Latest / Becker’s Healthcare Podcast / Ankit Rohatgi, MD, MBA, FACP, CPE, Vice President of Physician Advisory and Utilization Management at University of Cincinnati Health

Transcript

Ankit Rohatgi, MD, MBA, FACP, CPE, Vice President of Physician Advisory and Utilization Management at University of Cincinnati Health · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
• 0:04
  - understand what it takes to lead a health
• 0:05
  - system right now. The decisions are enormous.
• 0:09
  - The variables are constantly shifting, and the stakes
• 0:11
  - of getting a call wrong don't stay contained.
• 0:14
  - That's not a complaint. It's a structural reality.
• 0:17
  - And it's why the most effective c suite
• 0:19
  - leaders are deliberate about where do they go
• 0:21
  - to pressure test their thinking.
• 0:22
  - Becker's fourteenth annual CEO and CFO roundtable
• 0:26
  - brings together more than 1,500
• 0:28
  - executive level attendees
• 0:30
  - and nearly 400 speakers for four days built
• 0:32
  - around growth, financial sustainability,
• 0:35
  - workforce strategy, and the leadership questions that don't
• 0:38
  - have easy answers.
• 0:39
  - Join us November second through the fifth in
• 0:41
  - Chicago.
• 0:42
  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
• 0:47
  - and click on the events tab in the
• 0:49
  - upper right.
• 0:51
  - This is Alan Condon back with another episode
• 0:54
  - of the Becker's Healthcare podcast.
• 0:56
  - And today, I'm thrilled to be joined by
• 0:58
  - doctor Ankit Rohatke,
• 1:00
  - vice president in physician advisory and utilization management
• 1:04
  - at the University of Cincinnati
• 1:07
  - Health. Doctor Rohatke, a pleasure to have you
• 1:09
  - on the podcast with us today.
• 1:11
  - Before we dive into discussion, I'd love to
• 1:13
  - turn the floor over to you just to
• 1:15
  - hear a little bit more about your role,
• 1:17
  - and your background at the health system.
• 1:19
  - Sure. No. Thanks for having me. So I'm
• 1:22
  - Ankit Rohatki.
• 1:23
  - I'm a physician executive with a background in
• 1:25
  - hospital medicine, utilization management, physician advisory
• 1:29
  - services,
• 1:31
  - and health care technology.
• 1:33
  - Throughout my career, I worked at the intersection
• 1:35
  - of clinical care,
• 1:37
  - operations,
• 1:38
  - reimbursement,
• 1:39
  - and really helping health systems navigate the increasingly
• 1:42
  - complex payer requirements,
• 1:44
  - also ensuring that the patients receive the right
• 1:47
  - care at the right time. Today, much of
• 1:49
  - my work focuses on the clinical side of
• 1:51
  - the ref cycle,
• 1:52
  - particularly utilization management, documentation integrity,
• 1:56
  - medical necessity, and denial prevention.
• 1:59
  - And, really, what excites me most,
• 2:01
  - about this moment is that AI is creating
• 2:03
  - opportunities to reduce administrative
• 2:06
  - burden
• 2:07
  - and allowing clinicians to focus on higher value
• 2:09
  - decision making rather than transactional work.
• 2:13
  - So it's a good space to be at
• 2:15
  - the role where I am.
• 2:17
  - As mentioned,
• 2:18
  - I'm currently working as a VP of physician
• 2:20
  - advisory
• 2:21
  - and utilization management at UCHealth.
• 2:24
  - Just a bit about UCHealth. So University of
• 2:27
  - Cincinnati,
• 2:28
  - is in Greater Cincinnati's,
• 2:30
  - only academic health system and the region's leading
• 2:33
  - safety net hospital.
• 2:35
  - We care for the most complex and vulnerable
• 2:37
  - patients as a level one trauma center,
• 2:40
  - and we deliver advanced multidisciplinary
• 2:42
  - care across,
• 2:44
  - nationally recognized specialties such as neuroscience, cardiovascular
• 2:48
  - care, transplant, oncology, and critical care.
