Last year, contract labor in healthcare costs soared 258 percent during the COVID-19 pandemic. With Ascension’s operating margin falling to -2.9 percenting and Providence reporting $1.7B in operating losses last year, systems need to think creatively to improve profits.
These 38 industry leaders explain the most valuable technological investment their systems made in the last two years. The executives featured in this article are all speaking at the Becker’s Health IT, Digital Health + RCM Annual Meeting: The Future of Business and Clinical Technologies which will take place Oct. 3-6, 2023, at the Navy Pier in Chicago.
To learn more about this event, click here.
If you would like to join as a speaker, contact Randi Haseman at email@example.com.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: What are the most creative ways your health system plans to increase revenue over the next two years?
Randolph Siwabessy. CFO at UCI Health (Irvine, Calif.): UCI Health plans to increase revenue in various ways in the next two years. We begin opening our new Irvine campus in 2024, with a state-of-the art ambulatory building which will be the home for multispecialty medical and surgical services. This will be immediately followed by the opening of a cancer center serving as our oncology hub for quality, innovative, patient-centered oncology care for patients in Orange County and the surrounding regions. The opening of the Irvine campus will culminate with the opening of our new hospital in Irvine in 2025.
We are also seeking to improve our operational efficiency in our existing footprint by leveraging technology and adopting a healthcare-of-the-future framework through commercial innovation. This will allow us to provide care to more patients in need of complex, tertiary-quaternary care throughout the health system. In addition, we are seeking to partner with payers on innovative payment models and further value-based care.
Population health management and value-based care, coupled with our efforts to advance care at home, are foundational to our health system’s sustainability in the realms of quality and financial performance. Lastly, by focusing on these pillars, we expect to serve more patients in our community through our expanding care model. These efforts will allow us to diversify our top-line growth and ensure that we will have the capacity to invest in our tripartite mission of discovery, teaching and healing.
Katie Barr, RN, MSN. System Vice President and Chief Nursing Informatics Officer at Advocate Health (Charlotte, N.C): There are a few creative ways that our organization is working on to increase revenue over the next few years. The first is to capitalize on the consumer adoption of telehealth that resulted from the pandemic and focus on digital first care options, ranging from routine care to chronic care management. Tech-enabled patient care certainly has the potential to not only improve patient care and boost efficiency, but also increase revenue and boost patient satisfaction.
We are also evaluating care models across the continuum to determine where automation and technology can boost efficiency, and in turn maximize staffing and contribute to quality of care. Automation is also being considered as a way to optimize revenue cycle processes and efficiency, thus increasing revenue. As always, there is a focus on value based care and how by improving quality of care, we can maximize reimbursement.
David L. Reich. President at The Mount Sinai Hospital and Mount Sinai Queens (New York): Mount Sinai looks towards patient care innovations that are linked to revenue opportunities. Examples include 340B program optimization and other pharmacy initiatives, theranostics, cell-based therapies and novel antibody therapies for oncology care, and growth in complex procedural services including cardiovascular, neuroscience, transplantation and surgical oncology. AI-powered clinical decision support improves revenues through better outcomes and coding opportunities. Expansion of our Hospital-At-Home programs is expected to create opportunities for a higher case mix index of those patients remaining in hospital beds.
Seth Jeremy Katz. Vice President of Revenue Cycle and Health Information Management at University Health KC (Kansas City, Mo.): We believe our biggest opportunity to increase revenue is by leveraging the price transparency data files that are now available from both the provider side and from insurance companies. Though there are some challenges – compliance amongst hospitals is low and payers have tried to post their files in ways that make them very difficult to use – we believe that if we can be one of the first to crack that code, we can leverage that data in obtaining better rates for our services. As they say, ‘he with the most data wins,’ and we think that price transparency offers that opportunity.
Robin Damschroder. Executive Vice President and CFO at Henry Ford Health (Detroit): We are doubling down on optimization of our front door transformation and home-based care strategies to further expand our ability to care for patients and members. Our goal is to create a self-guided, differentiated experience that elevates access to our clinicians and services to a new level. Our hope is patients and members can move between virtual, home and physical facilities with little to no friction and be directed to best care options defined by their care needs.
