Latest / Becker’s Healthcare - Clinical Leadership Podcast / Ashley Toney, Director, Revenue Cycle and Chief Compliance and Privacy Officer at St. Luke’s Hospital, Atrium Health

Transcript

Ashley Toney, Director, Revenue Cycle and Chief Compliance and Privacy Officer at St. Luke’s Hospital, Atrium Health · Becker’s Healthcare - Clinical Leadership Podcast

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  Would you like to exchange best practices and ideas to improve care,
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  enhance operational efficiency,
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  and address financial challenges with your peers?
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  Becker's Healthcare is facilitating these conversations at their eighth annual
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  health IT digital health and R C M meeting.
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  You can check your eligibility for complimentary attendance at the link in the
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  description. We are excited to welcome you in October.
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  This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Ashley Tony,
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  director of Revenue cycle and Chief Compliance and privacy officer at St.
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  Luke's Hospital, part of Atrium Health. Ashley,
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  it's a pleasure to have you on the podcast today.
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  Thank you. Thank you. I appreciate you having me.
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  Now, I know we have a lot to talk about.
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  There's so much happening in healthcare and a lot of changes in transformation,
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  but before we dive into my questions,
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  can you tell me a little bit more about yourself and your background?
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  Certainly. I grew up in a small town in Western North Carolina. Well,
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  the location is approximately, I'm gonna say an hour between most major cities.
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  I was in a town where people would really get excited to have a Walmart,
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  and it's also the kind of place that you can't really see its value in full
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  until you're grown up. I couldn't wait to move away after college.
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  I was very excited about the career opportunities that I had,
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  but I quickly realized that the financial end was not lucrative enough to
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  sustain living in the urban areas that I'd hoped for.
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  So I began working at the local hospital system in the education department and
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  installing lifelines. I never intended,
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  nor did I expect that this would be a journey in healthcare.
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  This position was more than just installation logistics,
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  but recognizing that some people wanted to be heard or to have conversations,
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  find that need and fill it.
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  I learned that very quickly and have used it ever since.
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  I entered into the business office,
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  as it was more commonly referred to at the time,
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  and was surrounded by a group of seasoned teammates that helped me to learn the
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  ropes of patient financial services.
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  I was able to bring my knowledge of technology to help escalate patient
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  accounting, then patient access into modern day revenue cycle.
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  I'm really fortunate to those who recognized that I could be an asset in other
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  areas and allowed me to broaden my skillset to areas that would be
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  non-traditional for someone in revenue cycle,
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  I worked as a physician liaison who assisted with growth,
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  strategic planning and recruitment while leading marketing for the organization.
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  I'm now currently with Atrium Health,
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  now Advocate Health and back to my roots in revenue cycle with compliance and
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  privacy duties at St. Luke's Hospital.
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  Wow, that's an amazing career journey.
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  It sounds like you have had so many different experiences, um,
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  and I can imagine all of them really, uh, help you in,
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  in your current role and just really be an asset to the hospital and the health
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  system overall. Now, I know we're in a unique time in healthcare today,
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  and especially looking at, um,
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  where we're at financially for many organizations.
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  So where do you see some of the big opportunities as well as the headwinds that
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  you have your eye on?
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  Well, healthcare revenue has always faced its headwinds.
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  The current state feels particularly challenging.
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  Payers continued to make getting paid difficult and an obstacle course it was at
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  one time. If you understood how the payers lingo translated,
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  you were able to get paid maneuver, the denials, denial prevention,
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  being able to ebb and flow with the payers. Now,
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  the process feels a bit against the grain. To me,
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  the modern payer to facility relationship can feel about like whenever a child
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  asks why and their parent answers the cause,
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  it's vague and it's not straightforward.
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  The ebbing and flowing is not there anymore or really, uh, creating unrest,
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  but we are using this as an opportunity to reset our practices.
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  Then you add in lingering economical constraints to say that covid has changed.
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  The landscape is almost a given at this point.
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  Inflation coupled with volume pressures in the unstable market is eroding
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  an already slim operating margin.
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  Add to the mixed staffing labor shortages and demand for higher wages.
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  Without the volume,
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  an organization is strangulated and cannot afford to increase wages in the
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  revenue cycle.
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  You must have teammates to be able to tackle the payer issues to make any of the
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  remainder happen to be sustainable.
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  We're all base with increased patient angst and anger from the revenue cycle
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  side, and I'm not sure that this will subside.
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  Social media is not helping in this area,
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  but creating a platform that amplifies angst, anger, and misinformation,
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  we've all seen the post where people are talking about how much their bill was
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  in terms of total charges, and the full picture really is not shown.
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  They failed to mention that their patient responsibility is,
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  let's say $200 copay or they have a deductible that's met and the
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  full reimbursement piece is not reflected at all. Instead, in their minds,
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  healthcare facilities are ripping patients off.
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  Other users see this and they get angered all over again for some that even
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  drives their healthcare decisions off this misinformation,
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  and they vow to not use the hospital again,
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  if at all possible from a customer service perspective.
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  By the PA time a patient calls, they're fired up.
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  Now I'm very passionate about making sure our patients and families are taken
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  care of, so please don't misunderstand that. However,
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  when customer service hears these patients beyond angry,
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  every single workday,
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  it is taxing and teammates question their career decisions. So yes,
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  we have headwinds, but that is also an opportunity. What might not have worked,
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  what might have worked at one point might not today,
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  but let's mourn that change and move on to trying what might work now.
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  Try these things look creative, and most importantly of all,
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  figure out how to pivot quickly.
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  That's such a great point.
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  I know Pivot quickly has been really the name of the game for the past couple
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  years. I in mm-hmm.
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  responding to a lot of what's happened in the healthcare
