When talking to a medical practice manager recently, the person told me that the past couple years have been some of the hardest years they have ever experienced in healthcare. No doubt much of this was due to COVID and the aftermath of COVID. However, now that the pandemic has reached some sort of homeostasis in the world, there are a number of other forces at play that are making life painful for healthcare practices.

As we head into 2023, I see two major challenges we’re facing now and that will likely continue to be overriding topics of conversation throughout 2023—revenue and workforce.


The first major challenge we will continue to see heading into 2023 surrounds revenue. Prior to COVID, many practices kind of took revenue for granted. There was enough revenue to go around that a focus on revenue was not totally necessary. Today, this is no longer the case at most practices.

Of course, along with this need to focus on revenue has come a wide variety of forces that have changed the revenue picture. We have seen a dramatic shift in how much we collected from payers versus patients. Every practice is now collecting a much larger percentage from patients than they did previously.

Thanks to high deductible plans, this trend will likely continue. To make matters worse, payers are paying less for many services and inflation is changing practices’ cost structure. These trends will continue in 2023.

What’s the solution?

Most practices should start with engaging patients during their financial journey. This starts with having a 21st-century approach to collecting payments. Are you still sending out paper bills or do you have a paperless option? While some patients still need the paper bill, a growing number of patients won’t ever see a paper bill because they rarely check their mail and once they do they set the bill in a pile and forget about it.

While it is more effective to send a bill electronically to a patient, you also have to pair that electronic bill with modern payment options. Thankfully, most practices have started to embrace some sort of online payment option. However, are you also embracing things like Apple Pay and Google Pay which are becoming more and more popular? Are you also collecting text payments from patients? This technology is available and can help a practice improve their patient collections while providing a great payment experience for their patients.

Once you have opened a communication channel with patients, it’s an opportunity to take that relationship to the next level. The right personalized messaging to patients can drive more visits to your practice for things like wellness visits or even follow-up visits. There is an opportunity to show your patients you care while creating improved financial outcomes for your practice.

Another area to consider is looking at low-amount balances. By their very nature, these balances don’t seem like they are worth your time to collect. If a staff member is doing the work, that is true. However, using the right technology, you can scale your low balance collection efforts to ensure you are effortless recouping funds that can add up to larger sums over time.

Workforce Challenges

Healthcare has been hit by multiple workforce challenges all at the same time. The first is that many of our clinicians are burned out. Some are taking a break and will be back, but many of them are leaving the front lines to work for other companies that offer a better work-life balance.  Others are leaving the profession completely or retiring since they just can’t take it anymore.  Talking with a health leader recently, he said they were only at about one-third of their capacity.  Space is not the issue. Demand is not a problem either. The crisis is they can’t hire enough staff.

This is the reality for many organizations. Plus, a lack of clinical staff has a compounding effect.  Those staff that remain now have to work longer and harder to make up for the lack of trained professionals. This is brutal to see especially since we were already short on minimum staffing levels needed to care for patients.

The second workforce challenge Is associated with a broader movement that has been called “the Great Resignation.”  While prior to COVID many employees were loyal to a certain employer, the realization that virtual work is OK has opened up the door for many to explore other opportunities. It’s also become particularly challenging to fill lower wage positions.

The loss of practice staff has a compounding effect on practices as well. A trickle-down effect occurs. For example, when there aren’t enough front desk staff to manage patient check ins, it creates a bad experience which leads to unhappy patients. In that scenario, a dissatisfied patient has to wait to see a short-staffed doctor and the patient’s disappointment snowballs.  Combine a frustrated patient with an overworked doctor, and you know where this all leads.

What’s the solution?

It seems like this shortage of trained, qualified workers is going to last. This is where technology and automation can help. Technology is available to automate and improve the front desk and check-in experiences for patients and staff. Automation can help support an incredible patient experience at scale while reducing the burden on your staff. Patient communications are more effective and streamlined while patients get the kind of consumer-oriented attention they expect for an overall better patient experience.

Another effort practices need to make is around employee retention. What are you doing to ensure your employees have a great work environment? Ironically, where automation may previously have been viewed as technology to eliminate staff positions, now it is seen as a solution to better support an understaffed office. The tools streamline many of the mundane tasks that overwhelmed staff and enable them to be more successful at communicating with patients and booking more appointments. mundane tasks are being embraced by staff as a way to enhance their work environment.

When you are short-staffed and working 2-3 people’s jobs at the same time, automation is a welcome solution that creates a more enjoyable and rewarding environment for employees.

Key Takeaways

While practices continue to face revenue and workforce hurdles, they also present opportunities to  innovate and increase your business. In the past, many of these upgrades may have been overlooked by leadership who were seeing sufficient revenue earnings. But given the workforce and revenue pressures we will confront going forward, now is a ripe opportunity to leverage new approaches and adopt technology that will improve your practice both for patients and staff.