James M. Blum, MD, FCCM. Chief Medical Information Officer at University of Iowa Health Care (Iowa City): We’ve improved efficiency, telemedicine and virtual technologies.
Zafar Chaudry, MD, MS, MIS, MBA, CITP. Senior Vice President, Chief Digital Officer and CIO at Seattle Children’s: Some of Seattle Children’s strategies include leveraging technology to redesign our medical notes to simplify and streamline charting, using some remote process automation in revenue cycle, reducing the number of IT suppliers, IT application rationalization, and optimizing operations by streamlining administrative processes, reducing waste and improving patient throughput. We have also implemented a workforce optimization and management council which reviews all new and replacement FTEs to ensure we are hiring correctly and efficiently. We are also heavily focused on equity, diversity and inclusion initiatives that will impact patient outcomes, enhance staff satisfaction and retention, and increase innovation and creativity leading to improved revenues.
Josh Cutler, MSW, LICSW. Director of Behavioral Health and Well Being at Kinwell Medical Group (Seattle): We’ve introduced value based care contracts that incentivize reduced ER visits, high quality management of chronic conditions (diabetes, etc), and robust nutrition and behavioral health services.
Kristie Henson. Regional Revenue Cycle Director at Sentara Leigh Hospital (Norfolk, Va.): With more and more straight Medicare and straight Medicaid patients transitioning to replacement plans, we will be looking to implement a centralized pre-certification department to ensure proper coverages and decrease back end denials. With the changes surrounding medical bills and credit reporting and high deductible plans growing, we will look for several different ways to collect from patients point of service, whether it be in the department themselves or a mobile registrar who travels to various departments or locations to collect from the patient. In addition to this, we are looking at several different companies that are willing to take self-pay collections from us based on a sliding scale/rating of sorts such as ClearBalance.
James Lindgren. Executive Director of Revenue Cycle Systems Optimization at University of Miami (Fla.) Health: I wouldn’t characterize this as creative per se, but we see the biggest opportunity to radically personalize the experience for our patients and their support networks to increase retention and increase demand for our faculty. Medicine is highly personalized, but sometimes our business operations are less flexible and adaptive than they need to be. Therefore, our plan is to develop new workflows and new technology solutions to allow us to provide a precise, personalized approach.
Of course, this puts the next level responsibility on us to ensure we are growing our offerings by increasing the size of our workforce and geographic footprint in South Florida. In order to meet this challenge, we have to make strategic investments in new facilities and grow our provider roster.
Par Bolina, MD. CEO at Calarity (Salt Lake City): The lowest hanging fruit with the largest impact across health systems that continues to be overlooked is the enormous provider workflow efficiency waiting to be realized because of the transformative changes to the clinical documentation Evaluation and Management (E/M) Service Guidelines first made in January 2021 and most recently expanded effective January 1, 2023.
Providers, health systems, EHR vendors have struggled for decades under the unnecessarily onerous and complicated E/M guidelines of 1995 and 1997. The subsequent financial, clinical and personal consequences have been profoundly harmful to all parties. More than any other change in healthcare, refocusing provider documentation to assessment and plans will dramatically improve provider efficiency, ensure safer healthcare delivery for patients and streamline EHR design while reducing the risk of fraudulent billing. Not since Dr. Lawrence Weed introduced the SOAP format to clinical documentation have we been granted a greater opportunity to improve workflow efficiency and patient safety.
Recognizing the profound impact of incorporating these new guidelines across an entire health system is our challenge as this topic is so often misunderstood or overlooked by healthcare leaders, technologists and payers.
Isaiah Nathaniel. Vice President and CIO at Delaware Valley Community Health (Philadelphia): One of the creative ways we are looking to increase revenue at Delaware Valley Community Health in the new normal is to increase our enrollment in our new self-monitoring blood pressure program. By increasing our patient enrollment in this program, not only are we increasing clinical quality measures for our capture area but also the associated performance revenue with it increases. For patients in our office and in their homes, we are doing what we enjoy which is providing quality care and we love it.
