System VP Christina Slemp, a participant in the HealthLeaders Revenue Cycle Technology Mastermind program, explains how UNC Health unified billing operations amid a systemwide effort to use AI to improve all aspects of the revenue cycle.
For Christina Slemp, System Vice President of Revenue Cycle at UNC Health, the core strategies of revenue cycle management are fundamentally consistent across the healthcare landscape. However, her current focus is applying those universal strategies while navigating significant organizational and technological shifts.
Slemp was a participant in this year’s HealthLeaders Revenue Cycle Technology Mastermind program, which brought together RCM executives from roughly a dozen health systems for a series of virtual and in-person round-tables to discuss key benefits and challenges.
Shortly after being appointed System Vice President of Revenue Cycle, Slemp began guiding UNC Health through a major internal restructuring that consolidated professional billing (PB) and hospital billing (HB).
This exercise continues to remind Slemp that change management is the primary challenge to executing forward-thinking initiatives. Because the health system operates entirely within North Carolina, it also illuminated how much influence specific state regulatory issues and local payers have over revenue cycles.
Technology as the Strategic Imperative
UNC Health maintains an enterprise-wide innovation initiative dedicated to maximizing current resources, upscaling staff, and improving financial margins. AI and automation are central to this mission, Slemp says, noting that tech-based initiatives are ongoing across the front, middle, and back of the revenue cycle.
Like most health systems, UNC Health measures success by tracking traditional metrics like AR days, cash flow, and cost to collect. However, as an Epic shop, the organization also benchmarks its performance against peers in Epic reporting. UNC Health leverages this data to challenge staff to perform exceptionally well compared to peers.
The Payer-Provider Challenge: Preparing for "AI vs. AI"
Improving relationships with payers is one of the most persistent challenges for revenue cycle leaders. While interactions between providers and payers create administrative burden for both, providers seem to take on a greater load, according to Slemp. She questions the logic behind processes that require significant labor for services that are virtually always approved.
Moving forward, technology could conceivably reduce the administrative burden for both parties. However, she says, that hasn’t happened yet.
“I think that in a few years it's going to be AI against AI,” Slemp says. “Do we just let the AI fight it out and figure out what's there?"
Tailoring Tech Strategy
One of the biggest long-term challenges for AI adoption is not the technology itself, but the change management required to build trust among staff, according to Slemp. In a previous role, she experienced hurdles getting clinical staff organization to embrace internally developed AI for appeals and denials.
Ultimately, while the metrics remain the same across health systems, achieving excellence requires a strategy that is tailored to specific organizational needs and cultural requirements.
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Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
Change management is one of the most significant long-term challenges to AI adoption in the revenue cycle.
Achieving excellence requires exceeding peer benchmarks for Epic users, moving beyond average industry performance.
Payer administrative friction may lead to a future where provider AI battles payer AI for claims resolution.