SPEAKER_00 0:00

Welcome to part three of our conversation with Scott Cooper. In the previous segment, we explored staffing challenges, quality measurement, and determining whether a hybrid revenue cycle approach is right for your organization. In this final segment, we'll discuss implementation expectations, employee development, and the key indicators that signal it's time to consider a new approach. And if I'm um preparing myself for this implementation, is it similar to an EHR conversion where as I make this shift, I should plan for my cache to dip for a certain amount of time? Like what should I expect once this change is made?

SPEAKER_01 0:54

Yeah. If you've gone through one of those, you know you will see anywhere from six to 18 to 24 months worth of uh awesomeness for lack of a better term. Um, our our our road cycle implementations are meant to be pretty streamlined. Um, and there's also different kinds of ways we do this, right? We can do rebadge where we will take your folks and bring them over. We keep all the institutional knowledge, we'll add, you know, we'll add in our tools and our performance management and ideally kind of supercharge your teams. Um there are there are clients who say, hey, I just you know, I'm gonna find new homes for my people in the hospital. I want to give you everything. So you got to go hire 10 people or 20 people or 100 people or whatever it is. Um, that takes a little bit longer because in many cases we have to find find folks. But that's actually one of the advantages of the hybrid model is that um I'm gonna geek out a little bit here. If you think about like Amazon Web Services and, you know, you've got this cloud capacity, they have this idea of like burstable capacity where, oh no, I've run out of I've run out of compute power, but Amazon's like, that's okay. We'll, you know, we'll burst you more compute power for your needs. Um that's kind of one of the ways we think about this hybrid model, is not only is it just ingrained in how we do some of our work with the way we split the responsibilities, but you know, if we need 20 people for a project and we need them in a month, um, it's actually going to be much easier to find that through our through our hybrid model and through our through some of our offshoring. So um there's there's that advantage. Um, and then I think to to address your your your question in general, like we do not see um, we have not seen degradation uh from a financial performance perspective as a result of our implementations. And we're very thoughtful. We have an implementation team, we go on site, you know, our HR teams are talking to HR, IT is talking to IT. Um, we're doing a lot of process mapping in advance, so we'll send our consulting team on site to do process mapping and understand how everything works. Um, but the idea is to make it as seamless as possible. And we also try to be very thoughtful about timing. You know, we have we have some clients that say, hey, you got 30 days, which is really fast. Um and then some are like, yeah, we're gonna do this. And then here's the here's the three-month approach, and here's phase one, phase two, phase three. And we build that out to make sure that there is no degradation in performance and and and really like first and foremost, making sure that the cash cash is preserved and and you know, cash is king, so to speak. So um we've been very successful, very little disruption, if any, nothing like an EMR uh implementation.

SPEAKER_00 3:34

I want to circle back to something that you mentioned as far as like you taking on the staff that were on that revenue cycle team. So while I may recognize that my current state isn't working or isn't producing the result that I want to produce. And so I want to um go a different direction. I also want what's best for those people who are part of my team and I want them to have a network and get more education and be better served by leaders who are in the revenue cycle every day. That is their area of expertise. How do you provide that experience, not just from a patient standpoint, but also from an employee standpoint?

SPEAKER_01 4:23

Yeah, we um we have so we have a well, we have a lot of things. Uh we have a um like a learning and development team or a training team. So we have dedicated resources who do nothing but kind of continuous education of our folks. Um to we actually have a really cool kind of this is new as of the end of last year. We have uh like an enterprise license for HFMA. And so um folks on our team can say, hey, I want to go figure out how to get these HFMA certifications. I want to go do this continuing education from HFMA, which is kind of like the big recognized, you know, national, I don't know, authority on this, I don't know what governing body authority, whatever. Um but um so there's that. Um what I what I also really like is a lot of our clients, um, you know, again, smaller kind of hospitals, more rural community. Um, and you know, you're we've got folks who are on a team of 10 or 15 people and they've been working with the same hospital and the same team for 10, 12, 15 years. That's kind of all they know. Um, just kind of bringing them into our ecosystem now, right? Like we are we are much bigger than that. Uh, I won't go into specifics, but um, we are much, much bigger. We have the scale, we have the kind of the size. So people are just people are also just like learning on the job. It's hey, you now have a you now have a director that's overseeing everything. Maybe before you just had a manager and five people, and now you've got a director and a VP. And you have people who've been doing this for 25, 30 years who know what's going on. They're staying current with all kind of the changing, you know, the changing pace of the industry. Um, and you're being thrust into this kind of new environment where you've got this ecosystem of experts all over the place. Um, the other really cool thing I like, it's funny, we got off a call this morning with um with a hospital where folks are coming over in a month. Um, and they ask this question. Um, because we're bigger, there's a lot more opportunity, right? If you are if you are one of 10 employees at Hospital X and you've been there for 10 years, unless that hospital doubles overnight kind of thing, not necessarily going to be a ton of career opportunity for you if you're a rev cycle analyst or a coder. Um when you're part of a larger organization that's growing uh and has this kind of cool model and and hybrid model that scales, there's just a lot of new opportunities for you. So maybe you were an AR analyst for hospital X, but maybe you're gonna be manager for hospital Y next year. Or maybe you're gonna end up as director of Hospital Z in two years because we signed that. They need a director. You've shown that you're kicking some booty and that you can really perform. Um, so there's just a lot of like really cool new opportunity um that that I think most folks are really excited about when they join us.

