Latest / Becker’s Healthcare Podcast / Miguel "Mike" Vigo IV, MBA, Chief Revenue Cycle Officer, UC San Diego Health

Transcript

Miguel "Mike" Vigo IV, MBA, Chief Revenue Cycle Officer, UC San Diego Health · Becker’s Healthcare Podcast

• 0:02
  - The strategic agenda facing hospital and health system
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  - at the Hyatt Regency in Chicago,
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  - This is Laura Dierdahl with the Becker's Healthcare
• 1:00
  - podcast. I'm thrilled today to be joined by
• 1:02
  - Mike Figo, chief revenue officer at UC San
• 1:04
  - Diego Health. Mike, it's a pleasure to have
• 1:06
  - you on the podcast today.
• 1:08
  - Oh, thank you. It's a pleasure to be
• 1:09
  - here.
• 1:10
  - Absolutely. Now I'm excited for our conversation. I
• 1:12
  - know we're gonna talk through some of the
• 1:14
  - cool things you're doing at UC San Diego
• 1:16
  - Health as well as how you're thinking about
• 1:17
  - the future. But before we dive in, can
• 1:19
  - you tell us just a little bit more
• 1:21
  - about yourself and your background?
• 1:23
  - Happy to.
• 1:24
  - I'm Mike Vigo the fourth, so you can
• 1:26
  - imagine there's a a suffix there. I come
• 1:28
  - from a long lineage of Vigos,
• 1:30
  - but born and raised in Chicago,
• 1:33
  - started,
• 1:34
  - my health care career in the late two
• 1:37
  - thousands, 2010,
• 1:38
  - timeline,
• 1:39
  - And started on the provider side, it was
• 1:41
  - great. I worked my way up through financial
• 1:44
  - clearance centers and worked with EPIC teams for
• 1:47
  - a large organization in Chicago.
• 1:50
  - Was a bit younger, so I was looking
• 1:51
  - to grow my skill set and learn as
• 1:53
  - much as I could, so decided to go
• 1:55
  - down the consulting vendor partnership route for a
• 1:58
  - few years.
• 1:59
  - And that worked great because I got to
• 2:00
  - go all across the country and learn how
• 2:02
  - health care and revenue is handled
• 2:04
  - across the the nation, which was fantastic.
• 2:08
  - My father, unfortunately, fell terminally ill, so I
• 2:10
  - needed to get off the road. And I
• 2:12
  - went back to the provider side and was
• 2:13
  - able to work,
• 2:15
  - back in the Chicagoland area
• 2:17
  - for a couple organizations,
• 2:18
  - build a family, which was fantastic.
• 2:21
  - But after the family was
• 2:23
  - built,
• 2:24
  - I, asked the my spouse, hey. Are we
• 2:26
  - are we done with the family? She said
• 2:28
  - yes. I said, can I get my health
• 2:29
  - care career back in order? She said yes.
• 2:32
  - And decided to put my name out there
• 2:34
  - and was honored to be awarded the role
• 2:36
  - at chief revenue officer at United or, UC
• 2:39
  - San Diego Health in, San Diego, California, and
• 2:42
  - we moved out here about four years ago.
• 2:45
  - That's fantastic. And, you know, what a a
• 2:47
  - great
• 2:48
  - career journey you've had and that ability to
• 2:50
  - mix the personal professional is always very, very
• 2:53
  - much, a balancing act, but at the same
• 2:56
  - time, great to have that career and and
• 2:58
  - family building
• 2:59
  - at the same time and then, you know,
• 3:01
  - great opportunities across the board. So,
• 3:04
  - have fun, and I can imagine San Diego
• 3:06
  - is just a little bit different from Chicago.
• 3:09
  - Just a little bit. I will say the
• 3:11
  - two biggest things I miss from Chicago,
• 3:14
  - still have some family and friends there, but
• 3:16
  - the
• 3:17
  - amazingly delicious, but not good for you, healthy
• 3:20
  - wise at all food. I definitely miss that.
• 3:23
  - Yeah. Absolutely. Well, the Chicago food scene is
• 3:26
  - unparalleled, but it it's a lot of fun.