• 2:52
  - Our mission is really to combine academic medication
• 2:54
  - or... Sorry. Academic medicine,
• 2:56
  - innovation, and community responsibility to improve health for
• 2:59
  - every patient we serve.
• 3:02
  - Fantastic. So, doctor Hocky, really appreciate you taking
• 3:04
  - the time out of what I can only
• 3:06
  - assume is a very, very busy schedule to
• 3:07
  - be on the podcast with us today. Really
• 3:09
  - appreciate kind of, a little bit more detail
• 3:11
  - in terms of your core areas of expertise,
• 3:14
  - what you're focusing on, and more broadly, the
• 3:16
  - University of Cincinnati Health as well.
• 3:19
  - So I think to kick things off,
• 3:21
  - no doubt a lot of your work, focuses
• 3:23
  - on the clinical side of the rev cycle
• 3:24
  - which which you've mentioned in terms of documentation,
• 3:27
  - denial prevention,
• 3:28
  - working a lot on AI and and revenue
• 3:30
  - cycle workforce.
• 3:32
  - Can you give us a quick kind of
• 3:33
  - state of the union in terms of what
• 3:35
  - has gone well for your health system, for
• 3:37
  - you this year, and maybe what are you
• 3:39
  - focused on as you look to the end
• 3:41
  - of of twenty twenty six and into next
• 3:43
  - year?
• 3:44
  - Yeah. You know, this year has been really
• 3:46
  - about tightening our execution,
• 3:48
  - strengthening our core,
• 3:49
  - and proving that we can really scale responsibly.
• 3:53
  - So when I look back at 2026
• 3:56
  - so far, what stands out most is how
• 3:58
  - much stronger and more consistent we have become
• 4:00
  - as an organization.
• 4:03
  - We achieved age friendly health system recognition,
• 4:05
  - which was a major milestone,
• 4:07
  - not because of the recognition itself, but because
• 4:10
  - it showed what happens when teams
• 4:12
  - rally around what matters most to the patients
• 4:15
  - and caregivers.
• 4:16
  - It was a reflection of the cultural shift
• 4:18
  - we have been driving towards patient first, disciplined,
• 4:22
  - cross team execution.
• 4:23
  - You can see the same discipline in our
• 4:26
  - operational performance.
• 4:27
  - We worked on some key metrics, such as
• 4:30
  - better readmission outcomes,
• 4:32
  - tighter length of stay management,
• 4:34
  - better mortality reviews,
• 4:36
  - and more accurate documentation
• 4:38
  - that really reflects true patient equity.
• 4:41
  - They came from clearer communication, stronger interdisciplinary
• 4:45
  - collaboration, and workflows
• 4:47
  - that are finally reliable
• 4:49
  - at scale.
• 4:50
  - We also made real strides in
• 4:53
  - UMCDI and rev integrity.
• 4:55
  - Decision making is cleaner, friction is lower,
• 4:58
  - and alignment between clinical and operational teams, it's
• 5:01
  - much stronger than it's been ever.
• 5:04
  - We had 20,000,000
• 5:06
  - in financial improvement,
• 5:07
  - but what matters more is how we achieved
• 5:09
  - it,
• 5:11
  - through better processes, better data, better teamwork.
• 5:14
  - And, you know, everything
• 5:16
  - we did compounded.
• 5:18
  - Now coming to your next,
• 5:20
  - this... The latter part of the question for
• 5:22
  - the rest of 2026,
• 5:23
  - our focus is simple.
• 5:25
  - Scale what's working.
• 5:26
  - We are doubling down on repeatable systems, deeper
• 5:29
  - automation,
• 5:30
  - tighter collaboration across departments.
