Healthcare Cash Crunch: Complex Payments and Sidelined Treasurers Strain Financial Health

Healthcare is among the largest and most complex of industries in the United States.

As estimated by the Centers for Medicare and Medicaid Services, the sector accounts for more than $4.3 trillion in spending and more than 17% of total U.S. GDP, as measured in 2022.

PYMNTS Intelligence has chronicled the aches and pains of payments flows in the vertical. As spotlighted here, more than half of healthcare payment leaders describe payment and claims processing delays as a threat to operations. A full 80% are convinced that improving the efficiency of these processes is vital to the success of their organizations. However, just 53% report adequately automating payment workflows. The flows themselves wind their way across a broad range of stakeholders, a mishmash of digital and paper documentation, touching on everything from eligibility verification to preauthorizations for procedures, and interactions between patients, payers, insurers and providers.

The intricate networks that make up the U.S. healthcare system ultimately have an impact on the cash flows of the healthcare firms themselves. And as PYMNTS Intelligence found a report done jointly with Citi, “The Impact of Misunderstood Treasurers in Healthcare,” 44% of healthcare treasurers say that their cash flows are predictable.

Unpredictable Cash Flows

That leaves a majority, at 56%, of treasurers who say that their cash flows are unpredictable.

There’s a cultural headwind in place that stymies that predictability. The “misunderstood” treasurers we surveyed said that they are in roles that are not all that well-understood by fellow employees within their firms. PYMNTS and Citi found that just 32% of department heads understand the treasurer’s role well. As a result, the treasurers were not, and have not, been involved in the strategic functions of their organizations; if they’re not at the table, they don’t get a voice to declare what they need, in terms of technology or organization support, to improve cash flow.

And they’re also not getting the cross-department data that generates a broad view of the firm itself, and where other departments may be serving as a bottleneck for efficient cash flow. The negative ripple effect comes through never-captured insights into real-time cash positions and financial strategies that could improve cash flow and the overall financial health of the firm.

Among the departments they’d like to align with include finance (80% of treasurers said this), strategy (50% of treasurers pointed to this department) and sales and marketing (46%).

“Healthcare treasurers report an average of 44 ways their companies would benefit from greater involvement in interdepartmental decision making,” the report added. In fact, the treasury role within healthcare is the department that would see improvement in cash flow predictability in a cross-pollination of ideas and input — that metric is cited by 78% of treasurers vs. only 6% of other department heads.

There’s an additional boon in the returns on investments, as 64% of treasurers say the exchange of ideas across departments would improve those returns (and investment, we’d note, could include technology and automation). Only about 36% of other department heads said they’d envision a positive return on investment were a more collaborative approach set in place.