Causes of Revenue deficits of University Hospitals and Strategies to Reduce Them

Background: The hospitals' reliance on insurer organizations' resources is increasing due to the growing number of insured persons. However, a relatively large share of these revenues cannot be collected for various reasons and is considered as hospital deductions from revenue. Hence, this study aimed to investigate the causes of hospital deductions from revenue and strategies to reduce them in hospitals affiliated to Iran University of Medical Sciences. Materials and Methods: This qualitative study was conducted based on the phenomenological approach in 2017. Data was collected through semi-structured interviews consisting 17 finance experts in hospitals. Data analysis was performed using MAXQDA version10 and analytical framework of Gale et al. (2013). Results: Based on the framework analysis, two themes were identified as the underlying causes of hospital revenue deduction including direct causes and root causes of revenue deduction. Also, in order to reduce revenue deduction strategies, eight themes were recognized including interaction with insurance organizations;  analysis, assessment, and feedback on revenue deficit; coordination and empowerment of employees; proper organization of human resources; strengthening regulatory system, motivational strategies; good planning  and creating an organizational structure. Conclusion: The revenue deductions occur in all stages of converting services into income and the most important factor is lack of staff awareness and incentive to control deductions. Contributions of all process owners in the hospital and insurers and in particular the commitment of hospital’s senior managers are necessary to control the deductions.