• 3:28
  - And like you said, I'm sure, you know,
• 3:31
  - lots of great options in San Diego too
• 3:33
  - and a little bit healthier.
• 3:34
  - Yes. A 100%. My, let's just say the
• 3:37
  - time at the beach, the hiking, the lifestyle
• 3:39
  - out here has definitely been great. Just to
• 3:41
  - be clear, the food is fantastic. But, yeah,
• 3:43
  - like you said, Chicago's kind of in a
• 3:45
  - a realm of its own.
• 3:47
  - Absolutely. Well,
• 3:48
  - could we start off here and give us
• 3:50
  - a quick state of the union of everything
• 3:52
  - you're doing at UC San Diego?
• 3:54
  - What has gone well this year, and what
• 3:55
  - are you focused on for the rest of
• 3:57
  - 2026?
• 3:59
  - Well,
• 4:00
  - as you might know, we, in the financial
• 4:02
  - division, break it by fiscal year. So we
• 4:04
  - had a fantastic fiscal year twenty six that
• 4:06
  - just wrapped, in June 30
• 4:09
  - a few months ago.
• 4:11
  - It was really a year to,
• 4:14
  - accelerate cash, build a lot of foundations,
• 4:17
  - in place, not just to have a one
• 4:19
  - time win, but have a consistent,
• 4:21
  - stable
• 4:22
  - environment by which
• 4:24
  - we are able to not just achieve success,
• 4:25
  - but sustain it. So I do remember in,
• 4:29
  - my interview with the CEO
• 4:31
  - at UC San Diego Health, Patty Mason,
• 4:33
  - asked if there's a way and a a
• 4:35
  - goal was to stabilize
• 4:37
  - our accounts receivable and a lot of our
• 4:38
  - revenue operations.
• 4:40
  - And I committed to her that I would
• 4:42
  - do that. And UC San Diego Health is
• 4:44
  - a is a large institution, a lot of
• 4:45
  - factors, a lot of relationships to build,
• 4:48
  - a lot of details to fully understand and
• 4:50
  - to grasp before you start making decisions that
• 4:52
  - would impact
• 4:54
  - multiple teams and the ripple effects needed to
• 4:56
  - be fully understood.
• 4:57
  - So we took 2020 or fiscal year twenty
• 5:00
  - six as a way to not just accelerate
• 5:02
  - the work we did, but stabilize and build
• 5:04
  - that foundation in.
• 5:05
  - So a lot of areas that we did
• 5:07
  - in '26 that's gone well. We've got some
• 5:09
  - big plans for '27 was we did a
• 5:12
  - dramatic reduction or a controllable loss,
• 5:15
  - essentially,
• 5:16
  - reducing our fatal denials.
• 5:17
  - I'm happy to speak in details, but we
• 5:19
  - employed a bunch of tools,
• 5:22
  - a lot of, weekly
• 5:24
  - routines and exercises that we put in place
• 5:26
  - to make sure that once we resolved
• 5:28
  - a lot of these issues, we had good
• 5:30
  - eyes on it to make sure that it
• 5:31
  - would not, rear its ugly head again.
• 5:34
  - But we also wanted to balance that in
• 5:36
  - the right way with,
• 5:37
  - performance management.
• 5:39
  - So when we did the details and we
• 5:40
  - we looked through it for controllable loss, we
• 5:43
  - weren't just looking at how can we
• 5:45
  - secure that cash and make sure that it
• 5:47
  - stayed in our pockets. But what are the
• 5:49
  - workflows? What are the measurements, the key performance
• 5:51
  - indicators?
• 5:52
  - What's the team's work and all the details
• 5:54
  - that go with it so that we can
• 5:55
  - build that into
• 5:56
  - not just the result that we see once
• 5:58
  - the account comes back, but how are we
• 6:00
  - changing the day to day operations
• 6:03
  - for each team member as it can differ
• 6:05
  - between a commercial person or a government worker
• 6:08
  - or a coder versus a biller? How are
• 6:10
  - we gonna do that? How are we gonna
• 6:11
  - build that in at that intrinsic level? And
• 6:13
  - we're able to sustain and build a lot
• 6:15
  - of that in '26.
• 6:17
  - So we had a lot of great success.