• 5:33
  - We already have the foundation. I think now
• 5:35
  - it's about accelerating the parts of the organization
• 5:38
  - that are showing the strongest,
• 5:40
  - traction
• 5:42
  - and making sure that our growth stays intentional,
• 5:45
  - disciplined,
• 5:46
  - and anchored in the same patient centered values
• 5:49
  - that got us here.
• 5:51
  - This chapter through 2026 and '27 is really
• 5:54
  - not about doing more. It's about doing what
• 5:56
  - we do the best.
• 5:58
  - Just do it with greater consistency and reliability.
• 6:02
  - So doctor Ohakki, you mentioned
• 6:04
  - a lot of the strides, improvements that you
• 6:06
  - and your team have been making in terms
• 6:08
  - of
• 6:09
  - CDI, and revenue integrity.
• 6:12
  - I believe you alluded to kind of better
• 6:13
  - processes, data, and teamwork.
• 6:16
  - Curious if you'd like to highlight one specific
• 6:18
  - example, something that really stands out from you,
• 6:21
  - and from a revenue integrity standpoint,
• 6:24
  - where you've made great strides or maybe any
• 6:25
  - specific results you'd like to highlight there too.
• 6:29
  - Yeah. From revenue side cycle, you know, really,
• 6:31
  - we look at couple of key metrics, like
• 6:34
  - what's our denial rate, what's our ARR,
• 6:37
  - days to ARR, what's our aging,
• 6:41
  - and that impacts the overall financial
• 6:43
  - impact on the hospital system. So, really, that's
• 6:46
  - one area which we we have focused in
• 6:48
  - 2026, and we continue to grow.
• 6:51
  - So we have streamlined our processes.
• 6:53
  - We have operationally
• 6:55
  - been stronger
• 6:56
  - than last year.
• 6:58
  - We have... We are using some automation and
• 7:00
  - modernizing our tools
• 7:02
  - in order to have an impact both on
• 7:04
  - upstream and downstream revenue gains.
• 7:06
  - So I would say that's probably,
• 7:09
  - one of the key initiatives that we have
• 7:12
  - done and which we continue to evolve and
• 7:14
  - grow.
• 7:15
  - Fantastic. No. I really appreciate that kind of,
• 7:17
  - level of specificity and insight to kinda dive
• 7:19
  - one bit deeper there.
• 7:21
  - Turning to
• 7:23
  - the the lesser fun kind of part of
• 7:24
  - the conversation, there's a lot of challenges, no
• 7:27
  - doubt, in health care. I can only imagine
• 7:29
  - that some of the challenges that you, your
• 7:30
  - your your team are coming up against while
• 7:32
  - keeping an eye on next year.
• 7:34
  - From your perspective,
• 7:36
  - what are the biggest headwinds that that you're
• 7:38
  - keeping an eye on, that you're preparing for
• 7:40
  - in your role, when you think about that
• 7:42
  - 2027
• 7:43
  - and beyond?
• 7:44
  - Yeah. You know, that's a great question. You
• 7:46
  - know, there's... Everybody's talking about the biggest change,
• 7:49
  - which is the Medicaid reset,
• 7:51
  - that's unfolding over the next years. So we
• 7:53
  - know that CMS is capping state directed payments
• 7:56
  - closer to Medicare rates.
• 7:58
  - They are forcing states to publicly post fee
• 8:01
  - for service rates and tightening audits around supplemental
• 8:04
  - payments.
• 8:05
  - So large organ... Large legacy organizations
• 8:08
  - such as ours and many others, they've... We've
• 8:10
  - relied on add on payments,
• 8:13
  - loose documentation, and massive administrative teams
• 8:16
  - that are going to see real margin compression
• 8:19
  - because those dollars won't be simply allowed anymore.
• 8:22
  - And then we have new quality rating requirements,
• 8:25
  - standardized reporting, tougher EQR protocols.
