Latest / Becker’s Healthcare Podcast / Strengthening Revenue Cycle Strategy and Patient Financial Experience with Karen Brown

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Strengthening Revenue Cycle Strategy and Patient Financial Experience with Karen Brown · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
• 0:08
  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
• 0:14
  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
• 0:39
  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - This is Laura Dierdahl with the Becker's Healthcare
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  - podcast.
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  - I'm thrilled today to be joined by Karen
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  - Brown, revenue cycle director of Heart of the
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  - Rockies Regional Medical Center. Karen, it's a pleasure
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  - to have you on the podcast today. Thank
• 1:01
  - you. It's a pleasure to be here. Now
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  - I'm looking forward to our conversation. I know
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  - we're gonna talk a little bit about, some
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  - of the cool things you're doing at Heart
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  - of the Rockies as well as how you're
• 1:10
  - thinking about the future. But before we dive
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  - in, can you tell us a little bit
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  - more about yourself and your background?
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  - Yes, ma'am. So I grew up in the
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  - inner city of Chicago, Illinois.
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  - Left there and went to college at IU
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  - Bloomington.
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  - So go Hoosiers. You know, we did big
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  - things this year
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  - in football, college football.
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  - Stayed there for twenty years,
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  - worked under I did an internship,
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  - under,
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  - the CFO
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  - of Bloomington Hospital. His name was Jim Myers.
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  - Didn't think I necessarily want to be into
• 1:43
  - health care. I want to get a CPA,
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  - but, you know, he said, I don't see
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  - that in you. I said, okay.
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  - So,
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  - left there, stayed in Bloomington twenty years, left
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  - Bloomington, moved to North Dakota, was in North
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  - Dakota for twelve years where I worked at
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  - Trinity Health, and I also worked at Montreux
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  - County Medical Center.
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  - As of January
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  - of this year,
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  - I
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  - moved to Colorado
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  - and began my position as director of revenue
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  - at Heart of the Rockies Regional Medical Center.
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  - That's great to hear. And, you know, what
• 2:16
  - a journey that you've had and in good
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  - that you listened to the intuition to be
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  - in health care and be in the space
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  - because it's such an important industry and one
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  - that's so human driven and community driven too.
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  - So, fascinating to hear.
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  - And I guess to start us off, could
• 2:30
  - you give us a quick state of the
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  - union of Heart of Iraq's Regional Medical Center?
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  - What's gone well this year, and what are
• 2:36
  - you focused on for the rest of 2026?
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  - Well yeah. Well, like I mentioned earlier, I
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  - had just started my career at Heart of
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  - the Rockies Regional Medical Center in January.
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  - So the first part of this year has
• 2:46
  - been focused on learning.
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  - I've been trying to get to know the
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  - organization,
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  - our policies, procedures, Colorado Medicaid, and other state
• 2:54
  - specific regulations,
• 2:56
  - and most importantly, just the culture here at
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  - HRMC.
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  - At the same time, we they had decided
• 3:02
  - to implement EPIC.
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  - So a lot of my time has been
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  - invested,
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  - on trying to get the EPIC build out,
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  - collaborations across all of the departments, and I'm
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  - I'm actually really proud of how the team
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  - has remained engaged while continuing to meet the
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  - daily needs of our patients. So it's been
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  - pretty
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  - pretty
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  - tough six, six, seven months, but it's been
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  - amazing. So
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  - Absolutely. Well, you know, it's a great always
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  - to be in a a new place and,
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  - to see what's going well and then where
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  - you wanna be headed in this future. And
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  - and I know that's what we'll talk about
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  - a bit right now, you know, in in
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  - thinking about the future, obviously.
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  - We wanna talk about opportunities as well as
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  - some of the headwinds you have your eyes
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  - on. And let's start with some of the
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  - headwinds.
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  - What are you thinking about and and, keeping
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  - your eye on as you're looking into the
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  - future and and trying to plan around,
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  - some of these headwinds here?