Sunil Dadlani. CIO at Atlantic Health System (Morristown, N.J.): Some of our ways include: continuous improvements and optimization of service lines; driving innovation and digital transformation in clinical and non-clinical areas; building partnerships and collaborations; forming partnerships and collaborations to share cost and resources; leveraging hyper scale automation and AI and implementing value-based care models; and, most importantly, population health and providing access to care while addressing social inequities.
Chris Bergman. Vice President and CFO at Dayton (Ohio) Children’s Hospital: We actually started this process a couple years ago when we rented a vacated unit to Shriner’s Children’s Hospital-Cincinnati. It allowed us to rent some of our capacity to an organization that was looking to downsize from a full service hospital yet maintain their mission.
In addition, we continue to challenge our processes related to observation patients; specifically related to when they might meet inpatient criteria during their stay. Finally, we continue to expand our ACO in a fully capitated Medicaid product. Currently about 40 percent of our gross revenue is generated under this model, and there is still another 10 to 15 percent of our gross revenue which could be included within our ACO product.
Richard Zane, MD. Chief Innovation Officer at UCHealth (Aurora, Colo.): What we are most excited about are not specific initiatives which are designed to increase revenue but more to actualize our enormous investment in technology to go further and deeper into value-based care with the goal of improving outcomes and significantly reducing the overall cost of care.
With a robust capability to perform monitoring and surveillance across the spectrum of acuities in both the inpatient and outpatient environment, integrate devices and prescriptive analytics; understand how synchronous, asynchronous, in person and remote care can meld into a single episode of care; build the capacity, competency and infrastructure to prevent acute exacerbations of chronic diseases; prevent admissions and readmissions; and care for patients in the lowest cost environments. We know we are poised to break the cost curve while improving the lives of our patients.
Craig Norquist, MD. Chief Medical Information Officer at HonorHealth (Scottsdale, Ariz.): Over the next two years, we will continue to work on optimizing our referral systems in order to minimize ‘leakage’ out of the system by driving processes towards internal referrals as the default. The difficulty in scheduling either procedures or follow-up office visits should be automated to the highest extent possible, improving the experience for the patient as well as continuing to keep our patients in our system. Instead of discharge instructions to ‘follow up with GI,’ we will strive to have appointments with GI already on the calendar and with the same physicians who cared for the patient while in the hospital.
We will also continue to strive towards a more data-driven organization, using data to validate or justify virtually every action taken. We will use data to remove those actions or activities that do not bring improvement to the patients, clinicians or the system.
Shenny Sheth. Deputy CISO at Centura Health (Centennial, Colo.): This year and onwards, Centura is actively transforming its business and digital solutions in an innovative way. Keeping growth our focus, Centura tactically adjusts response to disruptions. Our strategic planning and portfolio selection processes span enterprise wide. We see that:  mergers and integrations enable business even further,  artificial Intelligence and process automation greatly improve efficiencies and upskill our talent while reducing burnout factor, and  composing secure, consumer-oriented, human-centric designs will unlock straight-through experiences and enhanced patient and provider relationships.
Nadim Ilbawi, MD. Physician Director of Innovation and Care Models at NorthShore Edward-Elmhurst Hospital (Warrenville, Ill.): Historically, we have designed and built innovative tools and solutions within our health system that serve only our health system. Given our early investments and successes in genomics, however, we believe we have created unique know-how that can be commercialized and implemented by other early adopter health systems.
We are also actively developing our capabilities to be the ‘partner of choice’ to start-ups and industry. This will allow us to create new revenue streams via co-development ‘sweat equity’ as well as direct investments in early stage companies.
Phillip L. Coule, MD, MBA. Vice President and Chief Medical Officer at Augusta (Ga.) University Health System: The Augusta University Health system is increasing revenue by growing our high margin service lines and leveraging our digital healthcare solutions. Our Virtual Care at Home program has resulted in significant cost savings by allowing the earlier discharge of select patients while simultaneously reducing readmissions. An EMR-based admission criteria solution has helped our admission criteria documentation and improved revenue through getting the patient into the correct admission status, reducing denials due to incorrect status.
John Heitner, MD. Clinical Professor in the Department of Medicine at NYU Langone Health and Director of Physician Network Development at Brooklyn Region: We are expanding our geographical region to cover NYC residents when they travel during the summer holidays and cold winter months by expanding our footprint in Long Island and Florida, respectively.
