Coping with COVID-19 – Part 1

How Front-Line Healthcare Leaders are Solving Financial Challenges During the Covid-19 Crisis

On April 9, 2020, Ingenious Med CEO Nimesh Shah and Founder/Chief Medical Officer Steve Liu, MD, convened members of our advisory board, who are on the front lines of the COVID-19 crisis. Our goal was to understand their key challenges during the pandemic and to provide a forum for sharing innovative problem-solving approaches.

Their top issues involved overcoming seismic volume and revenue challenges while managing resources strategically to provide effective care in a rapidly changing environment. Part 1 of this blog series reviews the volume and revenue challenges; Part 2 covers best practices for managing resources.

calculating hospital revenue during covid 19

Managing COVID-19 volume and revenue challenges

The onset of the pandemic meant that many providers were suddenly faced with a host of new coding, analytics and reporting issues. A large southeastern clinical outsourcing group was working out how to flag a chart where COVID-19 is suspected but there isn’t a definitive diagnosis. They have to determine if this represents a false negative test result or another issue. To partially solve this problem, they were attaching a stand-in code to the chart which could be flagged for later, as they weren’t yet sure how payers would treat these cases. They’re also trying to give as much direction about documentation to their providers as possible.

Dr. Liu noted that Ingenious Med had fast-tracked several new functionalities to help hospitals and physician groups address this and other COVID-19 related problems, including:

  1. New COVID-19 status codes and tools to quickly capture diagnoses
  2. COVID-19 flags to identify and track confirmed and suspected patients
  3. The ability to easily capture telemedicine encounters in inpatient and ambulatory settings
  4. Reporting and dashboards to report on COVID-19 daily totals and trends by location
  5. Recommended daily mobile and web COVID-19 clinician workflows

These new functionalities help providers track and capture revenue for all COVID-related cases more easily.

The vice president of physician services at another large physician group noted that they had activated the Ingenious Med COVID flags and were working with their many locations to help them capture the information they need. Additionally, the chief clinical officer of hospitalist services at an integrated medical practice with over 16,000 clinicians commented that the COVID flags and reports have enabled his organization to see a daily view of their volumes across sites. This enables them to see trends and predict where surges are about to occur.

“We want to define the worst period in this crisis and know when to declare it over. We’ve isolated those analytics from our regular run rates because we’re already negotiating renewals with clients.”

Advisory Board Member


A West Coast group was in renegotiations with its health system partners about managing finances at a time when the virus is forcing it to ramp up staff. It’s used Ingenious Med to isolate pandemic-related data from its normal run rates, spot trends and use this information in its renegotiations.

Managing declining hospital volumes and revenues

The irony of COVID-19 is that, while many clinicians have never been busier or more stressed, physician revenues are plummeting an average of 55 percent due to the loss of elective surgeries and in-person visits. One hospitalist group applied for the Payroll Protection Program, which offers forgivable grants of up to $10M for retaining staff; however, it found the Access Medicare advance payment program, which must be repaid quickly, less useful as a long-term solution.

hospital telemedicine during covid 19

Telemedicine has become a popular way to provide some continuity of care when in-person visits aren’t an option. Relaxed regulations and reimbursement increases by Medicare and commercial payers have made this a more viable option, but it can be harder to account for these visits properly. A West Coast health system is using Ingenious Med coding tools to track revenue when converting in-person services to telemedicine encounters.

Predictions about a post-COVID-19 world

One advisory board member spoke to the challenges of managing staff productivity in the face of a 30 percent volume drop. Noting the uncertainty around how long those low volumes would persist after the pandemic subsides, he asked, “Do we get back to normal or is there a percentage of these kind of discretionary admissions that are now gone and being cared for in other ways? I think that’s something we all have to anticipate.”

Using the productivity data from Ingenious Med can help groups to keep their costs low while being able to ramp up appropriately as volumes increase. Should the pent-up demand surge once patients feel safer about in-person care, organizations that closely track their volumes, revenues and staffing patterns will be better positioned to respond to the next shift in volumes.

“The stories that are out there are a reminder of why we all got into medicine. And my hat’s off to anybody that’s on the front line. Our healthcare providers truly have my ultimate respect.” 

– Advisory Board Member


What other changes will we likely see once the immediate threat of overwhelming COVID-19 outbreaks has passed? The group’s predictions included:

  • Value-based care metrics being put on hold in the short to medium term
  • Enduring and increased reliance on telemedicine
  • Fewer smaller, independent physician groups as revenue concerns drive them out of the market
  • A different mix of visits and more co-management arrangements
  • The right-sizing of procedure volumes

Preparing for needs well beyond the COVID-19 pandemic

As one participant indicated, the pandemic will reshape healthcare delivery in lasting ways. But hospitals, health systems and physician practices won’t be around to deliver that care if they can’t sufficiently manage their costs and revenue streams. That means organizations must become more nimble by coding accurately, managing productivity tightly, spotting trends quickly so they can anticipate future needs and capturing every possible charge.

Ingenious Med’s platform supports optimal revenue capture under many conditions with its new COVID-19 and telemedicine support, as well as its ability to easily and accurately capture revenue at the point of care from mobile devices. That ability can support clinicians across care settings, into the post-acute world and beyond.

To continue reading about strategies for managing resources strategically to provide effective care in a rapidly changing environment, please see “Coping with COVID-19 – Part 2.”