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  - Yeah. Well, first of all, Colorado is implementing
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  - major regulatory and eligibility changes,
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  - as a result of new federal legislation. So
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  - beginning October 26,
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  - they're just getting new stricter immigrant laws,
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  - followed by a new work requirements and six
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  - months eligibility
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  - with our Medicaid population starting in January. So
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  - just trying to understand those things. Every state
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  - has their own Medicaid regulation. I'm sure you
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  - know. So when you move from state to
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  - state, it's definitely a challenge,
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  - because these changes are gonna likely increase the
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  - coverage,
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  - desperations, and create more uninsured and underinsured
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  - patients.
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  - And it's gonna require additional financial counseling, insurance
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  - verification, and charity care discussions.
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  - At the same time, also preparing for the,
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  - Medicare support programs in the rural hospitals that
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  - will start in January
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  - 2027.
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  - The loss of some supplemental payments will increase
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  - the important optimization of our revenue
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  - as we have a huge retirement community here
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  - in some light of workforce
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  - community, so to speak. So I just wanna
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  - improve our upfront collections, ensuring accurate registration, and
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  - reducing avoid avoidable denials.
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  - And, really, my focus is on going to
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  - be making sure our team is educated, our
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  - workflows are efficient,
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  - and we are proactive in helping our patients
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  - navigate these changes while protecting their financial health
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  - at HRMC.
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  - That makes a lot of sense. And I
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  - think what you're describing is something that so
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  - many hospitals across the country are preparing for.
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  - Like you said, it sounds like Colorado is
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  - being a bit proactive here, but most states
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  - will have
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  - a similar change coming up, January 1, if
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  - not before. So,
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  - you know, looking at ways that you are
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  - not only trying to connect with the,
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  - Medicare beneficiary population and and make sure everyone
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  - knows what they need to do. But at
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  - the flip side, looking at the potential increase
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  - in,
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  - charity care and,
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  - uncompensated care that could be coming through the
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  - doors, I appreciate you talking through some of
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  - the upfront collections and continuing to reduce
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  - unavoidable denials. Are there other areas where you're
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  - trying to look at,
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  - bringing in additional revenue or anything else that
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  - would be helpful as you're trying to think
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  - through how the overall,
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  - financial stability of the organization
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  - will shift,
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  - with these changes.
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  - Yes. So
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  - the Colorado has a HDC program,
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  - which is basically
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  - it's a a health disc it's a hospital
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  - discount care. And this program is not funded
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  - by any like, we will give away this
• 6:31
  - free care, but we don't recoup any of
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  - this money.
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  - So we just give away care. But we
• 6:36
  - do that so that our patients could have
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  - what they need. Fortunately,
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  - here at HRMC,
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  - we have
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  - six clinics,
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  - throughout,
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  - this part of Colorado where we are able
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  - to provide services for our patients as far
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  - as rehab, cardio,
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  - oncology,
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  - urology,
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  - and we do do,
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  - surgery. So we're kind of a bigger rural
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  - health hospital.
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  - So we're just trying to make sure that
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  - we could remain financially
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  - stable,
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  - at the same time provide the best care
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  - for our patients. So it's just it's a
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  - whirlwind right now in a revenue cycle world
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  - for critical access hospitals.
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  - Absolutely. I think that makes a ton of
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  - sense. And, you know, thinking through all those
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  - different layers that you gotta, think about in
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  - in, programs and possibilities.
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  - I can imagine it takes a lot of,
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  - planning and foresight, but it seems like you've
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  - got a
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  - a great team in place that is doing
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  - that. Now I wanted to get your sense
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  - too of some of the opportunities.
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  - Where do you see spaces you can grow
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  - in the next two to three years or
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  - so?
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  - Oh my goodness.
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  - First of all, I want to strengthen the
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  - partnership with our local local organizations, employers, and
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  - community groups,
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  - to increase awareness and improve access to care,
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  - to help our patients understand their financial options
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  - before they receive services.
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  - Building trust within a community is very important
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  - to me.
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  - But, also, I wanna be able to support
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  - MC's mission of providing high quality and accessible
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  - health care.