• 6:19
  - From there, we kinda took our focus and
• 6:21
  - moved
• 6:23
  - to how can we move this more upfront
• 6:24
  - because we are looking at it kinda middle
• 6:26
  - to back end. We always respected and moved
• 6:28
  - the edits we needed to upfront, but
• 6:30
  - twenty seven's really been a a year that
• 6:33
  - we literally themed it and called it back
• 6:34
  - to the basics.
• 6:36
  - We were,
• 6:37
  - one
• 6:38
  - concur expense away from getting a bunch of
• 6:41
  - T shirts that were themed with Michael j
• 6:42
  - Fox or back to the future, but, decided
• 6:44
  - to save a little bit of money there.
• 6:46
  - But this year has been about back to
• 6:48
  - the basics. So how what else can we
• 6:49
  - do foundationally to,
• 6:51
  - again, not keep just keep the momentum going,
• 6:53
  - but how can we continue to rebuild our
• 6:56
  - foundation so that we have
• 6:58
  - a a true strong foundation for success?
• 7:01
  - The last thing I'll mention, I know it's
• 7:03
  - a very hot topic, is everyone's looking for
• 7:05
  - investments in artificial intelligence and automation.
• 7:08
  - And I think, unfortunately,
• 7:10
  - a few of the folks in my network
• 7:11
  - and a few articles that I've made across
• 7:13
  - have really proven the point that you need
• 7:16
  - to have strong bones. You need to have
• 7:17
  - a strong foundation because if you don't, the,
• 7:21
  - artificial intelligence programs and automation will simply just
• 7:24
  - take garbage in and give you garbage out.
• 7:26
  - And we know that, and we're we're working
• 7:28
  - really hard to continue to strengthen and enhance
• 7:30
  - our foundations.
• 7:31
  - Patient access,
• 7:33
  - coding,
• 7:34
  - billing collection work, all of the areas that
• 7:36
  - we can focus on both on the medical
• 7:37
  - center side and the physician group side.
• 7:40
  - I love it. I I think that makes
• 7:41
  - a lot of sense. You know, that message
• 7:43
  - back to the basics is so critical because
• 7:46
  - having that, you know, the right, data information
• 7:49
  - and everything else done the right way makes
• 7:51
  - the automation so much more powerful as you're
• 7:54
  - thinking through how health care is transforming and
• 7:56
  - in the ways that it could be,
• 7:58
  - completely,
• 7:59
  - you know, more beneficial, more useful for patients
• 8:01
  - as well as the entire organization, I think,
• 8:04
  - makes a lot of sense. And so,
• 8:07
  - I love that. And, you know, when you're
• 8:08
  - looking into the future as well, you're getting
• 8:10
  - back to the basics. And then what are
• 8:12
  - some of the headwinds that you're keeping an
• 8:14
  - eye on and preparing for?
• 8:16
  - The biggest headwind, it's not new, but it's
• 8:18
  - becoming more of a pressure is,
• 8:21
  - you know, as the margins continue to compress
• 8:23
  - across the industry
• 8:24
  - while balancing the complexities of, again, not just
• 8:28
  - maintaining, but trying to maximize reimbursement and payments
• 8:31
  - from our
• 8:32
  - insurance carriers or whomever the the guarantor is.
• 8:36
  - We're really seeing a lot of that pressure
• 8:37
  - come from all angles. And, again, that's not
• 8:39
  - new, but we're trying to look at it
• 8:41
  - differently. So how can we
• 8:43
  - balance all of these items at the same
• 8:45
  - time? Well, the quick and easy word is
• 8:47
  - to let's go to automation and artificial intelligence.
• 8:50
  - And
• 8:51
  - although that might be the right next step
• 8:53
  - depending on the situation, the organization,
• 8:55
  - and just the issue that's presenting itself, it
• 8:57
  - has to be done methodically.
• 8:59
  - It has to be planned as in detail
• 9:01
  - as you can,
• 9:03
  - knowing you'll never get perfection.