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  landscape. So, um, really just, I love your analysis here in,
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  in looking at some of the headwinds, um,
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  for the organization and for revenue cycle in particular. You know,
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  those aren't things going away and, and so I love the idea of being able to, um,
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  figure out creative ways to solve the challenges as they come in and, and,
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  and be able to move quickly. Uh, from your perspective,
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  how are you thinking about growth and development as well as adding value to the
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  organization? What does that look like for you and the teams that you work with?
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  I think we're gonna have to be on offense and defense.
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  This is not an worse situation anymore.
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  How can we tackle our issues with while growing our facilities?
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  How do you grow the volume? I realize that this is an old question,
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  but slice and dice it differently to view it at a different angle.
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  Customize your plan for your facility and your community.
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  Make sure there's the parts of your strategic plan that can be shared are so
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  that teammates can keep this in mind and to know where to focus their efforts at
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  a focus group on growth with the key players involved and held accountable to
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  analyze data, to think about and solve solutions together.
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  Although I realize that this can be labor intensive.
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  There is tremendous value here. Are your resources,
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  vendors and systems working for you? If not,
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  how do you maximize this focus on provider onboarding to make sure that the
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  process is as seamless as it can be?
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  The last thing you want is for a provider to have a sour taste before they ever
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  start practicing at your facility.
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  Your providers can be your ambassador and you have a part in this.
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  There's so many fires to put out at this point,
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  and that certainly dominates time and resources,
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  but I would challenge you to intentionally look beyond the fire and look at
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  those things that are not on fire.
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  While part of a firefighter's job is to put out fires,
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  a significant portion of their job is to assess the whole situation. Overall.
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  I'm not looking to graze the top only for low hanging fruit,
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  but to make sure we dig deep, to continue to strengthen our core,
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  maximize our resources and work toward correcting our issues to help maximize
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  the operating margin to be able to serve our community now and in the future.
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  Wow, that, that's really great insight.
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  I love that analogy of the firefighter and putting out the fires, but just,
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  you know, really assessing the whole situations and looking beyond, um,
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  the what's in front of you. I think that's so important,
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  especially tying back to, as you were talking about, being creative,
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  being able to pivot and, and really leaning into that innovation mindset.
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  I, I know that, um, from, you know,
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  many hospitals and health systems are facing challenges,
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  whether it's staffing shortages or some of the financial issues that we've been
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  talking through in other, um, headwinds,
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  but still important to be thinking about how do we continue to invest, um,
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  and wanna be successful in the future. So for those who have limited resources,
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  what do you think is one investment or risk that's still worth making this year.
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  To identify? How can we stand out and then to take the action?
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  All the things that we've been doing all on quality, patient care services,
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  et cetera, they're all important,
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  but at some point they become a bit of a baseline when we're making healthcare
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  decisions. So think about it like this. When you go to the restaurant for, for,
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  for the first time, you expect a good sanitation score, a visa atmosphere,
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  and nice people at the least. But what makes you come back, I guess,
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  would be that you would not pick the restaurant again,
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  only because it had a good sanitation score,
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  a decent atmosphere and nice people.
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  You would go because of something that stood out for healthcare.
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  Maybe focus on differentiating or adding a service line.
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  Maybe it is a program to increase patient's knowledge of healthcare,
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  their insurance, and how everything ties.
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  And if you can tackle an issue you have and stand out,
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  then even better patients and families won't feel special.
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  How can you con how can you do this while continuing to provide the excellent
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  care you already do? Incorporate your community and be intentional.
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  That makes a lot of sense. You know,
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  and it is really helpful to understand and have that mindset going into any kind
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  of new project or, um,
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  initiative that you're doing in really knowing that it'll make sense, um,
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  for the overall organization and improve that experience and improve, um, the,
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  the experience for both patients as well as the staff and team members.
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  Now, before we wrap up our conversation, I wanted to ask you one more question.
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  Where do you see some of the best opportunities for growth in the future for
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  yourself, um, as well as the teams that you work with closely?
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  I'm gonna have to go back to standing out.
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  In the past I've spoken with Becker's about personalized healthcare and I do
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  still feel like that's a big opportunity.
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  Don't forget about the resources you have.
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  Sometimes I think it's easy to automatically shift to try to go big,
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  but be cautious to make sure that you keep your base sturdy,
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  continually analyze trends within your organization and your community.
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  Recognize your demographics.
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  Do not forget the value of positive personal interaction.
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  Why do the large referrals source drop off? Go talk to them.
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  Thank the people for what they do and mean it. Write handwritten notes.
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  I know a lot of times it said, well, maybe you're at a small facility,
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  maybe you have more time at this point.
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  Nobody really has more time than another. It's just a different fire.
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  Don't let the size of your organization stop you.
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  Your plan for positive personal interaction might look different,
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  but there is still an opportunity and potentially more resources.
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  There are opportunities in the little things and sometimes those things are what
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  can make all the difference.
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  Fantastic. Well, Ashley, thank you so much for joining us on the podcast today.
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  This has been a really fun discussion and I look forward to connecting with you
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  more in the FU future.
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  And I'm excited as well to meet you in person at our Health IT Digital Health
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  and Revenue Cycle event, um, in October. I know it'll be a lot of fun, um,
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  a lot of these big topics being discussed and really a,
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  a space where we'll be able to connect and network and, um,
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  grow and learn from each other. So I'm looking forward to that.
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  Yes, I'm looking forward to it as well. Thank you so much for having me.
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