‘leakage’ by eliminating guess work, estimates and log
books.
Allocation and reconciliation. The system will automatically allocate receipts to the
appropriate GL/accounting lines, flag exceptions, and create credit notes.
ERP integration. An effective Expense Automation Solution will be configured to match
your general ledger and cost code structures for seamless integration with your ERP
systems, saving you time and money by eliminating re-keying.
We, at ExpenseAnywhere, think it is time to Break the Status Quo of the Paper Process in
Home Healthcare Expense Management
Thom Ripple, VP of Enterprise Sales – thom.ripple@expenseanywhere.com
Headquartered in Pittsburgh, PA, USA with offices on three continents and clients all over the globe, ExpenseAnywhere is a world–class provider of exceptionally powerful, easy–to–use, web–based solutions for travel and expense management, supplier invoice processing, and p-card / prepaid card management.