Rebecca Wiesner. Director of IT Applications at HonorHealth (Scottsdale, Ariz.): HonorHealth’s vision is to be the partner of choice as we transform healthcare for our communities. Healthcare systems are facing increasing financial losses due to staffing shortages, rising expenses, supply chain issues and market competitors whose first priority isn’t our communities and patients. Some of the ways we plan to preserve our financial stability, while continuing to improve the health and well-being of those we serve, over the next couple years include:
1) investment in innovation by identifying and delivering on consumer trends that provide care delivery in new and affordable ways (for example, telemedicine, at-home care, etc. which have potential to benefit and reach more patients);
2) improvements with automation by using AI to drive outcomes or improving highly manual, inefficient billing processes, technologically-driven automation is being developed to improve our revenue cycle experience and quality of care.
Vicki Brown. Director of Revenue Cycle Management at Lubbock (Texas) Heart Hospital: Our pre-authorization and patient access teams are on the ‘frontlines’ when it comes to patient collections. The pre-auth team tries to collect from the patient, when calling about their benefits and financial responsibility, and the PA team members, when the patient arrives for pre-registration and testing. They are our greatest asset when it comes to our patient collections which increases our revenue and lowers our outstanding A/R.
It’s never easy to ask for money, but after noticing both teams were very competitive, I’ve decided to implement ‘friendly,’ monthly competitions. The team that collects the most will be rewarded with a pizza party, Crumbl cookie party or some other surprise. The overall team member with the highest monthly collections will receive a yet to-be-determined prize. Your staff always needs to feel valued and appreciated.
Crystal Broj. Chief Digital Transformation Officer at Medical University of South Carolina (Charleston): We plan to focus on the patient journey from our online presence for how a consumer can learn about our services, to providing appointment schedules that are available online and at times that work for the patient’s lifestyle, to seamless integration for follow-up care and education and an easy way to pay with transparency to costs, insurance coverage and payment plans. If we get this right, reducing the friction and making it easy to do business with us, we anticipate seeing more appointments being scheduled and kept, more care gaps minimized and increased satisfaction, increasing our revenue.
Robert Young, MD. Vice President of Patient Financial Service at AltaMed (Commerce, Calif.): Some ideas include technology investments like automating our statements process by investing in a third-party vendor/application (i.e. Experian) and investing in a PointCare tool to proactively improve Medi-Cal retention rates.
Ally Deale. Director of Patient Access Operations at Luminis Health (Annapolis, Md.): We plan on enhancing our front-end patient processes to improve point of service collections by redefining patient access roles and incorporating innovative technology. Too many patients don’t have a clear understanding of what their responsibility may be or what options are available to help them. So, they either don’t continue care or hide from attempts to get them aid. We want our front end to be patient advocates and educators when it comes to collections. We’ll look to our tech partners to give them the information they need to help educate, advise and guide patients financially. That way, they will be more prepared to work with our financial counselors or lending partners and more focused on their clinical outcomes rather than the financial impact of their care.
Mary Daymont, RN, MSN, CCM, FAAN. Vice President of Revenue Cycle and Care Management at Children’s National Hospital (Washington, D.C.): Front end artificial intelligence to ensure all services that require prior authorization have prior authorization ahead of the date of service to reduce front end denials and write off to bad debt. Front end bots to ensure registrations are complete and accurate ahead of date of service to reduce front end denials and use human resources to work by exception only. Digital billing platform to increase self-pay after insurance and reduce paper billing expenses.
Russell Horton, DO. Medical Director of Clinical Innovation at Banner Innovation Group as part of Banner Health (Phoenix): We want to continue to grow our healthcare networks and insurance plans to increase revenue, but more importantly provide the services and coverages that our people truly need. This can provide a sound footing financially in the coming value-based care world.