• 9:04
  - But having a list of success factors to
• 9:07
  - base that off of so that you have
• 9:09
  - whatever that greater mass is, whether it's 80%
• 9:12
  - of knowing those items that you could move
• 9:14
  - forward,
• 9:15
  - You have to have that clearly listed out,
• 9:17
  - communicated out so that all of your team
• 9:19
  - leaders and all the teams involved are on
• 9:21
  - the same page for that. And then making
• 9:23
  - that step, taking that risk, it's a calculated
• 9:25
  - risk, but taking that to move it forward,
• 9:27
  - then and only then can you really achieve,
• 9:30
  - the success that you're looking for so that
• 9:33
  - you can get the maximum results with the
• 9:35
  - minimal cost and keep those margins where they
• 9:37
  - need to be.
• 9:38
  - The other big item that's been a headwind
• 9:41
  - for us is a lot of times I
• 9:42
  - find that we're getting caught. Our attention's being
• 9:45
  - caught up in
• 9:47
  - whatever the new national trend is or a
• 9:48
  - news article that came out or whatever we
• 9:51
  - might be seeing in our data.
• 9:53
  - And every time
• 9:54
  - our leadership team aligns with some of our
• 9:56
  - nonnegotiables, and one of those is we try
• 9:59
  - to self correct ourselves when we start going
• 10:01
  - down maybe some rabbit holes or some soap
• 10:03
  - boxes where we're talking about things that start
• 10:06
  - to go into areas that are uncontrollable.
• 10:08
  - They're outside of our control.
• 10:09
  - An example of this is we work very
• 10:12
  - closely with our physicians,
• 10:13
  - and one of the really important things for
• 10:15
  - them is authorization.
• 10:17
  - We're doing our absolute best
• 10:19
  - to reduce the peer to peers that are
• 10:21
  - being asked to them, to use technology and
• 10:23
  - automation, to work with our contracting team, to
• 10:26
  - get that messaging and work our contract language
• 10:29
  - to be
• 10:30
  - less invasive with the physicians.
• 10:32
  - So those are the items we can control.
• 10:34
  - What we cannot control is the ultimate decision
• 10:36
  - by some of those insurance firms and the
• 10:38
  - criticality or acuity that might be coming in
• 10:40
  - the door and how the contract's being based
• 10:42
  - or why that provider is being reached out
• 10:44
  - to. So in that particular example,
• 10:48
  - what can we control? What are our investments
• 10:50
  - doing? What's our team doing? The training and
• 10:52
  - education we're putting into it, escalating the appropriate
• 10:55
  - items to our contracting team to arc up
• 10:57
  - with the payers,
• 10:58
  - educating our doctors clearly and saying, you know,
• 11:02
  - physicians, this is what we can do. This
• 11:03
  - is what we are doing. We take your
• 11:05
  - concerns very seriously. Here's our plan of attack.
• 11:08
  - We'd love your input. But at the same
• 11:10
  - time, here are some items that we cannot
• 11:12
  - control. Here's the newest news article. Here's the
• 11:14
  - newest contract policy update. So that it's a
• 11:17
  - clear understanding of we are working very hard
• 11:19
  - on this. This is a big headwind for
• 11:21
  - us. But at the same time, we can
• 11:23
  - only focus on the items we can't control.
• 11:25
  - And that not only I think gets us
• 11:27
  - a better understanding of relationship with our providers,
• 11:30
  - but also our teams because I think that
• 11:32
  - they would love to solve all the problems.
• 11:34
  - We we truly do. We're a support service.
• 11:36
  - We know that. But at the end of
• 11:38
  - the day, we really need to focus on
• 11:39
  - what we can control.
• 11:40
  - So that's been a big headwind that we've
• 11:42
  - looked forward to. The last item is that
• 11:45
  - we're really looking at all opportunities for revenue
• 11:47
  - leakage. Our charge reconciliation teams, our revenue integrity
• 11:51
  - teams, we've done a lot of review, got
• 11:53
  - a lot of projects planned for them in
• 11:55
  - '27,
• 11:56
  - and how we can not only have a
• 11:58
  - very structured
• 11:59
  - approach to ensuring that we are capturing all
• 12:01
  - charges compliantly.
