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Revenue Readiness and How RCM Leaders Can Win with the EHR Transition · Becker’s Healthcare Podcast

• 0:00
  Hi, everyone. This is Brian Zimmerman with Becker's
• 0:02
  Healthcare. Thank you so much for tuning into
• 0:04
  the Becker's Healthcare podcast.
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  Today, we're going to talk about revenue readiness
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  and how RCM leaders can win with the
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  EHR transition.
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  Joining me for today's discussion is Jody Hillacre,
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  senior director of EHR services at HealthRise. Jody,
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  welcome back to the podcast, and and thanks
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  for joining.
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  Pleasure to be here, Brian. Good to talk
• 0:24
  to you again. Yep. Great great to have
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  you back on, and we'll begin here sort
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  of the usual way for folks that maybe
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  didn't tune in to the last podcast or
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  might not be as familiar with with you.
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  Jody, can you introduce yourself and share a
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  bit about your background and the work you're
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  doing now? Sure. So as you stated, my
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  name is Jody Hilliker, and I'm the senior
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  director of EHR services at HealthRise.
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  Been with the company for about four years.
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  Great organization. Happy to be there.
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  I have a,
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  very
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  strong clinical background, but,
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  as I've worked with HealthRise for the last
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  four years, I've learned a lot about how
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  revenue cycle and clinical
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  can be
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  can work together to create a great outcome
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  for any organization. So the last four years,
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  I've been kind of working on that and
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  and having a great time with it. So,
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  here we are today.
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  Excellent. Well, I'm excited to to pull from
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  your experience here again and and get into
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  it. I I the last time we spoke,
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  I believe we explored the idea of the
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  revenue ripple,
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  starting with provider optimization for for RCM leaders
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  preparing for an EHR go live.
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  Can you share where that ripple truly does
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  begin, and what are the most common, I
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  I suppose,
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  I guess, revenue blind spots organizations miss during
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  that transition?
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  What would you call out there?
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  Sure. So the the the ripple really starts
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  with provider experience. It starts the moment a
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  clinician opens that chart, starts to document care,
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  place orders,
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  and tries to move efficiently throughout their day.
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  If that workflow is clunky
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  and documentation
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  requirements aren't clear,
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  revenue issues begin to start
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  immediately, not weeks down the line like a
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  lot of organizations
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  think, well, we'll see this down the road.
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  It's really starting immediately.
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  So then you see delays in your coding,
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  your missed charges, your denials, and slower cash
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  flow,
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  which isn't good for any organization.
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  So one of the biggest blind spots is
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  the organization
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  thinking that, oh, this is mainly a technology
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  event, and it's not really,
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  you know, it's not it doesn't really involve
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  me, and and that's not true. It's really
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  an operational event that technology
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  is supporting.
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  So,
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  you know, those are things that you have
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  to think about. Another
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  common miss that I've seen, Brian, very frequently
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  is that
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  a lot of organizations feel that if they've
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  trained their end users, that that means that
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  they're ready, and that's not the case.
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  Readiness means that people can perform their job
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  from day one. So it's really great to
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  have,
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  sessions prior to
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  the actual go live where you put your
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  end users in
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  a situation where they can actually work through
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  their workflow during the day, get a feel
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  for what it's gonna be like, and they're
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  they're really far more prepared.
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  So I recommend operational readiness as being something
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  that is high on the list when you're
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  gonna do a boat live.
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  Yeah. Such an important call out there that
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  is more than a technology event and then
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  really getting folks, I guess, early reps. Is
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  is is that a fair way to think
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  about it in terms of getting comfortable with
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  with the operational workflow, Jody? Right. Absolutely. So
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  what we do when what I recommend is
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  that with operational readiness is that you run
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  a lot of labs,
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  what we call, you know, user labs where
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  you bring your end users in and you
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  let them work through the workflow in a
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  test environment.
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  Let them see what it's gonna be like
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  from day to day. Let them ask their
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  questions there rather than being panicked on that
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  first day and wondering, oh my gosh. What
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  am I gonna do tomorrow when we have
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  this first day of go live? How am
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  I going to learn to work with this?
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  The more that we prep people prior to
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  by having them a day in the life
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  of is the most important thing,
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  they they feel more comfortable. So day one
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  isn't such a shock to them.
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  Yeah. And and the preparedness goes a long
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  way. That that can't be pro probably overstated.
