Elevating the Revenue Cycle to the C-Suite at UHS

As UHS scales to nearly $2 billion in revenue, Chief Revenue Cycle Officer Ken Hogue is transforming operations by staying true to a foundational EHR build, embedding physician advisors to fight denials, and pivoting to an aggressive payer strategy.

As United Health Services (UHS) scales its operations, growing from $800 million to nearly $2 billion in revenue in recent years, the organization is rethinking how it handles payers and patients.

To bring revenue cycle from a back-office function and into the limelight, the health system established the Chief Revenue Cycle Officer (CRCO) role, now held by Ken Hogue. This position now brings managed care contracting, value-based payments, and payer strategy under the same umbrella, reflecting a broader industry trend to break the revenue cycle free from its silo.

Making the Most of an EHR

UHS has adopted an Epic-first approach and actively avoids over-customization of its EHR. When hospitals force new tools to cooperate with legacy systems, they scramble data and block future automation, Hogue says, drawing on 20 years of experience with Epic programming and optimization.

By staying close to a foundational build, UHS can roll out new tools much faster. The team also treats tech hurdles encountered during IT sprints as learning moments rather than failures. This approach helps build internal experts who can step into leadership roles, reducing reliance on expensive outside consultants.

Bridging the Clinical-Financial Divide

To fight medical necessity denials, UHS brought clinicians into the revenue cycle. This arrangement puts case management under the revenue cycle in a dual-reporting structure and embeds physician advisors directly into revenue cycle workflows.

When documentation issues arise, the feedback doesn’t come from a financial-minded staff member, it comes from a fellow doctor. This peer-to-peer approach removes tension and helps physicians see how documentation impacts both patient care and the bottom line.

Across the industry, revenue cycle executives are finding that without significant clinical collaboration, it is difficult to get in front of clinical leaders to change habits. At UHS, this strategy has led to the recovery of millions of dollars that would have otherwise been lost to denials.

Payer Strategy Over Payer Relations

With health plans relying more on third-party vendors and AI for high-cost reviews, providers need to move from passive payer relations to an aggressive payer strategy.

For UHS, this means knowing the fine print of payer contracts and pushing back against administrative delays. When needed, the team escalates systemic issues to executives, legal teams, or even state insurance commissions to hold payers accountable. At the same time, the organization strictly evaluates its own tech vendors. By using vendor scorecards and thorough security assessments, UHS cuts through the sales hype to ensure partners understand regional regulations and can deliver on their promises.

Driving Loyalty Through Financial Education

Perhaps the biggest shift at UHS is using the revenue cycle to drive patient retention. With the rise of high-deductible health plans, many patients simply cannot afford their care. The stakes are high; industry surveys show that more than half of patients would switch providers over a poor billing experience.

Instead of just writing off these balances to charity care, the UHS revenue cycle team steps in to help patients find alternative funding, such as grants, union benefits, or military coverage. Helping patients lower their out-of-pocket costs builds immense trust. Patients who feel financially supported are much more likely to return to UHS for future care, turning a financial headache into a clear advantage for the health system.