• 12:03
  - But if there are opportunities
• 12:05
  - where we can maximize some of the coding,
• 12:08
  - there are applicable modifiers or charge that need
• 12:10
  - to be added,
• 12:11
  - then we're doing that. I'm blessed that we
• 12:13
  - work at a large institution that pretty much
• 12:16
  - checks every single specialty box out there. So
• 12:19
  - it's a very complex set of patients we're
• 12:21
  - seeing. So we it's very rare that we
• 12:23
  - can have a one size fits all solution.
• 12:25
  - So balancing, again, going back to that previous
• 12:28
  - point about margins and resources,
• 12:30
  - what is the most effective way we can
• 12:32
  - maximize that charge
• 12:34
  - capture,
• 12:35
  - maximize the revenue opportunity, and reduce that revenue
• 12:38
  - leakage? And that's a big, big headwind in
• 12:40
  - in
• 12:42
  - strategic project for us in '27.
• 12:44
  - I love it. And, you know, I appreciate
• 12:46
  - you talking through all of those different challenges
• 12:47
  - because I think so many organizations have,
• 12:50
  - very similar as they're looking at looking at
• 12:52
  - AI automation and, what they need to do
• 12:54
  - in order to maximize reimbursements and everything else
• 12:56
  - that goes into that.
• 12:58
  - And then policy trends, obviously, national from the
• 13:01
  - payer level and state level too, very, very
• 13:03
  - complex and always changing. So,
• 13:06
  - being on top of that,
• 13:08
  - it really truly is
• 13:10
  - a challenge in and of itself. And then
• 13:11
  - to your last point, looking at revenue leakage,
• 13:14
  - is there any spaces
• 13:16
  - that you're able to talk through that you
• 13:17
  - found that you were surprised by, where you
• 13:19
  - were finding revenue leakage, or what kind of
• 13:21
  - was that process like, and how are you?
• 13:23
  - I know, as part of your plans for
• 13:25
  - the future is continuing to double down in
• 13:27
  - that space and in shoring up some of
• 13:28
  - those gaps.
• 13:30
  - You know, the the opportunities for charge capture
• 13:34
  - will change across even an area that you
• 13:36
  - might be sustained in within a year or
• 13:38
  - two, for example.
• 13:40
  - God bless the, you know, the government or
• 13:42
  - the payers. There'll be an updated change that'll
• 13:44
  - come through that we have to respond and
• 13:46
  - react to.
• 13:47
  - A lot of times, we'd like to get
• 13:49
  - ahead of that. We do testing and meet
• 13:51
  - with the various
• 13:52
  - subject matter expert and work groups as well
• 13:54
  - as our IS teams in building those edits
• 13:56
  - and those rule changes into place.
• 13:59
  - So a couple opportunities that came up was
• 14:01
  - we wanted to be as efficient as we
• 14:02
  - could. Some of the coding changes that occurred
• 14:05
  - with radiation oncology for the calendar year of
• 14:07
  - '26.
• 14:09
  - We were able to catch some of those
• 14:10
  - updates pretty early out in the year,
• 14:13
  - align our pricing to make sure that it
• 14:14
  - matched given the changes in the codes.
• 14:17
  - So and then monitor that to make sure
• 14:19
  - not only were they being paid accurately I'm
• 14:21
  - sorry, paid timely being but also being paid
• 14:23
  - accurately.
• 14:24
  - So that's an example of having the right
• 14:27
  - folks from the department with the specialties
• 14:30
  - I'm sorry, the special knowledge, the revenue integrity,
• 14:33
  - and charge description master pricing team, as well
• 14:36
  - as our billing and collection team to make
• 14:38
  - sure that we can go back when we
• 14:40
  - identify those opportunities if we need to rebill,
• 14:43
  - reprice,
• 14:44
  - whatever that is so that we can go
• 14:45
  - back, honor the timely filings by payer, get
• 14:48
  - those reprocessed and so that we are maximizing
• 14:51
  - catching all that revenue as best we can
• 14:53
  - as timely as we can.
• 14:55
  - Another item that we look forward to or
• 14:58
  - that we worked hard on was a little
• 15:00
  - bit in our
• 15:01
  - triage unit when it comes to some of
• 15:03
  - the way that we were monitoring the services
• 15:06
  - we were providing
• 15:07
  - and charging for the, hourly care that was
• 15:10
  - being provided there. As you can imagine, the
• 15:12
  - acuity coming in
• 15:14
  - through various points within the emergency department, whether
• 15:17
  - it's burn or trauma, whatever that is, we
• 15:19
  - had to make sure that we were respecting
• 15:22
  - the acuity of the patients coming in, honoring
• 15:24
  - the criteria and scoring that needed to occur.
