As RCM solutions grow in utilization, revenue cycle staff set the standard for efficient operations.
With the growing interest in revenue cycle management and automated solutions, there isn’t much focus on revenue cycle staff. This doesn’t mean that they’re less important to operations—in fact, staff play an important role in the successful implementation of RCM solutions.
Here are some HealthLeaders stories that reflect the importance of revenue cycle staff.
When an organization makes the decision to implement an RCM solution, a common misconception by staff is that they’re being replaced. In reality, the solution is intended to make their jobs easier by completing the simpler, repetitive tasks, enabling them work on more complex tasks.
“It’s [important] to show them the value [of the technology], get their buy in, and have them realize how it affects the whole practice,” Sherri Lewis, director of revenue cycle for Boulder Centre for Orthopedics, told HealthLeaders.
The rise of cyberattacks has made cybersecurity a priority in healthcare. Cyberattacks have the potential to disrupt operations, leaving providers unable to submit claims or even process payments. Situations like the Change Healthcare ransomware attack have demonstrated the importance of having individuals on staff that understand the changing digital landscape.
“There is a newer wave of IT leaders that grew up from the operational side of business and weren’t just tech people,” Bill Arneson, director of business operational transformation at Moffitt Cancer Center, told HealthLeaders.
Every employee begins their journey as a candidate, and it’s talent acquisition team’s job to know what to look for. From there, the best way to retain staff is to talk openly about what they want their future within the organization to look like—or show them. Succession planning is a good strategy to help employees actively work toward their goals and ideal titles.
The hiring process begins with the human resources department knowing what to look for in potential candidates.
At Moffitt Cancer Center, Lynn Ansley, vice president of revenue cycle management, has established a strong partnership with the organization’s talent acquisition team, calling them the “first line of review.”
“With seasoned professionals, we’re looking for very specific certifications from a specific set of governing bodies,” Ansley explained to HealthLeaders.
“It’s all well-defined within our job descriptions and we have a lot of checks and balances throughout the whole recruitment process to make sure we’re getting the right candidate with the right credentials for the right role.”
Moffitt does a good amount of outreach for niche roles requiring experience that can’t be cultivated in house. However, there are different methods in place to enable current team members to move up in the organization.
For example, within its coding team the organization has apprentice coders, where entry-level employees are able to start on the path to becoming a medical coder.
Previously, when most employees were in the office, Moffitt would offer classes where coders could come in to be trained on oncology and sign a contract committing to work with the organization for two years after graduation.
“We have not brought it back since the pandemic,” Ansley said. “But it’s something we’re actively talking about because we really just want to make sure that we’ve always got the pipeline of talent for those harder-to-fill roles.”
Moffitt’s talent acquisition team also creates partnerships with colleges and universities in the surrounding community, speaking with students, informing and getting them interested in different roles in healthcare and revenue cycle.
Succession planning in particular has been a successful strategy for developing a internal talent pipeline.
Entry-level roles can be hard to hire and retain, but showing employees a career path, as well as providing training opportunities, can make a difference.
“We’ll bring them in as Customer Service Representative I and after six months they’ll be able to apply for Level 2, and there’s a pay differential between them,” Ansley explained.
“There’s also opportunity for things like certifications that then build their resume and get them ready for other roles.”
Three areas revenue cycle leaders should pay attention to.
During last month's PFE NOW Summit, leaders noted three areas crucial to a seamless patient financial experience: communication, good customer service, and a simplified billing and payment process.
CMS found Stanislaus Surgical Hospital to be out of compliance with Medicare and Medicaid program requirements.
Since being found out of compliance with the requirements for Medicare and Medicaid in February, the fate of Stanislaus Surgical Hospital has gone from bad to worse.
On April 11, CMS issued a notice to the 23-bed short-stay Modesto, California hospital terminating its Medicare Provider Agreement, effective April 30. A complaint validation survey conducted found the hospital was out of compliance with a number of the Medicare Conditions of Participation, including nursing staff, pharmaceutical services, and surgical services.
With the termination of the agreement, the hospital won’t receive any payments from Medicare and Medicaid programs for care provided to patients admitted after April 30. Payment for care provided to patients admitted before the termination date would have been available for up to 30 days afterward.
According to a local news publication, the hospital has notified Stanislaus County officials that it will most likely close on April 30 for an “undetermined time,” with employees being laid off between April 29 and May 1. A statement from the hospital added that it is challenging the CMS’ decision to terminate its provider agreement.
Rather than closing the hospital, Mani Grewal, chairman of the Stanislaus County Board of Supervisors, told a local news publication that CMS should give the hospital some latitude to get in compliance with the Medicare standards.
“If there are some things they need to fix, there is an intermediary process where they can help them get through some of those violations,” he said. “We feel that is a better position than shutting them down, especially when we are low on healthcare services in the county.”
One revenue cycle VP shared three tips she uses in her organization.
HealthLeaders previously spoke with Lynn Ansley, HealthLeaders Exchange member and vice president of revenue cycle management for Moffitt Cancer Center in Tampa, Florida about the importance of succession planning.
During the recent Revenue Cycle Exchange, executives noted the importance of succession planning, yet many expressed that their organization’s didn’t have time for it. Here are three tips Ansley suggests to aid leaders in their succession planning efforts.
It’s never too soon to identify talent
“I’m always looking for talent because I know that there’s nothing more important than good people and good people will not stay if you don’t invest in their growth as well.”
Communication
“I have sat down and talked to people and found out that they don’t want to be leaders anymore, or someone that isn’t in a leadership role to gauge their interest. Do you want to manage people or manage projects? People change over the course of their career and it’s all about how fast or slow you want to accelerate.”
