New year. New role. Renewed resolve to improve payer relations, financial sustainability, and patient access.
Last month, Sherri Liebl was appointed vice president of revenue services for CentraCare, a 10-hospital health system headquartered in St. Cloud, Minnesota. Liebl, a 12-year veteran of the organization and previously its executive director of enterprise revenue operations, has a big audacious mandate for her new role, which reports directly to CFO Mike Blair: "Manage all of the various polarities that are coming at us in multiple avenues, and still remain flexible and viable enough so that we can continue to exist in the communities and provide the necessary care to our patients at an exceptional skill rate," she explains.
To do it, Liebl has assumed oversight of two departments — government reimbursement and payer contracting — while retaining the traditional RCM function she's long helmed.
It's a tall order.
"The first 90 days is really about structure — learning the additional two departments and looking at how we can position ourselves a little bit differently … so that we can be more flexible as regulations come down the pipeline and we need to shift and change," she explains.
Over the longer term, Liebl will focus on "creating strategies to mitigate payer challenges, reduce costs, improve CentraCare's financial sustainability, and reduce the cost of care for our patients and families," she said in a statement.
Liebl sat down with HealthLeaders to discuss the "more holistic" suite of revenue services she now leads, her priorities for 2025 and beyond, and the sometimes unlikely sources of inspiration that help guide her decision making in the face of ever-evolving regulatory and payer challenges. It's a playbook that fellow RCM leaders can take a page from as they blaze their own paths into the new year.
1. On building relationships
"One of my very first goals is to … settle into the relationships with some of the other senior leaders in the organization to understand: Where are some of their stress factors at, where are some of their concerns at, and how can not only myself, but also my teams help them maneuver and mitigate?" Liebl explains. "What I'm looking to do is to create those partnerships and also to provide some education into the work we do and the reason for that work."
She recalls a recent conversation with a leader who, in response to hearing that the RCM function implements solutions to abolish debt for patients, said, "I had no idea. I thought you were just calling the patients up and asking them for money."
To curb such misunderstandings, Liebl is educating her peers on how her departments can help them achieve their priorities and track toward a shared North Star: better serving patients.
2. On reducing costs
Liebl's priority areas for reducing costs for CentraCare, as well as its patients and partners, include:
Working smarter, not harder: A big part of Liebl's new role will involve finding cross-functional efficiencies. "Let's not touch a claim three or four times. Let's get it out the door once, bring it back in, and have it fully paid," she says. That means aligning practices, processes, and technologies across system locations — an expansive, ongoing effort that last year drove the transition to a single, enterprise-wide EMR vendor and now includes the procurement team creating standard products and negotiating contracts "so that we get the best pricing, and we don't have one-off buys."
Readying for regulatory changes: "Right now, we've been focusing a lot of attention on what's going through Congress," Liebl says. Her team is closely following movement on the telehealth front, which earlier this month brought a stopgap budget bill to extend key program waivers for 90 days. CentraCare has invested heavily in this space since the start of the pandemic, contracting a company to provide some of its urgent care services, and the fate of those offerings hangs in the balance. "So we're doing those financial analyses to say, 'okay, if we can't do these telehealth services the way we have been doing them for the last couple years, what's the financial impact to us, and to the patient? Do we have the access available to the patients to still get them in? And how is this going to affect us going forward? Because now this is going to be a bigger lift."
Reducing patient burden: That means strengthening care access by improving geometric length of stay and ensuring services are being sought and provided in the right setting. It also means alleviating patients' financial strain. "We might decide that one area we'll need to reduce costs in might not be favorable to our bottom line. But is there another area where we can actually bring in additional revenue to make up for that lost revenue?" Liebl asks. "We're trying to find all of those hidden treasures under the rocks that we can control and we can impact to change that cost structure for our patients."
3. On mitigating payer challenges
"Nothing is more concerning to a patient [than] when they get a notice from the payer that their authorization isn't covered," Liebl says. "So we are really into the quality aspect."
At the same time, CentraCare must receive the payment it needs to "continue to thrive as a health system, so that we can continue to be here for the patients that we serve, knowing our populations are extremely rural, [and] we are one of the largest rural-setting facilities in our in our state."
It's a balancing act, and Liebl's strategy reflects that.
She approaches challenges, such as arduous prior authorization requirements, as areas of mutual challenge and opportunity. "It's really looking at how we partner with our payers differently and in a more effective and efficient way," she explains. "To say, 'hey, we understand this is a burden for us. It must be a burden for you. How can we come to terms where it's beneficial for us, and really putting the patient at the center of the entire experience … so we can create those long-term partnerships that are favorable to all of us."
Aside from seeding a resolution strategy that's gaining early traction with payers, Liebl will continue the work started by CentraCare's CFO and CEO, who asked different organizational stakeholders to lead collaboration experiments with a specific insurance partner. "Then we're going to come back and look at the successes because ideally, what we would like to do is blueprint this out and say, 'this really worked well with this payer; now let's move on to the next big payer to see what we can do,'" Liebl explains.
4. On finding inspiration in unlikely places
When it comes to professional development as a healthcare finance leader, Liebl is a fan of the usual haunts: She reads the publications of HFMA and related industry groups, attends conferences, and participates in a woman's health leadership group.
She's also an avid reader and podcaster with three books going at any given time. "One is always very much so on leadership or something that I can relate back to work," she explains, but not always in the way you'd expect. "I find that there are a lot of tips and tricks that we should be trying in healthcare that come from other industries."
Two recent favorites from other disciplines: The Mindset Mentor podcast with Rob Dial ("It really does help you … formulate your brain a little bit differently") and The Outlier: The Unfinished Presidency of Jimmy Carter by Kai Bird. "The Outlier was a non-leadership book, but there were so many things to be gained in there," Liebl says. "The relationship building that he did within his tenure to bring two countries together was quite amazing. And I feel we can use that same type of technique as far as building relationships because healthcare is about relationships. It really is."
5. On restoring trust
Speaking of relationships, some need repairing. "There are a lot of folks who don't trust healthcare any longer. There are a lot of folks who feel we're just out for the bottom dollar," says Liebl. For her part, she sees dollars as a means to an end.
"What I'm hoping to achieve in this position is to leave the financial state for CentraCare better than when I came into this role, and even when I came to work here," she explains. "[So we can] say, 'okay, we did something really great here, and we kept the patient at the center of all the work we were doing, and look: Now we can continue to serve them for the long haul.'"
Delaney Rebernik is a freelance editor for HealthLeaders.
KEY TAKEAWAYS
In her November promotion to VP of revenue services for CentraCare, Sherri Liebl gained oversight of two departments — government reimbursement and payer contracting — plus retained the traditional RCM function she long helmed in her previous role as executive director of enterprise revenue operations.
The goal in consolidating the departments under Liebl's leadership is to provide a "more holistic" suite of revenue services that reduces costs and payer challenges to better serve patients over the long haul. RCM leaders can take note as they chart their own courses for the year ahead.