Jim Zuran. Regional Vice President of Revenue Excellence at Loyola University Health System (Chicago): Over the next two years, Loyola plans to increase net revenue by improving the fundamentals of the revenue cycle. We are focusing on ‘doing simple better’ – whether it’s processes or people (knowing technology can only get us so far). With the existing labor challenges, we need to improve accuracy and efficiency within patient access. By doing so, it will help mitigate denials and reduce unnecessary PFS account ‘touches.’ As payers continue to evolve, we must match their pace while also holding them accountable when identifying unfair payer behavior. This approach will help accelerate payment(s) and reduce days in AR.
Ash Goel, MD. Senior Vice President and CIO at Bronson Healthcare Group (Battle Creek, Mich.): Our focus on revenue growth comes from three strategic approaches. Looking at better consumer alignment and activation using digital technologies to match consumer needs to the best place of care and providing services where the patients need them delivered is a continuing strategic initiative that we will build upon.
The second approach is to look at the improvement in operational efficiencies which cause systemic waste and reduce the availability of service delivery resources at the point of care. Using lean principles, system-level capacity and command structures to help load-balance and optimize delivery as well as remove bottlenecks, improve resource allocation and utilization ultimately provide new capacity which can help grow revenue. We also expect to explore growth in revenue by looking at business models enabling cross-industry partnerships such as payers and life sciences.
Tara Nooteboom. Head of Consumer Digital Strategy at UCI Health (Irvine, Calif.): A critical component of our growth strategy over the next two years is an emphasis on patient retention and relationships. By engaging patients strategically with digital communications, personalized outreach and relationship management at scale through CRM, and through an emphasis on excellent, coherent brand experience, we aim to drive loyalty. By creatively addressing opportunities in our care continuum service offering and expanding our view of health and health services, we aim to grow the patient ‘basket’ and meet increasingly more consumer health needs.
Joel Klein, MD. Senior Vice President and CIO University of Maryland Medical System (Baltimore): There’s cost management and then there’s revenue. With respect to the latter, our revenue cycle team has developed a three-year plan to integrate and transform their operation. This means taking on challenges like better management of denials, requests for documentation, pre-authorization, automating more tasks and appropriate coding and documentation. This work is especially meaningful because it simply means we are getting paid more fairly for honest work we have already performed and care we have already delivered on behalf of our patients and their families.
We are also working to make it even easier for patients to remit their co-pays and deductibles and set up payment plans where appropriate. None of this is flashy or special – it’s just doing a better job at basics and trying to be as consistent and efficient as we can be.
Dhaval Desai, MD. Director of Hospital Medicine at Emory Saint Joseph’s Hospital (Atlanta): As a Medical Director of a hospitalist group within Emory Healthcare at Emory Saint Joseph’s Hospital in Atlanta, the best way I can align my group and myself is to focus on efficiently navigating patients through their hospitalization without delays and safe transitions on discharges, ultimately reducing the length of stay and decreasing readmission risk. To ensure we do this, multidisciplinary efforts are rapidly being revamped to aggressively hold all team members equally accountable for respective clinical roles through reorganized daily collaboration / huddles.
Another area to ensure our community hospital can withstand competition in this market is to position the hospital medicine team essentially to serve as ambassadors for the hospital. Examples of this include facilitating outside transfers for higher levels of care, efficiently admitting direct admissions from community PCPs and specialists (not alienating them to refer to competitors), and ensuring high satisfaction and communication with patients. These go a long way to ensure the reputation of the hospital is as welcoming and collaborative in order to care for more patients and accept more referrals into the system.
In addition, other innovative ways are to ensure each hospitalist has the opportunity to be involved in QI, HAC reduction and projects that matter to the hospital and system’s bottom-line. All of these areas are risky for financial penalties from payers which lead to loss of revenue. We have emerged post-COVID, and now is the ultimate time to leverage and engage hospitalists who represent such a key stakeholder for the inpatient culture and future at hospitals.
Laura Smith. CIO at UnityPoint Health (West Des Moines, Iowa): UnityPoint Health continues to evaluate opportunities where intelligent automation can be leveraged in our clinical and administrative processes to improve efficiency and productivity across our organization. Although there are many opportunities for health systems to use intelligent automation, we are being purposeful in our efforts to continue to explore how we can increase throughput in our surgical and clinical areas. We know that creating efficiencies like these allows us to care for more patients in the communities we serve.