• 8:28
  - And any organizations
• 8:29
  - who can't prove the outcome,
• 8:31
  - they won't be able to have the defensible
• 8:34
  - data,
• 8:35
  - and they will lose a lot of revenue,
• 8:37
  - contract leverage, and even eligibility for certain payment
• 8:40
  - streams.
• 8:42
  - So we know that Medicaid is shifting towards
• 8:45
  - efficiency, transparent... Trans... Transparency and value, and we
• 8:49
  - are preparing by making compliance automatic with AI
• 8:51
  - driven workflows,
• 8:53
  - aligning our care models with Medicare benchmarks,
• 8:56
  - building very transparent
• 8:57
  - audit audit ready systems
• 9:00
  - just so that we can measure our everyday
• 9:02
  - operations.
• 9:03
  - The real headwind that I'm watching for this
• 9:06
  - year and next,
• 9:07
  - most closely is how do we scale without
• 9:09
  - compromising quality?
• 9:11
  - You know, having both and clinical background,
• 9:14
  - we know that growth introduces complexity and complexity
• 9:17
  - introduces risk.
• 9:19
  - The real test of my leadership and our
• 9:22
  - leadership for an organization
• 9:24
  - in this environment is building systems that are
• 9:26
  - strong enough, simple enough,
• 9:29
  - and reliable enough to support that growth, at
• 9:31
  - the same time protecting the integrity of the
• 9:33
  - care we deliver.
• 9:35
  - So that... Doctor Hocky, that actually ties directly
• 9:38
  - into my next question in terms of,
• 9:41
  - scaling without compromising that quality. No doubt a
• 9:44
  - a key opportunity for the system. No doubt
• 9:45
  - some challenges to come along with that as
• 9:47
  - well. But
• 9:49
  - it ties into my next question, like I
• 9:50
  - said. Is that the best opportunity, the biggest
• 9:53
  - opportunity for you to grow over the next
• 9:54
  - couple years? Or is there anything else you'd
• 9:56
  - like to highlight in that regard as well
• 9:57
  - for the future?
• 9:59
  - Yeah. You know, our biggest opportunity is to
• 10:01
  - double down on what differentiates us and scale
• 10:03
  - it with discipline.
• 10:05
  - At UC, we have done
• 10:07
  - extremely well in the last few years. We
• 10:09
  - have implemented age friendly care models.
• 10:12
  - We have smarter utilization management.
• 10:15
  - Those trends position us well for the next
• 10:17
  - two or three years, especially in the revenue
• 10:19
  - cycle environment as it becomes more challenging.
• 10:22
  - But at the same time, we are facing
• 10:23
  - increasing payer complexity, rising denial rates,
• 10:26
  - heavier prior authorization requirements,
• 10:29
  - and very slow reimbursement cycles.
• 10:32
  - And then at the other side, we see
• 10:33
  - workforce shortages,
• 10:35
  - administrative overload, which are adding press... Pressure too.
• 10:39
  - Teams are asked... Teams are being asked to
• 10:41
  - do more with fewer resources,
• 10:43
  - you know, which creates operational fatigue and makes
• 10:46
  - efficiency harder to sustain.
• 10:48
  - So our biggest opportunity
• 10:51
  - I see is to invest in in in
• 10:53
  - modernizing the data,
• 10:56
  - invest in automation,
• 10:58
  - making sure all our decisions are data driven.
• 11:02
  - They're repeatable,
• 11:03
  - operating models that can scale without adding complexity.
• 11:07
  - So we are building systems that reduce friction
• 11:10
  - for the staff, strengthen the documentation
• 11:12
  - accuracy,
• 11:13
  - and improve upstream decision making so we can
• 11:16
  - prevent denials before they occur. And I think
• 11:18
  - by modernizing the workflows and supporting our teams
• 11:21
  - with technology enabled solutions,
• 11:23
  - we can enhance
• 11:24
  - our overall efficiency,
• 11:26
  - optimize revenue capture, and create more sustainable
• 11:29
  - operating environment.
