Latest / Becker’s Healthcare - Clinical Leadership Podcast / Christopher Ault, Chief Revenue Officer at Cooper University Hospital

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Christopher Ault, Chief Revenue Officer at Cooper University Hospital · Becker’s Healthcare - Clinical Leadership Podcast

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  Becker's Healthcare is facilitating these conversations at their eighth annual
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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 Christopher Alt Chief Revenue Officer at
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  Cooper University Hospital. Christopher,
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  it's a pleasure to have you on the podcast today.
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  Yeah, thanks for having me, Laura. Happy to be here.
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  Fantastic. Well, I know we have a lot to talk about today.
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  There's so much happening in healthcare and really a lot changing.
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  I know we spoke a bit last fall and, and even since then a lot has happened.
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  So I'm looking forward to our conversation and your expertise here.
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  But before we dive into the broader discussion,
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  can you tell us a little bit more about yourself and your background?
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  Sure. I currently work at Cooper University Healthcare, Camden, New Jersey.
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  I serve as our Chief revenue officer overseeing all of the revenue related
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  functions for the health system. Uh, Cooper's a level one trauma center,
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  academic medical center. Uh, we've got over a hundred outpatient locations,
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  urgent care, um, all the subspecialties you can think of, um,
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  and, and, uh,
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  one main hospital here in the city of Camden with about 650 beds.
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  I've been here since 2018 and, uh,
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  we've seen tremendous growth over those last five or six years. Uh,
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  when I got here, the health system was about 1,000,000,002 in, in net revenue,
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  and this year we will hopefully exceed 2 billion. So, um,
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  it's been a very fun experience, uh,
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  having been at Cooper thus far and looking forward to what's to come.
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  That's an amazing growth over the last few years,
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  and especially on the revenue side. And,
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  and during a time when it's been challenging for a lot of organizations, um,
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  you know, through the pandemic to really, um, stay successful.
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  When you look at your strategy, um, for growth and development,
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  what are some of the the things that you think have, have been really key, uh,
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  for you to have been successful over the last few years?
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  Yeah, it's, it, it, we have been very fortunate. Um, you know, a large,
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  large portion of our revenue growth is related to growth in number of providers,
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  right? And so we have done a lot of investment in expanding our,
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  our clinical footprint in South Jersey, um, and,
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  and doing all that we can to serve the communities, um,
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  that we're fortunate enough to serve and keep business in New Jersey. Uh, we,
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  you know, we, we saw maybe a decade ago,
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  a lot of out migration from New Jersey into Philadelphia for, uh,
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  specialized care. And we've made a lot of investments to, uh,
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  provide that care here right at, in the patient's backyard. And so, um,
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  you know, the other thing that supported our growth has been, uh, enhanced, uh,
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  managed care rates and, and revenue cycle processes. Um,
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  to answer your question about how we have experienced such growth,
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  while, you know, the industry faces a lot of headwinds. I mean, we,
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  we haven't been immune to the headwinds right, over the last couple of years,
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  particularly with the pandemic and coming outta the pandemic. You know, we,
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  you and I talked last time a lot about payer behavior and the challenges around
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  increased audits and retrospective reviews of medical necessity,
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  things like that. We've not been immune to those things. Um, but we were,
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  you know, call it luck or, or, um, you know, good strategy.
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  But pre pandemic,
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  we invested a lot of time and resources and people
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  into establishing, um,
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  a centralized training and education function that supports all the growth we've
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  had. So, um,
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  we have one team here at Cooper that is responsible for and is the source of
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  truth for all things revenue cycle throughout the enterprise, uh, which has,
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  it's, it's been a great foundation for us to scale growth on top of. Um,
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  and as we've grown in terms of number of providers and locations and,
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  and all those sorts of things, we've got this,
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  this underlying chassis of training and
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  education that,
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  that has allowed us to not experience a lot of headaches, uh,
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  that we may have otherwise had to go through. So, um,
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  I credit a lot of it to that.
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  Absolutely. That makes a lot of sense. You know,
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  and it was really great to hear you have that type of foresight down there and,
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  and could really fortify, uh, the revenue cycle and,
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  and whatever possible, I guess, um, ahead of the pandemic,
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  although obviously it's hard to predict that, but really, you know,
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  just being able to be in a solid place, um, and have a great strategy, uh,
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  as the foundation going forward. Now,
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  what are some of the opportunities as well as the headwinds that you have your
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  eye on right now?
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  I know you mentioned already kind of some of the regulatory challenges and the
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  different policies coming from payers, um, that,
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  that can keep you up at night. Um, you know,
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  what's the landscape escapee like now?
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  Do you see any changes in one direction or another?
