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The Exec: Lifepoint Health Eyes Automation, No Surprises Act Regulations for 2023

Analysis  |  By Amanda Norris  
   December 14, 2022

Lifepoint Health's vice president of revenue cycle operations chats about trends the health system is watching for 2023.

Hospitals and health systems have been struggling financially as they try to navigate rising expenses.

Challenges like this mean organizations are going to finish out the year in the red, according to recent reports from Kaufman Hall.

As organizations plan to tighten their belts in 2023, revenue cycle leaders are feeling the pressure of cost cutting, regulatory burdens, and staffing shortages.

HealthLeaders recently chatted with Tina Barsallo, vice president of revenue cycle operations at Lifepoint Health, to get a better idea of the revenue cycle trends the health system is following for 2023 and how it navigated challenges in 2022. 

HealthLeaders: How has the financial strain on hospitals affected your revenue cycle in 2022? Did budget cuts or restraints have you adjusting any workflows or processes?

Tina Barsallo: Reductions and the strains on ability to hire have created the need for additional automation around patient access and patient self-scheduling here at Lifepoint.

Also, manual claim reviews and delays in authorizations with payers have caused increased denials, appeal delays, and untimely payment. As payers allow, additional Joint Operations Committee meetings have been established to work through delays and various processing backlogs.

Staffing challenges have also created the need for modified workflows on low balance insurance follow up and need to outsource/offshore certain customer service and follow up activities.

HealthLeaders: What was your biggest obstacle in the revenue cycle for 2022 and how did you overcome it?

Barsallo: Staffing and recruitment. Changes in payer policies and behaviors post-pandemic drove the need to establish new approaches, modify workflows, and additional payer meetings without additional resources at best.

Pictured: Tina Barsallo, vice president of revenue cycle operations at Lifepoint Health. Photo courtesy of LinkedIn.

HealthLeaders: What trends do you see coming for revenue cycle leaders in 2023?

Barsallo: In 2023, we anticipate we will continue to see the same challenges, such as staffing challenges, regulatory changes (like pricing transparency and the No Surprises Act), payer policy changes with limited notice, higher volume of post-pay reviews, and denials and underpayments as a result.

On a positive note, CMS has delayed enforcement of part of the No Surprises Act which will give us the much-needed time to work on ways to automate the good faith estimates, an essential part of the act.

HealthLeaders: On that note, what regulatory burdens are you watching the closest for 2023?

Barsallo: Definitely the No Surprises Act. We want to create ways to better automate and communicate the good faith estimates with co-providers, patients, and payers. 

HealthLeaders: What is one goal you have for your revenue cycle in 2023?

Barsallo: In 2023 we want to implement patient experience technology to help minimize resource constraints and improve performance (reduced wait times, speed to schedule, etc.) by increasing automation and patient self service capabilities. We also want to offer scheduling ‘as a service’ at our facilities.


Amanda Norris is the Director of Content for HealthLeaders.


In 2022, staff reductions and the strains on ability to hire have created the need for additional revenue cycle automation.

For 2023, leaders are expecting more staffing and regulatory challenges, as well as payer policy changes.

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