• 15:27
  - And at the same time, are we balancing
• 15:29
  - the hospital,
• 15:31
  - leveling as well as the, professional fee leveling
• 15:34
  - with the, you know, the facility's resources
• 15:37
  - being used as well as the physician and
• 15:39
  - the provider's resources being used. So two areas
• 15:42
  - that we've been focusing on that we've had
• 15:44
  - some great success.
• 15:45
  - But, as I kinda mentioned at the beginning,
• 15:48
  - the target's always moving. So what is the
• 15:51
  - process? How are we relooking at that to
• 15:53
  - make sure that we're maximizing value there?
• 15:56
  - That's helpful to understand. Thank you so much
• 15:58
  - for digging a bit deeper and sharing these
• 15:59
  - examples. This is so powerful to kinda get
• 16:02
  - inside and and behind the door a little
• 16:03
  - bit and, hear, you know, those real world
• 16:06
  - examples of what you're doing. Now I wanted
• 16:08
  - to ask you about, growth as well. Where
• 16:11
  - do you see some of the best opportunities
• 16:12
  - for growth in the next two to three
• 16:13
  - years or so?
• 16:15
  - For growth,
• 16:17
  - we're really trying to focus on the not
• 16:19
  - just the strategic
• 16:21
  - view we've had for back to the basics.
• 16:23
  - We're really trying to reinvigorate our team. So
• 16:26
  - when I mentioned earlier about looking at all
• 16:28
  - the processes and workflows,
• 16:30
  - we're also looking at arming our teams with
• 16:33
  - the right technology,
• 16:34
  - skill sets, and education
• 16:36
  - because the tools are changing.
• 16:38
  - And how are we doing that? How are
• 16:39
  - we making sure that they have the right
• 16:41
  - level of,
• 16:43
  - education
• 16:43
  - available to them, not just for the job
• 16:46
  - they're doing, but as a career ladder in
• 16:48
  - the next role they wanna do and take
• 16:50
  - on for, their career. So
• 16:52
  - I think that's a big opportunity for us
• 16:54
  - to reinvest and look at, our our teams
• 16:57
  - internally because our employee experience is incredibly important
• 17:00
  - to us.
• 17:02
  - Another item we look at is, of course,
• 17:03
  - our patients.
• 17:05
  - We've been blessed at UDC San Diego Health
• 17:07
  - that our market share continues to increase. We
• 17:09
  - take that very seriously with our community.
• 17:12
  - So we have been looking at our financial
• 17:14
  - clearance setters. I mentioned a little bit earlier
• 17:16
  - about the patient access team and getting back
• 17:18
  - to the basics with them.
• 17:20
  - But while we do that, it's making sure
• 17:23
  - that we're doing so with the patient in
• 17:24
  - mind and at the forefront. So we're making
• 17:27
  - it easier for them to find us, easier
• 17:29
  - for them to complete
• 17:30
  - the, you know, information entry that they need
• 17:32
  - to, and requesting minimal information,
• 17:35
  - still required, but minimal information so that we
• 17:38
  - can leverage our technology investments to get
• 17:41
  - a more clear picture of what that patient's
• 17:43
  - financial experience is gonna be.
• 17:46
  - I think another big area for us to
• 17:48
  - grow is more into the, EMR functionality
• 17:51
  - that exists.
• 17:52
  - We'll be fortunate
• 17:54
  - that we'll be moving forward with a a
• 17:56
  - large upgrade this year, which will bring a
• 17:58
  - lot more options to
• 18:00
  - our teams, both operation as well as experience,
• 18:03
  - because it will help reduce a lot of
• 18:04
  - clicks and administrative burden. So we've been working
• 18:07
  - with our
• 18:08
  - information services team and our epic leaders so
• 18:10
  - that we can see what are the most
• 18:12
  - significant accelerators,
• 18:14
  - rate those opportunities
• 18:16
  - to see what the way we're set up
• 18:17
  - and our biggest operational needs,
• 18:20
  - what features and functions
• 18:21
  - can really help us automate.