• 11:31
  - Also, like, UC
• 11:33
  - being a large academic center, we are heavily
• 11:36
  - grounded,
• 11:37
  - into HRO or high reliability organization principles.
• 11:40
  - Mhmm. So we are very intentional about designing
• 11:43
  - our processes that are consistent, predictable, and deeply
• 11:45
  - focused on safety
• 11:47
  - and reliability, both for the organizations and the
• 11:49
  - patients we care for.
• 11:51
  - Got it. Fantastic. Certainly, a lot on the
• 11:54
  - books, it sounds like. A lot of exciting,
• 11:56
  - a lot of challenges, no doubt, but a
• 11:57
  - lot of exciting areas in which you, your
• 11:59
  - team, your health system overall is working towards
• 12:01
  - growing and and improving overall.
• 12:03
  - Doctor Ohadke,
• 12:05
  - fascinating to kinda get a deeper level of
• 12:07
  - insight into yourself, your team at the University
• 12:09
  - of Cincinnati Health. But the last question that
• 12:12
  - I have for you was a a leadership
• 12:14
  - focused question.
• 12:16
  - I'd love to wrap on hearing from you.
• 12:18
  - Is there a
• 12:19
  - leader within health care or even without health
• 12:22
  - care that you particularly
• 12:24
  - admire
• 12:25
  - and why?
• 12:27
  - You know, so I admire leaders who transform
• 12:29
  - culture without drama.
• 12:33
  - So so one leader I really admire is
• 12:35
  - Satya Nadella,
• 12:36
  - the CEO, founder of Microsoft.
• 12:39
  - You know, he took one of the world's
• 12:41
  - largest and most complex organizations and reshaped it
• 12:43
  - around clarity and long term thinking.
• 12:47
  - He really shifted Microsoft from know it all
• 12:49
  - culture to learn it all culture,
• 12:51
  - and I think that mindset is really what
• 12:53
  - health care need... Needs right now.
• 12:56
  - Now if I tie it to and rev
• 12:57
  - cycle,
• 12:58
  - you know, payer rules are changing daily.
• 13:01
  - No team can know everything anymore.
• 13:03
  - So there is a big AI arms race
• 13:06
  - happening between payers and providers,
• 13:10
  - but I don't believe that the answer is
• 13:12
  - for providers to simply build more AI than
• 13:14
  - the payers.
• 13:16
  - Payers digest lot of data. They're using automation
• 13:18
  - to identify patterns, manage utilization,
• 13:22
  - and scrutinize what gets paid, and we have
• 13:24
  - a very different advantage of clinical context, operational
• 13:27
  - context, and patient relationship.
• 13:29
  - So it's really to use technology to make
• 13:32
  - sure that we are automating the repetitive work,
• 13:35
  - identifying denials before they happen, predicting where claims
• 13:39
  - will fail,
• 13:40
  - and giving our teams better information at the
• 13:43
  - exact moment they need it.
• 13:45
  - So all in all, I'd say Nadella showed
• 13:46
  - that AI doesn't replace people. It elevates their
• 13:50
  - ability to adapt at scale.
• 13:52
  - And I think this is the kind of
• 13:53
  - leadership I like, which is calm, culture driven,
• 13:56
  - and future focused, and that's what I admire
• 13:58
  - the most. Yeah. I think a fascinating gonna
• 14:01
  - take to end on there. Leaders who transform
• 14:03
  - culture without drama. I loved your take on
• 14:06
  - the... How providers should be approaching this,
• 14:10
  - AI arms race, for lack of a better
• 14:11
  - term, with the with the payers. No doubt
• 14:14
  - revenue cycle leaders like yourself are key key
• 14:16
  - point, for the future. But, doctor Rohatki,
• 14:18
  - fascinating conversation. Thank you so so much for
• 14:21
  - joining us on the Becker's podcast. I really
• 14:23
  - look forward to connecting again down the line.
• 14:25
  - Thank you. Thank you. Looking forward to it.