Meet executives who are leading the way toward revenue cycles that are more streamlined, transparent, patient-focused, and automated than ever.
By now, the importance of consumerism, price transparency, and automation in the revenue cycle is undebatable. The industry is changing—fast.
But often, when it comes to putting these ideas into practice, excuses abound: There's not enough time, staff, money, or IT resources to embark on daring new initiatives when just getting through each day is a challenge.
Yet real-world change within the revenue cycle is achievable, necessary, and worth the investment. Meet four revenue cycle vice presidents who are leading the way within their organizations and the industry.
They share their experiences, challenges, and accomplishments as they move toward revenue cycles that are more streamlined, transparent, patient-focused, and automated than ever. Along the way they've saved millions, slashed denials, and boosted patient and employee satisfaction.
Revenue cycle executives like these will share their ideas and successes at the HealthLeaders Revenue Cycle Exchange December 9–11 in Palm Beach, Florida.
Here are four VPs building the revenue cycle of the future:
Price transparency pioneer
UCHealth was one of the health systems that Centers for Medicare & Medicaid Services Administrator Seema Verma held up as exemplars of providing price transparency and going beyond CMS requirements—a public acknowledgement that Greer called "a really great surprise."
"I think we have more services available on an online tool than anyone else in the country right now," Greer told HealthLeaders.
In a two-part interview, HealthLeaders talked with Greer about UCHealth's pioneering tool, which takes into account the service, the facility, each patient's individual insurance information, and any contractual discount negotiated with the payer, to instantly generate a real-time estimate.
"It's the combination of all those things that provide the patient a complete estimate," she said.
UCHealth is constantly making tweaks to ensure the highest degree of accuracy, using a dashboard that monitors every estimate and compares it to the ultimate amount that the patient was charged.
"We want to get to the point where patients can have absolute confidence," Greer says. "There's no sticker shock, no surprise bills."
Greer added that her peers in other organizations likely already have everything they need within their EHR systems to implement price transparency initiatives of their own.
"It's not like they need to go out and buy something to do this, it's probably within their electronic health record. And bottom line is it's incredibly better for the patients," she said. "It's just a totally different experience for their patients and a much better way to manager customer service."
Patient payment innovator
Steve Scharmann, vice president of finance and revenue cycle management at Dignity Health
After tech startup OODA Health expanded its real-time healthcare payments pilot program with Dignity Health (which is now part of the newly formed CommonSpirit Health), HealthLeaders checked in with Scharmann for an update on the pilot.
The pilot, which aims to give consumers a retail-like payment experience, while reducing the burdensome administrative costs of billing, is underway at Mercy Gilbert Hospital and Chandler Regional Hospital. There are also plans to begin at two additional hospitals and other facilities this fall.
"Our partnership is enabling us to streamline the administrative billing process with payers to allow patients to pay for their care as easily as they pay for everyday consumer transactions," Scharmann said.
"We have replaced the need for each provider to send their own statement, which simplifies things for the patient," he said. "Our goal is to develop a single statement that requires a single payment from the patient for treatment from multiple providers."
"Staffers no longer need to engage in patient billing activities, freeing them up to focus more on activities that contribute to a positive patient experience," he added. "They also have fewer electronic payments to post to the patient accounting system."
Streamlined billing champion
Intermountain Healthcare has been working to digitally streamline its patient financial experience, allowing patients to consolidate, view, and pay all of their Intermountain bills from a single electronic location.
The goal is to give consumers a more consistent and cohesive billing experience, regardless of how the business has been segmented, Craghead says of the Salt Lake City–based health system.
Intermountain has been working with the company VisitPay to give patients electronic access to a comprehensive view of everything they owe across the system, channeling all their bills into one place and in a single monthly statement.
The opt-in system presents what patients owe in a single dollar amount, breaking it down by charge, payment, and insurance coverage for each visit.
Patients are given the option to pay their balances in full or set up payment plans. There's flexibility in how and when they pay, too. For instance, they can use their credit card or Health Savings Account credit card to pay.
They can also set parameters for automatically paying bills that fall within a certain dollar amount.
A single user can also channel multiple family members' bills together, such as spouses, minor children, and even aging parents, with the appropriate authorizations.
Since implementing VisitPay, yields from out-of-pocket payments improved by 15–20% at Intermountain. Intermountain is also tracking to a 25% increase in overall yield, while experiencing cost reductions.
In addition, the number of Intermountain patients who rate their billing experience as good or excellent is up more than 40%.
Clear communications leader
Sandra Peterson, executive director of revenue cycle management, UAB Medicine
When different revenue cycle functions don't communicate well or don't operate under the same leadership umbrella, organizations can experience high denial rates, unresolved coding queries, and much more.
That was the case for University of Alabama at Birmingham (UAB) Medicine, which integrated its hospital and physician practice revenue cycles, as well as its HIM and hospital patient access functions under a single governance structure and saved $68.7 million in the process through a combination of cash acceleration, reduced costs, and net revenue increases, according to a case study.
"Without having everything under one leadership, you had the different functional areas potentially going in different directions," Peterson says.
At the heart of the changes is a new governance structure that includes an executive committee for high-level and strategic functions; a program committee and subcommittees for managing ongoing operations; and a revenue cycle committee that deals with tasks such as action plans and benchmarking.
Each of the committees includes representatives from throughout the system who meet regularly. For instance, the program committee meets three times a week for huddles in which they discuss hot topics and issues that need immediate attention.
The open and ongoing communication that the new governance structure provides, alongside other changes to revenue cycle functions, have led to big improvements in a relatively short amount of time.
Denials management, discharge not submitted to payer, and uncompensated care UAB improved because of the new governance structure that contributed to the $68.7 million savings tally.
The Revenue Cycle Exchange is one of six healthcare thought-leadership and networking events that HealthLeaders holds annually. While the events are invitation-only, qualified healthcare executives, director-level and above, will be considered. To inquire about the HealthLeaders Exchange program, email us at firstname.lastname@example.org.
Alexandra Wilson Pecci is an editor for HealthLeaders.
Photo credit: Photo credit: Zachary Darby, enterprise denials team manager, Mayo Clinic; Cassi Birnbaum, HIM & revenue integrity director, UC San Diego; Julie Franer, revenue cycle administrative director, Sierra View Medical Center (Photo: David Hartig)