Breaking the status quo of paper processes in home healthcare expense management

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.

The best way to illustrate this point may be to contrast Expense Management in healthcare to Expense Management in a Fortune 1000 company. The differences are clear.


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.


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.


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.


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.

So how can the home healthcare industry protect patient confidentiality while ensuring one hundred percent accuracy, cutting processing costs, and streamlining workflows? By adopting an Expense Automation Solution, one that contains the following elements:

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

About ExpenseAnywhere

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.

To learn more about ExpenseAnywhere’s state-of-the-art corporate spend management solutions, visit us at or call us at 412-858-1111.