Rethinking Revenue Cycle Leadership During a Complex System Integration

When Bellin Health and Gundersen Health System merged to form Emplify Health, integrating eight distinct revenue cycles into a single Epic instance required overcoming technical complexities, staff resistance, and redefining what it means to be a healthcare finance leader.

When Bellin Health and Gundersen Health System merged in 2022 to form Emplify Health, the new organization encompassed 11 hospitals and more than 100 clinics across the Upper Midwest. For Michael Finley, Vice President of Revenue Cycle, this merger presented a massive operational hurdle: integrating eight distinct revenue cycles into a single, cohesive unit.

The Challenge of Epic Consolidation

Bellin and Gundersen both used the Epic EHR platform, with completely different builds.

Following the merger, leaders decided to bring the organization together under a single, unified Epic Foundation instance. Emplify Health went through a staged go-live to this unified instance in July and August 2025.

"You peel it back to Epic Foundation so that you can add functionality that you previously would not have been able to because you had customized things so much," Finley explained.

The integration was further complicated by simultaneous changes to the organization's claims clearinghouse and banking relationships, requiring intense, coordinated decision-making. This overhaul meant the same resources were tied up ensuring payer notifications were sent and new routing protocols for 835 remittances were established. Strict deadlines necessitated completing the integration in a shorter time period than recommended, increasing the risk of unexpected issues.

Looking Beyond the Technology

During times of transition, Finley stresses that health systems cannot rely on technology alone to solve operational inefficiencies.

"If you're just laying technology over the top of poor workflows, the technology is not going to work as it is intended," Finley noted.

To prevent this, leadership must establish effective bidirectional communication across multidisciplinary teams before technological decisions are made. Jumping straight to brainstorming solutions often causes leaders to overlook underlying challenges that have not yet surfaced.

A major hurdle during the Emplify Health EHR merger was overcoming "muscle memory" among staff. Employees had been executing tasks in Epic in specific ways for years. The transition back to a foundational build meant a temporary loss of efficiency while teams adapted to new workflows, requiring significant change management to counter resistance from staff who struggled with changes.

Redefining Revenue Cycle Leadership

To sustain these massive operational shifts and achieve top-quartile performance, health systems must rethink how they cultivate leadership.

Finley warned against the common governance mistake of simply promoting top-performing technicians into management roles.

"Your subject matter experts are not necessarily going to be your best leaders," Finley said.

The expectations placed on healthcare leaders today are fundamentally different than they were 15 or 20 years ago, requiring a much stronger focus on employee retention, adaptability, and team development. To address this gap, Finley and his team developed specific revenue cycle leadership characteristics to identify "now, near, and far" needs for the department.

Because the revenue cycle is not a single entity, but multiple distinct departments functioning together, these leadership traits must be universally applicable across the entire organization.

By formally defining expectations around flexibility, adaptiveness to change, and transparency, Finley said Emplify Health is working to build a leadership bench capable of managing the strategic demands of a newly integrated health system.