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  But at the same time, right, there's still
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  variables and things are will change. So you've
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  gotta watch this, I imagine, as you you
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  begin to roll this out. I guess,
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  Jody, what would be some indicators RCM team
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  should monitor to to
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  potentially identify
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  workflow gaps or or documentation breakdowns before they
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  start to to impact that cash flow, which
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  as you pointed out, this can happen right
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  away. So Right. What what what should folks
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  be on the lookout for once they do
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  go live?
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  So there are a lot of early signals,
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  Brian, that they can be looking for. They
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  don't wait for the end of the month
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  financial report to tell them that, oh my
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  gosh, we're in trouble. So you can look
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  for charge lag, unsigned charts,
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  on on
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  encounters that aren't closed,
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  claim edits, coding, backlogs,
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  encounter and encounter close times that are very,
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  very lengthy,
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  any kind of denial trends, and then provider
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  pro productivity.
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  And you should watch for behaviors.
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  If you are,
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  a manager or you're in the hierarchy position
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  and you're walking through your clinic and you're
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  seeing increased after hour work, frustrations,
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  workarounds being developed, or teams just saying, you
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  know, I'm I I don't like this system.
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  This is taking twice as long. And it
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  doesn't matter what what system they're working on,
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  whether they're
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  in Epic,
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  you know, Meditech, Cerner.
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  It does not really matter. It's if you're
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  hearing those words that, you know, we don't
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  like this system because it's taking too long,
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  then those are signs that you're gonna have
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  a a downstream problem with your with your
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  revenue as you keep going. So the faster
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  that you catch those workflow
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  frictions,
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  the faster you're gonna protect that cash flow.
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  It's such a great call out to really
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  be have your eyes open, right, when you're
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  when you're walking through and and and figure
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  things out and
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  spot those issues.
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  And can you sort of as you describe
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  sort of some some of the proactive
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  training, the the preparedness work folks can be
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  doing here to get ready, can you expand
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  more on what sort of this the the
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  ownership of this looks like in terms of
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  who's accountable for what and what kind of
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  cross functional alignment,
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  should should take place here to ensure that
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  that performance that performance dip doesn't happen. Because
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  I imagine that you've gotta get different different
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  people
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  to work together from different departments and also
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  take some accountability and ownership here. Can you
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  share a little bit more of what you
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  think that should look like?
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  Absolutely. So strong ownership means that everybody owns
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  a piece of the go live success. It's
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  not just an IT situation. Just as I
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  said, it's not just an IT project. It's
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  really an operations project that's supported by IT.
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  So operation owns your workflows, making sure that
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  everything flows correctly.
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  Clinical leaders own adoption. They're responsible for making
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  sure that their teams adopt to the EHR
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  and that they get familiar with it and
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  they feel comfortable with it. Revenue cycle,
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  they own their downstream integrity,
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  and then executive leadership pays a big plays
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  a big part in making sure that they
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  own the speed of decision
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  making and accountability.
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  If we are bringing
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  as as end users
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  or as managers are bringing to our leadership
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  that we need
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  to change something and they don't react,
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  then you're gonna have an issue.
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  And this should always happen before go live.
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  So the best organizations
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  are aligned before the go live on what
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  success looks like. What are our productivity targets?
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  What are our charge leg thresholds?
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  What are the our escalation path?
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  How do we do daily reporting? And who
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  fixes what when something happens? If you have
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  a clear path on that,
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  you're going to win. If your ownership is
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  vague and performance drops,
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  there's gonna be an issue. If ownership is
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  clear, the organization will recover quickly from any
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  kind of problem that pops up.
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  Yeah. And and the ultimate goal here too,
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  I mean, the the go live is important.
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  The preparedness
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  thing is important as well. But you also
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  wanna set up teams for for long term
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  financial success here. And you've shared examples previously
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  where,
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  optimization can really lead to measurable revenue improvement
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  without adding provider hours because that's another thing,
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  of course, folks are are pursuing is trying
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  to,
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  achieve this and and get revenue improvement without,
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  you know, adding to the plates of of
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  of providers.
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  For executives listening today, how should they think
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  about investing in provider support and workflow optimization
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  as they're looking at that long term financial
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  sustainability
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  and success?
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  So if I were a leader in an
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  organization that's about to go live, I would
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  look at provider support as a margin protection.
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  When providers can move very efficiently throughout their
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  day, document cleanly, close encounters on time,
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  the organization
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  benefits
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  everywhere. Revenue capture,
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  throughput, patient access,
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  retention of their patients, retention of the providers.
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  It's a margin protection.
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  You don't need massive investments
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  when you're, you know, when you're looking at
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  provider optimization.