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  - Internally,
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  - I know those, I would say,
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  - I also want to continue to build a
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  - collaborative
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  - relationship
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  - across all of our departments where we can
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  - work together to remove any barriers for our
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  - patients and create a more seamless
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  - experience
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  - when registering and from registration all the way
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  - through billing.
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  - So I just think that piece is important.
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  - Absolutely. And, you know, when you, are are
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  - talking about building that relationship,
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  - across departments and and thinking through the patient
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  - experience,
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  - I I know that's going through a lot
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  - of change right now. There's technologies new every
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  - single day that are focused on it and,
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  - different projects and initiatives. And so when you
• 8:49
  - think about how that patient experience is changing,
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  - could you talk a little bit more about
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  - what that looks like and how you're discovering,
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  - what patients want and what's possible in terms
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  - of streamlining things and improving how they enter
• 9:02
  - the health care system and what their journey
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  - looks like. Yeah. Well, currently, right now, we
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  - use some very archaic systems as far as
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  - registration goes.
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  - So when they come in, it's always like,
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  - let me ask. You know, we're always feel
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  - like we're repeating the same questions, but you
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  - do that, right, when you're when you're seeing
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  - people repeatedly in critical access areas.
• 9:24
  - So the whole goal right now is just
• 9:26
  - to bring the patients in, let them feel
• 9:28
  - welcomed.
• 9:29
  - Once they're here, just get them to understand
• 9:32
  - their insurance.
• 9:33
  - And that's the big I think that's the
• 9:35
  - biggest key. They come in. They have some
• 9:37
  - of these
• 9:38
  - Medicare Advantage Plans because I said we have
• 9:41
  - a lot of Medicare population with retirement.
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  - So a lot of people come they've come
• 9:46
  - from other places, and they have these Medicare
• 9:48
  - Advantage Plans that we are not networked with.
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  - So then they don't understand why we can't
• 9:53
  - see them, why their bill's so high, and
• 9:55
  - and they just don't understand.
• 9:58
  - They get really good health care, but then
• 9:59
  - when it comes to the billing, our billing
• 10:01
  - system is Arcadic.
• 10:03
  - We're doing a lot of things manually, which
• 10:05
  - is why we implemented Epic.
• 10:07
  - And then just trying to get them to
• 10:09
  - understand what we can provide for them as
• 10:11
  - far as getting them through their financial woes
• 10:13
  - and not basically going bankrupt with health care.
• 10:16
  - Just letting them know that we are here
• 10:17
  - to provide the most amazing care. And, also,
• 10:20
  - we want you to understand your insurance and
• 10:23
  - what you can and can't do. And we
• 10:25
  - do that a lot with, upfront collections.
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  - We also have a really
• 10:30
  - robust self pay,
• 10:32
  - plan that we can do. So, yeah, we
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  - we're just really trying to
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  - just be there for our patients,
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  - not only by providing good
• 10:42
  - physician care, but also being able to just
• 10:45
  - close the loop from registration all the way
• 10:47
  - through billing and collections.
• 10:50
  - That I I really appreciate how much you
• 10:53
  - take into consideration the patients, their current situation,
• 10:56
  - what it takes to provide that type of,
• 10:59
  - amazing,
• 11:00
  - high quality care, and then,
• 11:02
  - dovetailing that type of,
• 11:04
  - energy into
• 11:06
  - the pay process as well and and, making
• 11:09
  - it all come together. So, I I think
• 11:11
  - that is really cool and great
• 11:13
  - great thoughts and insights,
• 11:15
  - when you're thinking about, you know, as many
• 11:17
  - health systems are, how do I make sure
• 11:19
  - that patient experience, especially with a point that
• 11:22
  - could be a friction point in some ways,
• 11:24
  - when you're looking at payment,
• 11:25
  - really is easy and seamless and something that,
• 11:29
  - can come more as a natural,
• 11:32
  - experience for them like they do in other
• 11:33
  - types of transactions in their lives. Yeah. And
• 11:36
  - to piggyback off that, the other thing I
• 11:38
  - think too is that I've really worked with
• 11:40
  - the physicians, the providers,
• 11:42
  - our hospitalists,
• 11:44
  - our CEO, CFO,
• 11:46
  - to just get people to understand. I don't
• 11:48
  - think people really understand the revenue side of
• 11:50
  - it, and it stems from, you know, getting
• 11:53
  - your notes signed, getting
• 11:54
  - done. You know, it all stems to bringing
• 11:57
  - in revenue for the hospital.