• 18:23
  - And then as I mentioned a little earlier
• 18:25
  - as well, making sure that those processes we
• 18:27
  - have are taken into consideration. Are they clean?
• 18:29
  - Are they working well today? And doing
• 18:32
  - a, a ranking system or a scoring system
• 18:34
  - to make sure we're making the best decision
• 18:36
  - we can.
• 18:37
  - The ideal
• 18:38
  - point of all this, input is to not
• 18:40
  - just reduce administrative burden, but if we're seeing
• 18:42
  - these issues downstream,
• 18:44
  - I'd love to move that prevention,
• 18:47
  - upfront and get to your prediction type of
• 18:49
  - model.
• 18:51
  - The last item I think we're really focusing
• 18:53
  - on to the big opportunity
• 18:55
  - is to I mentioned we've had some great
• 18:56
  - results with controllable loss reduction in '26.
• 19:00
  - There's still more there.
• 19:02
  - So we are looking for working very closely
• 19:04
  - with a lot of our clinical leadership within
• 19:07
  - medical necessity,
• 19:08
  - a lot of our patient statusing,
• 19:10
  - and looking to support the patient throughput as
• 19:13
  - best we can to make sure we're getting
• 19:15
  - the patients the right care they need at
• 19:17
  - the right time at the right location, but
• 19:19
  - also making sure that,
• 19:21
  - all of the the both the providers, the
• 19:23
  - patients, and the team members have all those
• 19:25
  - resources available to them. Because at the end
• 19:27
  - of the day, that means the patient's getting
• 19:29
  - the right care at the best time.
• 19:31
  - The the burden on the physician and the
• 19:33
  - care team is reduced. The employee experience is
• 19:36
  - maximized,
• 19:37
  - and, also, we're maximizing the revenue and the
• 19:39
  - reimbursement that we're getting from that care. So
• 19:42
  - those are the the two to three big
• 19:43
  - opportunities that we're looking for in the next
• 19:45
  - couple years that we are working on now
• 19:48
  - knowing
• 19:49
  - that some of those timelines are six months,
• 19:51
  - a year, eighteen months, and two years.
• 19:54
  - That's helpful to understand. And, you know, really
• 19:56
  - cool that you've got, all that opportunity ahead
• 19:58
  - and in really being able to work with
• 20:00
  - your teams, maximizing your teams, and and then
• 20:03
  - growing into a space where, you know, you
• 20:05
  - have a lot of,
• 20:07
  - growth potential in getting great results. So I
• 20:09
  - know you mentioned, you know, had a great
• 20:11
  - fiscal year 2026,
• 20:12
  - and it seems like a lot of exciting
• 20:14
  - things in store for 2027
• 20:15
  - as well. And as we wrap up here,
• 20:17
  - I wanted to ask about leadership.
• 20:19
  - Could you tell me a a leader that
• 20:21
  - you really admire from any industry and why?
• 20:24
  - I'll just be a bit biased.
• 20:26
  - I have never in my career had the
• 20:29
  - support of the CEO. I have now with
• 20:30
  - Patty Mason.
• 20:32
  - She's been fantastic in every way, and I
• 20:34
  - mean that with my entire heart.
• 20:37
  - So I'm a bit biased there, but that
• 20:39
  - would be the CEO that I admire,
• 20:42
  - very much.
• 20:43
  - I think Alan Mulle from,
• 20:45
  - Ford is another one that stands out to
• 20:47
  - me.
• 20:48
  - I do a bit of reading and like
• 20:49
  - to keep
• 20:50
  - a pulse
• 20:51
  - on various industries.
• 20:53
  - One of the things that he brings that's
• 20:54
  - really important is he created an environment where
• 20:58
  - people aren't afraid to speak,
• 21:00
  - and I think that that's,
• 21:02
  - very, very important.
• 21:04
  - I think it's important that we need to
• 21:05
  - keep the microphone on for everybody.
