Latest / Becker’s Healthcare Podcast / Austin Willuweit on Rural Health Finance, Growth and AI

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Austin Willuweit on Rural Health Finance, Growth and AI · Becker’s Healthcare Podcast

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  - The strategic agenda facing hospital and health system
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  - leaders right now is not a short list.
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  - Growth in a consolidating market, sustainable margins in
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  - So join us November second through the fifth
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  - at the Hyatt Regency in Chicago,
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  - Register on our events page at beckershospitalreview.com
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  - This is Madeline with the Becker CFO and
• 1:00
  - revenue cycle podcast, and I'm so excited to
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  - be joined by Austin Willowwhite,
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  - CFO of Monument Health. Austin, thanks for being
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  - on with me. Yeah. Thanks for the invite
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  - to the podcast. Excited for our discussion today.
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  - Well, me too. But before we begin, do
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  - you mind sharing with our listeners just a
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  - little bit about your role at Monument Health
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  - and more on your background in health care?
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  - Sure. Yeah. Currently serve as CFO for Monument
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  - Health.
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  - Started with the system about ten years ago
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  - in a vice president of finance role.
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  - Prior to that worked, in healthcare, in the
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  - finance roles, as well as public accounting. So,
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  - it's been a great ten years. Looking forward
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  - to continuing to grow and develop with the
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  - system.
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  - Alright. That's incredible. I appreciate you sharing.
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  - So, obviously, you know, in your time throughout
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  - health care, we've continued to see trends
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  - constantly changing. There's so much going on. But
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  - what would you say is one thing that
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  - you're keeping a real close eye on right
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  - now from the CFO seat, and why is
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  - this trend right now so important to you?
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  - Sure. In our local market, we're really paying
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  - attention to demographics.
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  - Our system is located in Western South Dakota,
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  - very heavily tourist area, Mount Rushmore, the Sturgis
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  - Spike rally,
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  - all of those fun things. But what that
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  - does is it brings a lot of folks
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  - through our communities,
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  - that see,
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  - the communities and get excited and want to
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  - move here. That's a great problem to have,
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  - really good growth.
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  - But sometimes those folks are retirees.
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  - Sometimes they are folks that aren't bringing,
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  - labor force with them in the healthcare space
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  - because they work from home and some other
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  - things. So we've continued to see our governmental
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  - payer mix, rise and rise.
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  - We're more than 50% and not well on
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  - our way to 60%,
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  - with the Medicare program.
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  - So we pay attention to those shifts. We're
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  - looking at ways, to consistently update our service
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  - offerings as well as manage our reimbursement to
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  - handle that kind of long term payer shift.
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  - Yeah. So it sounds like you're quite busy.
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  - We are. We are. Yes. For sure. What
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  - would you say, you know, we're right now
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  - seeing and I personally myself have covered rural
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  - and regional health systems. They're continuing to face
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  - margin pressure.
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  - What would you say are some financial levers
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  - that you're more focused on that that maybe
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  - you weren't even prioritizing a couple years ago?
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  - Sure. Post pandemic, we really focused on growth.
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  - We've been incredibly successful in growing,
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  - both our organization, recruiting physicians,
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  - just really continuing to add services that were
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  - previously not offered in the community.
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  - Well, that strategy will
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  - probably always be there and will continue to
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  - be. We're kind of turning our attention a
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  - little bit more now to the expense side,
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  - really focusing in on per unit type cost
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  - metrics.
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  - We try to learn where we have partnerships.
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  - We have a we recently entered into a
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  - partnership with a national dialysis,
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  - operator, which anybody who's in dialysis knows that
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  - margins are incredibly thin, and they're just relentless
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  - pursuit of reducing cost at the unit level
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  - is is really something that we've latched onto
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  - and we're working toward.
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  - We've always had good benchmarking data and things
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  - like that, but we didn't necessarily use per
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  - unit costs as as a basis and a
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  - reason to make changes.
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  - We're now adopting that approach and just continuing
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  - to push.
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  - You know, we're also making sure that we're
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  - setting a high bar for capital allocation.
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  - In the past, you know, if you had
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  - a project that that looked good, checked several
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  - of the boxes, maybe provided a return just
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  - a little bit in excess of what we
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  - could get off of our investment portfolio, you
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  - were you were good to go. But as
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  - margins tighten up, in the rural health care
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  - space, we just are directing our attention towards
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  - setting that bar higher, making sure the the
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  - right projects, making sure that the ROI is
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  - there,
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  - and that it makes sense to pursue.
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  - Yeah. And you touched on growth. You know,
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  - obviously, that is something that's super important to
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  - a lot of systems. Systems wanna be growing,
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  - but getting factors get into the way right
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  - now, certain challenges. But, however, you guys in
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  - early May just,
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  - acquired rapid Rapid City Medical Center in South
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  - Dakota. So could you share a little bit
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  - about how that integration process has been going
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  - and what's that look like from the finance
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  - side?
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  - Yeah. Absolutely. We've been long term partners, with,
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  - the Rapid City Medical Center physicians and we're
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  - excited when they were were interested in joining
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  - the system.
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  - From the core finance side, they had a
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  - really strong team. They had good processes in
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  - place, which make life a lot easier.
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  - No turf wars or anything like that.
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  - The one things they probably did not have
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  - is maybe as strong of as an of
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  - an ERP system.