Raymond Lowe. Senior Vice President and CIO at AltaMed (Commerce, Calif.): AltaMed has a strong focus on value based care ensuring that the proper care is provided to our patients. VBC allows AltaMed to build a complete model of care management infrastructure to effectively oversee lives across the continuum while also maximizing fee-for-service. Our goal is to successfully expand capacity and support the care-model infrastructure for effective operations and data-based risk approach. This also includes a focus on population health and social determinants of health while expanding equitable care programs and partnerships for members and patients.
Another focus area for AltaMed is on data excellence where we have created an interoperable data infrastructure, governance and process with leading-class analytical tools to support care delivery and management. Providing enterprise-wide data capabilities that enable real-time decision-making support across all corporate channels to achieve organizational goals is a priority for the organization.
For 2023, AltaMed is focusing on: 1) maximizing performance incentives from health plans; 2) reducing emergency room visits; 3) reducing hospital costs (re-admissions and length-of-stay); and 4) general reduction in specialty costs.
This summer, AltaMed will focus on utilization and quality review as part of the IT clinical enablement strategy. We will implement Epic Chronicles Claim Loader and leverage health plan claims data that are aligned with specific clinical measures. We will also use the Epic Cognitive Compute Model to identify populations and patients at risk of admission and ER visits. For example, a ‘risk score’ will indicate an adult patient’s one year risk for a hospital admission or ER visit, allowing our care managers and clinicians to see the percent-chance for hospitalization or ER visits.
The Epic Cognitive Compute Model will enable our care teams to review a patient’s risk factors and allow proactive intervention. Separately, to improve integration with specialty providers, AltaMed IT is implementing the Epic Healthy Planet link to allow a specialty provider, hospitalist and our managed services organization to enter specialty results into the patient record, thus providing a more comprehensive view of the patient care plan.
Kevin Makati, MD. President and CEO at Tampa (Fla.) Cardiac Specialists: As hospital systems emerge from pandemic related strains, they face more unique challenges ranging from supply chain constraints to modifications in workforce norms. While strategies to increase revenue might be specific to locale and market segments served, there are some commonalities that apply to most major healthcare systems across the country.
1. The rise in Medicare eligible patients in forthcoming years will create opportunities for systems to form strategic partnerships with insurance carriers to develop system specific Medicare Advantage plans or expand network participation in established value based opportunities as a way to capture additional revenue streams instead of relying on historic payment models that only reward for acute care visits.
2. Maximizing value-based purchasing programs will have an increasing importance as Medicare and at risk insurance products stress quality of care over rewarding quantity. To that end, progressive hospital systems will embrace chronic disease management strategies by leveraging remote services and high density access points outside of the hospitals to manage patients more effectively at home or within their communities to avoid the need for acute care services.
3. Forward thinking hospital systems will leverage technology with ready made solutions or partnering with innovation hubs to create system specific solutions. There are several areas that make for perfect opportunities solved by health tech which include: AI platforms that identify patients who are likely to require acute care and potentially benefit from higher frequency at-home services to avoid hospitalizations; software that complements the increasing trend of patient consumerization to provide higher patient satisfaction and transparency of care; technology that standardizes delivery of care as systems continue to face high staff turnover; and finally, technology that supports local distribution centers to remedy ever increasing supply chain constraints
Regardless of the specific strategy that health systems ultimately take to increase revenue, technology will play an increasingly important role in maximizing revenue potential and decreasing the cost of delivering care.
Michael Hasselberg, PhD. Chief Digital Health Officer at University of Rochester (N.Y.) Medical Center: In the wake of rising costs, health systems need to double down on investing in key organizational priorities such as improved patient care through the use of digital technologies while developing new revenue approaches that can be scaled. At URMC, we pride ourselves in being a great health system partner with industry and our plan is to grow those partnerships over the next two years. As a mid-size health system, we are the perfect venture studio that can be flexible and creative with onboarding industry technologies with lower friction and at higher adoption rates than our larger health system counterparts. Once onboarded we leverage our intellectual capital as a fully integrated academic health system to support the validation, co-development and exploration of new value propositions for those technologies.