Understanding who employees are outside of work
“I’m an executive that also has three young children. I’ve never really felt the need to hit the breaks in my career because of my family, but not everyone is the same in that regard. And so, I was always very open and honest about my career aspirations with my boss because she asked.
Organizations are considering new measures to protect patient information.
In the aftermath of the Change Healthcare ransomware attack, affected providers are doing their best to resume normal operations and looking for proactive measures to protect them in the future.
The attack was a major disruptor to the revenue cycles of providers throughout the country, leaving them unable to submit claims or process payments. The gravity of the disruption emphasizes the importance of having a business continuity plan in place.
“We’re in the business of treating patients, so a lot of the time, if you don’t have people that are focused on this type of stuff and know its importance, it gets thrown by the wayside,” Joi Lee, manager of cyber governance, risk, and compliance for Moffitt Cancer Center, previously told HealthLeaders.
She noted that healthcare is behind other industries when it comes to making cybersecurity a priority. According to Lee, many companies either don’t have a business continuity plan, don’t have an updated plan, haven’t tested it, or haven’t communicated it to the necessary individuals.
The increasing frequency of cyberattacks has made cybersecurity a priority for organizations, particularly as it relates to revenue cycle management solutions. In some organizations, information technology specialists are included in the decision-making process for finding and implementing RCM solutions.
“There is a newer wave of IT leaders that grew up from the operational side of business and weren’t just tech people,” Bill Arneson, director of business operational transformation at Moffitt, previously told HealthLeaders.
“I think those are the people that you need, someone that can speak business and IT, to bridge those gaps,” he said. “Those are the people getting stuff done.”
Organizations can be proactive in protecting their data by ensuring their tech infrastructure is secure and appropriate controls in place prior to implementing a new solution or integrating a new platform. Additionally, organizations should inquire about antivirus and data protection controls in conversations with potential vendors and RCM partners.
The average tenure of employees on the VPs team is 10 years.
Succession planning was revealed to be a common issue among revenue cycle executives during the recent HealthLeaders’ Revenue Cycle Exchange. The leaders agreed on its importance, yet many stated their organizations didn’t have the time to allocate towards it.
However, at Moffitt Cancer Center in Tampa, Florida, Lynn Ansley, Healthleaders Exchange member and vice president of revenue cycle management, has made succession planning an integral part of the employee experience for her team and has seen great outcomes because of it.
Where to Start
Simply creating an organizational chart is a step in the right direction.
“When you look up an [organization’s leadership] chart, no matter where you’re sitting in that org chart, you want to know there’s a path for you to go,” Ansley told HealthLeaders. “Whether it’s up or even laterally across the organization.”
Succession planning then begins with an informational interview, where the employee is able to learn more about the role or department they’re interested in, qualifications, and discuss what they need to do to meet those qualifications.
During this stage, in particular, Ansley looks for potential leaders and will give them stretch assignments, which is a task where they have the chance to display their skills and capabilities as a leader.
They’ll be included in the organizational wide programs Moffitt’s development team puts together where they learn more about the organization and how different roles intersect with each other. Employees will also meet with their leader each quarter for professional development meetings to check their progress.
“When you look down in any area of my front, middle, and back-end shared services, there’s a pipeline of who’s up next for that leadership role,” Ansley said.
Different ladders within the organization require a particular HFMA certification, which, upon receiving the certification, makes them qualified to advance in the organization and increases their marketability should they ever decide to pursue other opportunities at a different organization.
Pictured: Lynn Ansley attends the 2024 Revenue Cycle Exchange.
Looking Forward
In addition to training opportunities, employees are encouraged to think about how and where they want to grow in the organization, especially now that the practice is growing.
“What I encourage our team members to do a lot is not just focus on the next six months, but look out a little bit further,” Ansley said.
“If the role that you think you want isn’t available today, we’re going to be multiplying the number of opportunities in the short term and into the next 10 years.”
The average tenure of members on Ansley’s team and leaders she reports to is 10 years. Because of this, she stated, the organization has a wealth of internal knowledge on their operations and processes, which contributes to a greater culture of continuous learning and improvement.
“We have a lot of, I call it ‘musical chairs’ in rev cycle, because it means that our team members are growing throughout all of the areas,” Ansley said.
“I’m not sure that there’s any more valuable of a team member that has sat in multiple seats on the bus and got to see the view from all of those different angles to see how the cycle really impacts one another.”
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Ochsner Health has seen improvements in patient experience since expanding its digital presence.
Since expanding the health system’s digital presence, Ochsner Health has seen improvements in patient communications and collections.
“There’s so much patients can utilize, from scheduling visits, to interfacing and coordinating with their healthcare team,” Eduardo Benitez, Ochsner director of physician payments, told HealthLeaders. “Being able to request their prescription refills, pay their bill, and even being able to do a telehealth visit.”
For other organizations looking to expand their digital offerings, Benitez identified two essential elements: desire for innovation and listening to patients.
“It takes patience, time, expertise—and really with that, keeping security at the forefront of the project,” he explained. “Assuring that security is [prioritized], I think, is most essential a lot of the time.”
He added ensuring security concerns are addressed from the initial stages of exploring digital expansion and protections are put in place is important to the security of the organization as a whole going forward.
Benitez stated that listening to patients and meeting them where they are can help guide a systems approach to digital expansion.
Currently, the system estimates its patient portal utilization to be between 35-45%, with some variation according to location. For example, New Orleans has the highest utilization for the patient portal of all the regions the system serves, while patients in areas like Lafayette prefer to manage their care by phone.
According to Benitez, the system’s new pay by phone option has captured several thousand calls since launching in January.
“Us putting mechanisms into the platforms that our patients are choosing yields [higher] utilization and a better experience for our patients,” he said.