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  - We're on a pretty robust ERP, so we're
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  - able to bring them over, you know, in
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  - practice that really looked like just cutting over
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  - one day. We stopped entering data
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  - bills and things like that into their previous
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  - their legacy system, and we then began bringing
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  - them onto our platform. Now having said that,
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  - that's the finance side. The revenue cycle side
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  - is is always more challenging.
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  - We're an epic shop, which, helps,
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  - in several instances, including reducing resistance. Most folks
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  - would prefer to be on epic given the
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  - choice, but that that's not that common in
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  - private practice.
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  - So after
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  - the the merger, we really had to focus,
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  - build a plan, to bring them over onto
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  - Epic. They are still on their current legacy
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  - system, so their teams are are working both
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  - sides of the fence right now. They're actively,
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  - billing and then posting payments and doing all
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  - of the revenue cycle activities in the legacy
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  - system while they're working, to help us build,
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  - an Epic module and systems that look that
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  - work well for them.
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  - You know, if we look back at lessons
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  - learned, I think we we did a great
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  - job of,
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  - building integration teams, including detailed teams both for
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  - finance and the revenue cycle, and that that
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  - just served us incredibly well. It it brought
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  - the teams together, one, to build the relationships
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  - before it was time to do the work.
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  - And now those teams continue, and I'm I'm
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  - not sure. We may we may not discontinue
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  - them at all. We may just continue those
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  - into perpetuity,
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  - to keep working on all the activities that
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  - we wanted to, but merger,
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  - really, really went well. That's incredible to hear.
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  - Do you have any further plans in Monument
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  - Health as you look, you know, towards even
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  - next year for for further acquisitions or growth?
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  - We're always paying attention.
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  - We're we're a system that has historically grown
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  - organically, so that's kind of our highest priority,
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  - but we're certainly always open to options.
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  - And then I suppose final question for you
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  - here,
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  - where do you see, you know, obviously AI
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  - is such a hot topic. When I talk
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  - to CFOs,
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  - they're constantly saying, you know, they're keeping a
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  - close eye on AI,
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  - you know, investing in technologies,
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  - just trying to be smart in that area
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  - as well. But where do you see it
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  - making a real near term difference in health
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  - care finance and the revenue cycle, of course?
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  - Could you share maybe where you think the
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  - hype might still be outpacing this reality?
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  - Sure. Sure. We've adopted several AI related projects.
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  - We're we're not cutting edge. We're probably somewhere
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  - in the middle seeking established technology.
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  - You know, if we look back a few
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  - years, even some basic things,
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  - that we've adopted,
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  - robotic process
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  - organization,
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  - where we've
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  - taken payer portals, the numerous payer portals that
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  - all of our teams have to log into
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  - upload data or pull down data. We're able
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  - to automate that saving several 100 hours. So
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  - that's just one basic level. You know, other
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  - successes we've had really in the ambulance listening
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  - side for our physicians,
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  - that has helped tremendously both from a documentation,
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  - but also a workload perspective. Maybe the ROI
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  - is not as high on that as originally
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  - promised, but the reduction
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  - and stress, for our providers has just been
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  - tremendous.
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  - We've also adopted,
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  - some documentation,
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  - AI tools,
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  - particularly in the inpatient side with our hospitalists
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  - that have paid big dividends. I think for
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  - that, we actually probably did hit a a
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  - two to three to one, ROI. So we're
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  - incredibly excited about how those have gone.
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  - We're also looking at rolling out, some autonomous
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  - coding,
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  - very short order. We're really excited about that.
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  - We know coders are hard to come by,
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  - and we wanna make sure we're coding all
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  - claims accurately for a variety of reasons, not
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  - the least of which is long term financial
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  - stability. So we're excited for that as well
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  - as rolling out our clinical documentation improvement areas,
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  - some tools to enhance their work. You know,
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  - we certainly would like to continue to build
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  - out, that
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  - program,
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  - but it's you it leverages,
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  - RNs to do the work in many cases.
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  - And so we wanna be respectful and make
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  - sure we're using their their efforts to the
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  - top of their license and skill sets. So
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  - we'll be rolling that out in short order.
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  - And, you know, I think early indications are
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  - that those are going well, and we are
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  - excited to reap the rewards over the next
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  - year. Yeah. No. It's incredible to hear all
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  - the success, you know, with with these AI
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  - tools, and so I appreciate you diving a
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  - little bit deeper there.
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  - When you think about Monument Health, even in
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  - the next three to five years, what's that
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  - look like to you? What what does success
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  - mean to you right now, and how do
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  - you plan to get there?
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  - Sure. I mean, success for us is managing,
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  - payer mix that is challenging, continuing to provide
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  - rural health care. You know, we are excited
• 9:34
  - about the rural health transformation funds. We we've
• 9:36
  - got several projects and awards that are already
• 9:38
  - approved that we think will help drive the
• 9:40
  - health care system
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  - a lot in the digital space, but drive
• 9:43
  - us forward over the next couple of years.
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  - So we think we're through those funds and
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  - also just the initial investments we're gonna make
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  - in several other areas are are exciting and
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  - and will lead us forward.
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  - Well, I cannot wait to, you know, continue
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  - following Monument Health's path and listening to all
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  - the incredible things you had to say today.
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  - I'm I'm very excited for you guys, and
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  - I, look forward to connecting again sometime soon
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  - to to chat about all your successes. So
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  - thank you for being on, Austin.
• 10:08
  - Yeah. Thank you. Appreciate the time today.