SPEAKER_00 7:24

That's great. Thank you. I think we're getting close to time, but I do have one final question for you, if that's okay. Well, what is a good indicator or indicators of this might be right for me? Like I think about uh several hospitals that I work with that are on CPSI and they've got to find another solution and they were doing their rev cycle, and that seems like you know, a good opportunity for that conversation. But what other things would you point to as hey, you might have an opportunity. This is at least worth a conversation.

SPEAKER_01 7:59

Yeah, I mean, I would I would argue that uh everybody has an opportunity to get better. Um uh I think there's a couple of things you can do. One, arguably, there are best practice benchmarks. I don't necessarily agree with all of them because I think every hospital is different, right? You can't you can't say best practice for AR days is 45 days uh if you're a mega hospital in New York versus you know a $20 million hospital in Iowa. Like you just you can't compare those benchmarks, they don't make sense, right? Different payers, different environments, different payer mix, it's just uh it's all wonky. But there's some rough guides for what performance should be. Um, and you know, if if if you're missing a few of those, if there's two or three things where you're just totally whiffing on, that's a good indicator. Um, that's one. I think two, um if you've seen your overall rove cycle of performance decline over the last couple of years, regardless of whether you do it or a vendor does it, um, that's usually a leading indicator that there's something that needs to be fixed or something that needs to be looked at. And the truth is that may not even it may be completely out of your hands, right? I think the the payer environment is such that it has just gotten much, much more difficult to be really good at Rev Cycle over the last couple of years. And and you know, one one stat uh one stat that uh really sticks out is um you know initial denial rates nationally. It used, you know, five years ago, if you were under 10%, um you're probably doing pretty good. Uh and now that's almost gone up 50%. So 10% to like 15%. Like now people say, well, if I'm under 15%, I'm actually doing pretty good. The problem is, is like you still want to be under 10%, but the payers have made it really difficult to do that because they keep changing the rules and they keep doing the underpayments and they just keep messing with stuff. Um so structurally, structurally, it's kind of just institutional headwinds that there's not a ton you can do about. If you're worrying about those, you're seeing the impact of that, that's generally something that you would want to go seek help for. Um also, like if you're just trying to get ahead of cost pressures, like if you know that the one big beautiful bill is going to disrupt your hospital over the next year or two, you want to start having conversations about what are the things I can do. You know, if if you're all on shore, if you're struggling to retain staff, if you're struggling with raising, you know, high uh rising kind of payroll costs, all kind of like leading indicators of maybe it makes sense to have a conversation. I think about this very simply into two or three levers. There's a there's a yield lever, which is how am I performing from a cash perspective, how much am I actually bringing in versus what I think I should be bringing in? And if you think you're underperforming, good indicator that it's worth having a conversation. That's one. Two, there's the cost lever is am I getting the performance that I would expect at this cost? And but do I think I'm overpaying? Are my prices or are my costs just rising and it's kind of uncontrollable? Um, that's the second thing. And then the third, the third lever here is is similar is just like, is my cash slowing down? Have I seen my AR days go from 45 to 55 over the last year? You may still be getting the money, but if you're struggling to make payroll every week or every month or whatever that may be, that 10 day slowdown in cash actually hurts you. And that's another good reason to say, hey, I need some help.

SPEAKER_00 11:31

That makes a ton of sense. Thank you. Um, is there anything else that we haven't talked about that you wanted to mention?

SPEAKER_01 11:38

I'd say maybe two or three things. One, uh if if you think you are struggling with Rev Cycle or your organization is struggling with Rev Cycle, you are not alone. Uh as I said, I think the the macroeconomic forces, the forces, the headwinds that we're dealing with uh as a result of government policy decisions or you know, payer changes, uh, that's impacting everybody. It's impacting people in different ways, but I think everybody is looking for help here in Rev Cycle. Um, so I think that's one. I think two, um, we talked about this. Uh I do think this idea of the hybrid Rev Cycle model is the right answer. And I do think that over time more and more people are gonna move towards that because of the pressures they're facing. Now, I'll caveat that with all the things we talked about, which is you got to make sure you have your system set up. You got to make sure you got the tracking, you got to make sure you have the performance management, you got to have the technology, you got to have that kind of that one team unit. Um, but if you're able to get the performance at a lower cost price, I do think that that's I do think that that's important. And and again, it doesn't mean you should offshore everything, which is what a lot of organizations do. And I think that they are not necessarily happy with the results of that. Um, but if you're smart about it, if you're deliberate about it and you can manage it well, I do think that it pays dividends. So I think those are two big parting thoughts.

SPEAKER_00 13:04

Well, I think that brings us to the end of our time today, Scott. It's been really great chatting with you and enjoyed um getting to learn more about the hybrid Rev Cycle solutions. I always learn something whenever I um have the chance to sit down with you. So thank you for your time.

SPEAKER_01 13:19

Thank you. Appreciate it.

SPEAKER_00 13:21

And thank you for those of you listening uh today. If you don't already follow us, please do so on LinkedIn and at Ovation Healthcare. If you found this episode interesting and would like to learn more, you can visit us at ovationhc.com. Thank you.