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  It's just to make sure that you target
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  the workflow, redesign if you need one,
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  specialty optimization for those specialty providers, making sure
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  that they have the templates and the tools
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  that they need,
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  reduced inbox burden, show them how to use
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  tools so they can reduce the inbox burden
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  that they have. Hands on support, like I
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  I think I mentioned in the last podcast
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  is finding a team of people that will
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  sit down with your providers and make sure
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  that they have everything that they need to
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  use the EHR efficiently and effectively,
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  and then spending the time on optimization and
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  training workflows,
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  making sure that if you change something that
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  you actually train the providers on the change
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  that you made and talk to them about
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  the changes that you want to make and
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  make sure that it is something that's going
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  to improve their day to day processes.
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  Jody, thank you so much. And it really
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  is a pleasure to have you come on
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  and share so many,
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  tangible,
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  actionable piece of advice with with our listeners.
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  We'll close here by just
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  asking you, you know, for for RCM leaders
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  out there that are thinking about their next,
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  EHR milestone or or optimization phase.
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  What final piece of advice do you wanna
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  leave them with before we sign off today?
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  I would say don't confuse complexity with more
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  con control.
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  A lot of organizations
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  will add multiple layers, reports,
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  approvals, rules when performance dips,
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  you know, trying to make it more complex
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  when it it really could be just a
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  simple solution.
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  The better answer is simplifying the work,
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  clarifying accountability,
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  and fixing the root causes. Get right to
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  the root cause. Get it fixed.
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  Stay focused on what truly moves the performance.
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  Don't lose touch with what frontline teams are
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  experiencing every day. Make sure that you get
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  down into the nitty gritty, and you talk
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  to your teams to see what exactly
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  is is happening. Why are you experiencing
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  roadblocks? What are you feeling?
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  My my strongest advice is don't treat ready
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  operational readiness as a line item. Treat it
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  as a necessity.
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  It is something that you have to do.
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  Start to engage
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  operational readiness at the very beginning of your
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  organization's
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  launch into the EHR process.
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  Productivity loss, denial volume, provider frustration, delayed cash,
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  and rework
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  can follow organizations
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  for months after an implementation
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  if you don't jump on them and if
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  you're not prepared ahead of time. So, again,
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  you know, my favorite my favorite speech, Brian,
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  find a partner
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  that's based in experience and execution. Make sure
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  that you've got a team that's not just
• 12:14
  about price and promises. Make sure that they
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  come in and really get engaged. Get down
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  and down with your teams and sit down
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  with them and find out what their pain
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  points are. Work with them.
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  The right partner should understand both or operations
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  and,
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  revenue cycle. And that, I think, is
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  another problem that a lot of organizations have.
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  They'll pick an org to work with that
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  only has one or the other, and you
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  should have somebody that has the whole you
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  know, that can fill the whole basket.
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  Strong partner doesn't help launch the system,
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  but they protect performance while you do it.
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  So that's that my gist is just to
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  make sure that operational readiness is is not
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  just a line item, but it's something that
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  you dive into.
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  Yep. And and and if you're diving into
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  it as an an executive for for a
• 13:02
  health system,
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  your expectation should be the partner's gonna dive
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  into it with you. Correct?
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  Absolutely. You should be hand in hand, and
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  you you're looking for a partner that's just
• 13:12
  not gonna be a yes, man. I I
• 13:14
  really have a strong feeling about that. You're
• 13:17
  looking for a partner that's gonna be prescriptive
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  and that's gonna say, from our experience,
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  this is what we've seen in the past
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  and this is what we recommend. Whether the
• 13:26
  organization decides to go with that or not
• 13:28
  is totally up to them. But pick a
• 13:30
  partner that's gonna prescribe for you what they've
• 13:33
  seen and what they recommend that you do,
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  and and listen to their advice because sometimes
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  when you've gone through 400 of these like
• 13:40
  our organization has,
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  you have a little bit of experience there,
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  and you know what the pitfalls are. So
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  you should really take advantage of that and
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  and utilize them as a partner, not just
• 13:50
  as an employee.
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  Yeah. Jody, thank you so much once again
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  for for taking the time to come on
• 13:56
  the podcast.
• 13:57
  Always a pleasure to speak with you. You
• 13:58
  too, Brian. Thank you so much for your
• 14:00
  time. We also wanna thank our podcast sponsor,
• 14:03
  HealthRise.
• 14:04
  You can tune to more podcasts from Becker's
• 14:06
  Healthcare by visiting our podcast page at beckershospitalreview.com.