• 21:08
  - Now reality is that we cannot answer every
• 21:10
  - single request or at least complete every single
• 21:13
  - request or task that's brought forward. But
• 21:15
  - when it comes to having a very solid
• 21:17
  - culture,
• 21:18
  - the ability to allow an environment and encourage
• 21:21
  - it so that your folks can bring their
• 21:23
  - concerns forward without fear, without retaliation
• 21:27
  - is super important.
• 21:28
  - And I think that Ford has done a
• 21:29
  - fantastic job with that.
• 21:31
  - I think that's also one of the reasons
• 21:33
  - why
• 21:34
  - they've had a lot of great success, both
• 21:36
  - continued,
• 21:37
  - as well as historical.
• 21:40
  - And I just wanna make sure that with
• 21:43
  - my teams
• 21:44
  - that there's always chain of command that's respected.
• 21:46
  - But if that chain of command is causing,
• 21:50
  - that information, those escalations not to move forward,
• 21:53
  - every town hall I send, every or attend,
• 21:55
  - every email I send, and make sure I
• 21:57
  - make it very clear, and I repeat that.
• 21:59
  - Please follow your chain of command. But if
• 22:01
  - you feel that your voice is not being
• 22:03
  - heard, you I am always available. I'm the
• 22:05
  - only Mike Vigo, the fourth in the system,
• 22:08
  - so it's usually,
• 22:09
  - pretty easy to find me within Outlook or,
• 22:12
  - my information is posted so that people can
• 22:14
  - get ahold of me. And that's worked out
• 22:16
  - well. Yes. It's more time that I need
• 22:18
  - to take. I can't get to all those
• 22:20
  - emails or requests as timely as I'd like,
• 22:22
  - But the folks know that if they reach
• 22:24
  - out to me, I will respond.
• 22:26
  - I will take their concern, and I will
• 22:28
  - get them an answer. It might not always
• 22:29
  - be the answer they're looking for, but it
• 22:32
  - it is an answer nonetheless than a response.
• 22:35
  - The last thing I'll say is, you know,
• 22:36
  - we work in health care. It's extremely complicated.
• 22:39
  - I'm not an expert in the auto industry,
• 22:41
  - but I believe,
• 22:42
  - when I look at an engine, but all
• 22:44
  - I can do is the oil change. I've
• 22:45
  - done a brake brake pad change here and
• 22:47
  - there and the tire rotation to, obviously, replacing
• 22:50
  - tires.
• 22:51
  - Outside of that, maybe an air filter. I'm
• 22:52
  - not your guy. The engine is extremely complicated.
• 22:55
  - The amount of electronics
• 22:57
  - that exist today in vehicles is far beyond
• 23:00
  - my knowledge. So what I what I reason
• 23:02
  - I'm mentioning that is I look at the
• 23:04
  - overall,
• 23:05
  - comparison between the auto industry and the complexities
• 23:09
  - exist there and try to bring that into
• 23:11
  - health care.
• 23:12
  - And I think that we share
• 23:13
  - in in those similarities that
• 23:16
  - the best leaders and the best results,
• 23:19
  - come from clarity,
• 23:21
  - communication,
• 23:22
  - being very accountable,
• 23:24
  - and bringing all the right team members together
• 23:26
  - so we can solve those difficult complex problems
• 23:29
  - together.
• 23:31
  - I love it. And I I think that's
• 23:32
  - such a great way to think about leadership
• 23:34
  - and thinking about, you know, the industry as
• 23:37
  - a whole, health care, and a way to
• 23:39
  - approach it. So, Mike, thank you so much
• 23:40
  - for joining us on the podcast today. This
• 23:42
  - has been a really fun conversation and inspiring
• 23:45
  - to hear about everything you're doing at UC
• 23:46
  - San Diego Health, and I look forward to
• 23:48
  - seeing you as well at our IT and
• 23:50
  - RCM conference coming up in a couple weeks.
• 23:53
  - It's gonna be a great time, and so
• 23:55
  - look forward to seeing you in person.
• 23:57
  - Sounds great, Laura. Yeah. I'm honored to be
• 23:59
  - in this role and work for UC San
• 24:00
  - Diego Health, and I'm very much looking forward
• 24:02
  - to Becker's. I'm always looking forward to it,
• 24:04
  - but this year more than others. So thank
• 24:06
  - you, Laura, and see you guys in a
• 24:08
  - couple weeks.