Jawad Khan. Chief Data and Analytics Officer at Tufts Medicine (Boston): 1. Reduced length of stay – we are looking for ways to identify ways to reduce our LOS so that beds become available. This involves improvements in workflows for discharging, room cleaning and transfers. Beyond these fundamental areas of improvement, we also leverage the AI/ML to predict LOS and implement appropriate clinical interventions. None of these initiatives requires new investment, it only requires focus and tighter alignment from teams. Fortunately, our analytics teams have organically developed data platforms to support the AI/ML work to predict LOS.
2. Access improvement – we have kicked off projects to implement open scheduling. In order to achieve this, we are first looking closely at our ambulatory providers scheduling templates. We have deployed a physician-led team to meaningfully create a template framework that while addressing physician burnout also opens up appointment slots. Again, these projects also do not need any net new investment. There are other projects that also help increase revenue like physician inbox optimization, documentation improvement and integrating our network providers into a single instance of EHR. These do require new investments and funding.
Liz Fulford, MSN, RN. Executive Director of Case Management at Community Health Network (Indianapolis): Community Health Network has been creative and continues to be creative in leveraging virtual care opportunities. Community has invested in increasing access to care for patients by leveraging virtual care. Additionally, from an acute care setting, Community has leveraged virtual technology to assist in the multiple tasks required by nurses to ensure the safety of our patients.
Stacey Johnston, MD, MHA. Vice President and Chief Application Officer at Baptist Health (Jacksonville, Fla.): In today’s healthcare environment, organizations will need to continually evaluate creative solutions for increasing revenue. Baptist Health in Jacksonville is currently evaluating vendors that will assist with decreasing length of stay and cost of care for hospitalized patients by providing real time data to the physicians about the aggregate cost of care. However, we are also tasking ourselves with reducing spending by continuing to focus on standardization in care, standardization of surgical preference cards and deploying technologies, such as robotics that support more efficient nursing workflows.
Sandra Bossi. Senior Director of Care Delivery Innovation at Hospital for Special Surgery (New York City): At Hospital for Special Surgery Innovation Institute, we protect and commercialize our intellectual property and know-how which allows us to scale our best clinical practices worldwide and generate revenue. We do so through licensing agreements, surgeon partnership for new ventures, sweat equity or royalties type of deals with our growing portfolio of companies we partner with to co-develop breakthrough technologies that can transform musculoskeletal patient care. We take pride in sharing unique knowledge and clinical excellence to improve care delivery globally, but also to ensure we secure the resources necessary for our vibrant culture of innovation to thrive.
Denise Huffman. Director Middle Revenue Cycle at Hennepin Healthcare (Minneapolis): At Hennepin Healthcare, we have strategic planning initiatives underway to achieve financial vitality and growth goals specifically targeting volumes, staffing ratios and revenue growth. To highlight a few creative plans specifically within the revenue cycle, we are turning our attention to front-end registration and authorization errors causing denials by partnering closely with operations and providing real-time feedback through dashboards and collaboration meetings.
Additionally, we are implementing Epic’s eMPA (Electronic medical prior authorization) module which will enable us to send nearly instant authorization requests with appropriate clinical information up front. On the HIM/Middle revenue side, we are exploring and implementing technology to create efficiencies through automation, leveraging simple visit coding and single path coding options and focusing on quality initiatives such as Outpatient CDI and HCC coding. Our PFS team remains focused on denial mitigation with an emphasis on preventable denials and will continue to play a big role in the front-end denial management in the coming years.
Daniel Uzupis. CIO at Jefferson County Health Center: As a critical access hospital in rural Iowa, we have the chance to change our designation to the newly created ‘rural emergency hospital’ to increase revenue over the next two years, but this is short-sighted. Those revenue projections won’t address the biggest problem facing rural Iowa: the needs of our communities. As CAHs attempt to switch to the REH designation, they can realize increased revenue; however, this comes at the cost of acute care for an already marginalized population.
Our commitment to the community means we are not looking at increasing revenue; we’re looking inward at improving quality care. To that end, we are looking at process automation and improvement, as well as a renewed focus on telehealth and telemedicine, the two tactics we find are most amenable to our goals as a critical access hospital.