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  So in terms of the payer behavior and regulatory sort of climate, um,
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  it's not changed much. And I think, you know, more than anything we're,
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  we're trying to figure out how we,
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  how we batten down the hatches and how we prepare for that for the next five or
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  10 years. Um, I don't anticipate that, um,
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  legislation at the state or federal level is gonna sway necessarily in the
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  provider's favor. If you, if you, if you read, um,
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  a lot of what's going on in the press, um,
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  there's a lot of focus on cost and price transparency and a lot of, um,
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  you know,
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  a lot of pressure on hospitals to justify the small margins that we already
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  make. So, um, we're really focused on how do we,
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  how do we support growth of the organization without continuing to
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  add necessarily the, the one-to-one, uh, f t e count,
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  and how do we get smart with labor?
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  How do we attract people to come work at Cooper, and then once they're here,
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  how do we keep them here? Um, you know,
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  healthcare and more specifically,
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  revenue cycle within healthcare is not a field that most people dream of going
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  into. I mean, I think talk to anybody, um, who's been in it a long time,
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  they fell into it, right? For one reason or another. And so, you know,
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  we have really been talking a lot about career laddering,
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  professional development. How do we invest in,
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  once we can attract the right talent here,
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  how do we invest in them to keep them here, um, keep them engaged,
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  keep them growing, um, to develop the next generation of leaders because,
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  um, it's just, it's a really difficult industry to recruit into.
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  And, uh, particularly when you, when you think about, you know,
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  remote work and flexibility of, of work arrangements and things like that, um,
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  healthcare has always sort of lagged behind, um, you know,
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  over the, with the pandemic and,
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  and the unfortunate onset of all that that brought with it, uh,
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  that changed. And some of that was for the good. I think candidly,
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  as an industry, we probably move too quickly in one direction, but we had to,
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  um, and now I think if, you know, depending on who you talk to,
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  I think everyone's trying to figure out where's the middle, right? How do we,
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  like, where does this ultimately settle in terms of working from home and,
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  you know, productivity management and quality management, and how do we, um,
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  you know, call what revenue cycle's so diverse just within itself,
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  between registration and coding and billing and case management, scheduling,
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  training, education. Um, not all of those jobs are the same.
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  Not all of them come with the same capabilities of remote work.
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  Um,
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  and so trying to figure out a standardized way is probably not
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  the, not the best approach. It's,
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  it's how do you come up with the way that works the best for everyone while
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  being able to, you know, serve the customized needs of, of each of those groups.
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  And so, you know, we spend,
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  that's what we spend a lot of our time talking about now is,
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  is what's that look like and what are the investments we need to make now?
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  What should we be thinking about, um,
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  so that we can do our jobs as good financial stewards for the health system,
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  while also being there to support what the growth that, um, you know,
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  we expect to achieve. So yeah, I said a lot, but I, you know, there's a lot,
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  a lot, a lot of challenges going on right now,
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  but I think there's solutions and, you know, whoever does it best will win,
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  and that's what we're focused on.
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  Absolutely. I think that makes a lot of sense. And,
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  and definitely it was fascinating to hear you talk about, uh,
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  bringing in the next generation of healthcare revenue cycle leaders.
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  Certainly it's an important field and so important for any hospital or health
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  system to have, uh,
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  those leaders in place that are going to make sure that on the financial side of
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  things, um, you know,
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  you're doing what you can in order to stay in a great place and be solid to
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  provide care going forward. And, you know, when you're looking at, um,
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  the workforce, whether it's, you know, the, the, um,
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  up and coming leaders or those who are just entering the field as well as those
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  who are maybe seasoned veterans or from other industries,
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  are there any trends that you're noticing in what they really are expecting and
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  looking for in the workplace and in what they really appreciate? Or, um,
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  you know, what does that look like for you? What has, uh, have you noticed in,
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  in, are working towards, um, making available to your team? Well.
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  That's the hardest part is that this generation, the next generation of leaders,
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  um, you know, the, the folks who are, or recent graduates of college,
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  the 22 to 25 or six year olds call it, um,
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  they have a very wide ranging set of
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  preferences in relation to,
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  or as in regards to kind of where they wanna work and what they want that to
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  look like. And so, you know,
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  it goes back to this one size fits all approach is probably not gonna work
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  anymore. Um, but at the same time,
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  you can't have a hundred different offerings for a hundred different people
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  because it's impossible to manage. And so, you know, that's what, that's,
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  that's, I don't necessarily have a great answer. It's just, you know, the,
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  the question was how do, what are the headwinds? Um,
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  this is number one on my mind is, you know,
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  for the last decade plus, um, most of the folks who,
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  if you walked around a business office or you walked around any kind of rev
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  cycle area,
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  a lot of the folks that you would run into are people who had been there for 15
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  or 20 years. Um, and, you know,
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  they grew a loyalty to the organization and they grew to appreciate the
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  benefits, um, that come with, you know, being an employee of a health system,
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  you know, medical benefits, 4 0 3 B matches, all those kinds of things. Uh,
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  but this is a different,
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  different climate and a different labor market and a different set of
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  folks coming into the workforce. And, um, you know, I think as an industry,
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  we have to figure out what the right offering is that's gonna track those
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  people because we're losing them to, to banks and, and,
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  and manufacturing and, um, you know,
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  any other industry that's more flexible, more forward-thinking, more remote. Um,
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  we just, we need to, as a whole, I think we need to, um,
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  speed up a little bit the thought process around how we attract that next
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  generation, um, and how do we grow and develop them.