• 11:59
  - So, a little joke that we have here
• 12:02
  - since I've started is they do they do
• 12:05
  - all the care, and I handle the money
• 12:07
  - to make sure they get paid.
• 12:09
  - So that way, we're piggybacking off of each
• 12:11
  - other to make sure everything. We just closed
• 12:14
  - the loop. They understand how important it is
• 12:16
  - to make sure documentation is done and dictation
• 12:19
  - is done and just,
• 12:21
  - getting notes and stuff signed so they see
• 12:23
  - how that affects. If that doesn't happen, then
• 12:25
  - we can't bring in revenue.
• 12:27
  - And that revenue is so important. It powers
• 12:30
  - everything else that's going on in the health
• 12:32
  - system. And and so, I can imagine that's
• 12:34
  - a real, real, helpful to have those types
• 12:37
  - of conversations.
• 12:38
  - Now before we wrap up here, I wanted
• 12:40
  - to ask about leadership too. Who is the
• 12:42
  - leader that you admire really from any industry
• 12:45
  - and why?
• 12:47
  - Great question.
• 12:49
  - Kind of loaded one.
• 12:51
  - To me, great leadership is built on integrity,
• 12:54
  - accountability,
• 12:56
  - humility,
• 12:56
  - communication,
• 12:57
  - empathy,
• 12:58
  - and the ability to just make difficult decisions
• 13:01
  - while treating people with respect.
• 13:04
  - I admire so many leaders. So I try
• 13:06
  - to take the good and the bad from
• 13:08
  - the leaders because, you know, we all work
• 13:09
  - with different leaders throughout our lifetime. So I
• 13:12
  - just look at all leaders, and I sit
• 13:15
  - back and I watch what worked for them
• 13:16
  - and what didn't work for them. And then
• 13:18
  - I try to implement it my way, not
• 13:20
  - mimic their way, but do it my way
• 13:23
  - and just bring everybody together.
• 13:26
  - My goal is just to continue to develop
• 13:28
  - my own leadership qualities
• 13:30
  - by learning from the people around me, seeking
• 13:32
  - their feedback,
• 13:34
  - and just growing into the kind of leader
• 13:36
  - who inspires, trust, encourages growth, and creates a
• 13:39
  - positive culture
• 13:41
  - for the people that work with me,
• 13:43
  - and just let them know that they're valued
• 13:45
  - and that they are supported. So
• 13:48
  - it's a lot of people that built into
• 13:50
  - me.
• 13:52
  - Absolutely. That's, you know, such a a great
• 13:54
  - way to look at it and and seeing
• 13:56
  - that how,
• 13:57
  - when you grow in into your current role
• 14:00
  - that people have poured in and, made a
• 14:02
  - difference for you, being able to do that
• 14:03
  - then for others,
• 14:05
  - is so gratifying
• 14:06
  - and and so important too in building out
• 14:08
  - the talent pipeline for the next generation.
• 14:11
  - Well, thank you, Karen, so much for joining
• 14:12
  - us on the podcast today. This has been
• 14:14
  - such a a great conversation. I feel like
• 14:16
  - you had so much to share, that it
• 14:18
  - was really,
• 14:20
  - eye opening and insightful for our audience. And
• 14:22
  - then I I look forward to,
• 14:24
  - seeing you again too. I know you'll be
• 14:27
  - speaking with us at our Office IT RCM
• 14:29
  - conference coming up in September, and so we'll
• 14:31
  - be able to dig into some of these
• 14:32
  - themes more. And it'll be great to see
• 14:34
  - you in person.
• 14:35
  - Yes, ma'am. Thank you so much.