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  The hardest thing for me to figure out, quite honestly is,
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  um, in this world of flexible work arrangements and, and remote work,
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  which I support, uh, to some extent, I think there's a lot of value to it.
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  The question is how do you teach people,
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  how do you teach them the application of their work? I mean, mean,
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  I think in rev cycle specifically, uh,
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  there's so much value to a registrar knowing what a biller
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  does and vice versa,
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  and there's so much value to the scheduling people sitting arm in arm with
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  the authorization team. Um, there's so much handoff.
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  Uh,
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  I I think that in-person comradery is something that we built a lot of success
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  on over the years, not just at Cooper, but as a whole.
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  And so what's the right way to do that? Uh,
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  how do you train a 25 year old analyst, for instance, about
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  the application of the denial work that they're doing?
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  How do you teach them what really goes on within case management and what may
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  have caused that denial in the first place at registration without being able to
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  touch and feel it? I think, you know, it's not that it's impossible,
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  it's just we have to figure out a different way to do it.
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  And I don't think we're there yet. Um, again, not just at Cooper, I think,
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  you know, more globally, we're just, we're just not there, uh,
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  to figure out that development path. And so that's, that's the, that's the,
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  the majority of my focus, our focus.
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  Those are such huge issues to grapple with. And like you said,
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  across not only healthcare organizations, but industries too,
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  I know here at Becker is we have a similar challenge of trying to just make sure
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  that as we work together, cross-departmentally and now, uh,
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  very much either hybrid or remote, it, it's a lot to, uh,
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  instill our culture and make sure that we're not missing anything,
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  missing any links and,
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  and continuing to do the great things that we are aiming to do, um,
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  within the organization. So I think that's so critical and,
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  and definitely something that, um, you know, we don't have a solution yet for,
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  but it'll be fascinating to see how that grows and develops in the future.
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  And speaking of that, what are some of the best opportunities that you see, um,
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  for adding value to the organization overall?
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  How do you think about growth in particular if you're able to look into a
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  crystal ball for the next couple years here?
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  So, to answer the first part of your question about value, um, we, you know,
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  we're an overhead area, right? We're, we're, um, we cost the organization money.
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  And so our focus every year is how do we pay for ourselves, uh,
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  year in and year out? How do we,
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  how do we provide incremental value to the bottom line that supports
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  the investment and resources that we consume? Uh, that's number one.
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  And I think every overhead area in any health system ought to think that way
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  because, um,
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  ultimately you're eating into the margin if you're not adding to it. Um,
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  and then in terms of growth, you know, Cooper, specifically around Cooper,
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  we've got a lot of exciting things on deck. Um,
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  we're opening a new 160,000 square foot facility local to us that's gonna be
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  kind of an ambulatory hub for, um,
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  all of our specialties that we offer here and be able to provide our world-class
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  cancer care, uh, out in there, out, out in that, um, out in that area,
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  as well as bring all of our, um, you know,
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  orthopedic and neurological and other subspecialty expertise out to the folks in
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  that region. So that'd be, that's extremely exciting for us, and we plan to,
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  to continue that strategy over the next few years. Um, you know,
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  new Jersey's a very interesting state in terms of healthcare. There's a lot of,
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  there's been a lot of m and a over the last few years,
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  and so it remains to be seen what will happen with that. But, uh,
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  we're very well positioned in this area to, to, uh, you know,
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  control our own destiny and, and, and we provide amazing care to,
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  uh, a community that we take a lot of pride in serving. Um,
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  and so what does growth look like? I mean, you know, for us, uh,
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  as a revenue cycle unit, um, and within our managed care team,
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  I think growth is,
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  is about doing all of the right things to develop our workforce so
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  that in 10 or 15 years, uh,
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  whoever the next person you're talking to sitting in my chair,
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  hopefully it's still me, but you never know. Um, you know, they are,
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  they are armed with a,
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  a workforce that is well positioned to continue the success that, uh,
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  we've been able to enjoy. And so I think, you know,
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  take a lot of pride in preparing the next generation succession
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  planning, uh, training, education, all those kind of things we've talked about,
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  you know, so far, how do we hardwire success for the next five or 10 years? Um,
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  that is where our focus is, and that's what growth looks like to me. So, um,
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  yeah, a lot, a lot going on, a lot of exciting stuff, but it's, you know,
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  without challenge, in my opinion, it's not very much fun.
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  I love that. Thank you so much, Christopher,
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  for joining us on the podcast today.
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  This has been a fun discussion and certainly excited to see you at our events
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  this fall as well.
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  Yeah, my pleasure. Look forward to seeing you. Thank you.
• 16:50
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