Latest / Becker’s Healthcare Podcast / John Mallia, Interim Chief Financial Officer at Methodist Le Bonheur Healthcare

Transcript

John Mallia, Interim Chief Financial Officer at Methodist Le Bonheur Healthcare · Becker’s Healthcare Podcast

• 0:02
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  Hello, and welcome to the Beckers HealthCare podcast.
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  My name is Will Riley from r one.
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  With me today is John Marria,
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  interim chief financial officer at Methodist de Bonheur
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  Healthcare. Welcome to the podcast, John. Thank you,
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  Will. Appreciate you having me. Absolutely. To start
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  us off, tell us a little bit about
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  you, your role, and some of the key
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  priorities that you're Great. Are working on. Absolutely.
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  So I'm, as you mentioned, the interim CFO
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  at Methodist Le Bonheur Healthcare. I've actually been
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  there for about a little over three months
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  now.
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  I do interim work for a living. Before
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  this, I was, actually in New York for
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  about six years at at two separate systems
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  doing similar work. But at Methodist, we have
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  six hospitals in and around the Memphis area.
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  We have, Le Bonheur, Children's Hospital, which is
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  a world class children's hospital, of course, and,
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  an academic medical center as long as as
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  well as a bunch of other fantastic facilities
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  in and around the Memphis area. So,
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  my Midwest accent
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  is kind of new there. Not everyone talks
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  the way I do, but it's actually really
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  cool. I mean, they're a very welcoming
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  community, and and it's just been fantastic to
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  get started there.
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  We have a lot going for us. We
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  have a lot of opportunities
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  ahead of us. We just went live with
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  Epic,
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  in October,
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  went live with Workday
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  in July.
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  So, we're getting through all of that kind
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  of post epic cleanup, if you will.
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  And we just went live with our new
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  partners, Ensemble, for an end to end outsourcing
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  of our revenue cycle. So looking forward to
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  leveraging that for a lot of great things
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  going forward. Excellent. Excellent. That's great background.
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  Let's talk a bit about revenue cycle and,
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  payer dynamics.
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  Obviously, we've got a really dynamic legislative
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  environment right now,
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  and lots of there's been a lot of,
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  let's say, foreboding
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  at this conference
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  about the big beautiful bill and some of
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  the implications on that in terms of reimbursement.
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  Right.
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  And payer provider dynamics have been tricky for
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  for a long time as well. Yep. Commercial
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  payer, I mean. Right. So, you know, how
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  are you adapting your financial strategies for that
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  Right. Emerging reality? So, you know, on the
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  commercial side, it is becoming, more difficult, a
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  lot more friction, particularly on the managed Medicare
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  side, the Medicare Advantage side.
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  You know, we're about 50% penetration in terms
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  of our managed Medicare,
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  and it's challenging.
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  A lot more prior auths, a lot more
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  denials, a lot more friction that we're having,
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  and it's slowing up access. So it's something
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  that we're, attempting to address. We're tripping attempting
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  to face it head on, with our payer
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  partners,
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  and also working with, some legislative folks to
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  figure out if there's a a way forward,
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  in that regard. So,
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  you know, there's opportunities. I think we have
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  a good relationship with our our payor community,
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  but, there's some opportunities, I think, to do
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  some things in a better way. Do you
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  think that,
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  like, technology
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  can play a role here, and, like, how
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  how can that Absolutely. And and and, again,
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  going back to our,
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  relationship with with Ensemble,
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  you know, they're helping us kinda take things
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  to the next level. We made a big
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  step with implementing the EPYC
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  system and and a lot of the infrastructure
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  that was new to us,
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  from our previous systems.
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  Obviously, Ensemble has a lot of experience. They've,
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  implemented and invested a lot of r and
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  d in in new technologies and AI that
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  probably would have taken us much longer to
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  implement.
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  So we're looking forward to being able to
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  to use that,
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  to to move things forward from a technology
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  standpoint.
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  Revenue cycle does feel like a place where,
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  you know, it's been a very labor labor
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  centric
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  paradigm.
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  Right? And
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  it does feel like it can shift to
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  more or less
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  a automated automation first paradigm. Absolutely.
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  Do you agree with that? And and, like,
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  as you as you think about that, what
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  are some of the hurdles and Yep. That
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  you've gotta get over? Yeah. You know, anytime
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  you go through an epic transition, and this
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  will be my second one,
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  there's a lot of change management that has
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  to take place, and not all of it
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  can get done. Sometimes you kind of implement
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  over some bad workflows.
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  And after the the cleanup and the and
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  the post implementation cycle, you have to clean
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  a lot of that up. A lot of
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  the change management has to take place.
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  A lot of,
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  employees and and,
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  our staff,
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  and really just revenue cycles
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  across the country,
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  have been trained in old systems, perhaps spending
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  a lot of time taking information out of
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  one system, moving it into another, just human
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  interface, if you will.
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  I think we we're at a stage where
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  we can move past that.
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  I think the the workforce of the future
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  is gonna be one that is more of
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  a a learning workforce as opposed to a
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  knowing workforce.
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  But making that transition sometimes takes a little
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  bit of time, and we're going through that
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  journey right now. Mhmm. Mhmm. I mean,
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  how how do you do it? How how
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  do you
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  make that transition? I mean, you've got you've
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  got folks that have been in roles for
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  a long time. Those roles are changing.
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  How do you Yeah. How do you how
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  do you navigate it? Yep. It doesn't happen
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  overnight. And Yeah. A lot of it has
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  to be really focused
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  change management in particular areas.
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  Just, for example,
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  the the prompts on the front end,
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  that, that Epic provides that in terms of
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  picking insurance,
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  a lot of that took a lot of
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  manual effort before. A lot of that is
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  automated now, but folks don't necessarily know how
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  to use those
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  goals to to pick through that. So, you
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  know, that that's just one example. There's a
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  bunch of other,
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  things that are automated, but folks still kinda
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  migrate towards their previous workflows, perhaps even using,
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  paper when everything is online.
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  So working through that kind of one
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  issue at a time is is the the
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  the part that we're going through right now.
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  Yeah. Okay. Okay.
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  You you're talking about things there that make
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  sort of revenue and financial processes really slow.
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  Technology has the potential probably, we think, to
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  make it all happen a lot quicker. Right?
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  You know, as consumers, we expect real time
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  everything. Right? Real time transactions.
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  Our exposure to AI
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  is making us
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  expect things quicker and in a more synthesized
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  form.
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  Like, how do you think health care can
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  rise to meet some of that demand and
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  potential for real time experiences?
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  We're behind.
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  I mean, I think patients today are expecting
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  that out of their health care providers.
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  They get it in banking, they get it
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  in retail,
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  and then they come to their their health
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  system, their doctors, and their and their hospitals,
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  and they get almost nothing like it. Now
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  my MyChart
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  is moving the dial for us,
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  in a real way.
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  You know, we have to optimize it. We
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  have to make sure that our patients are
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  actually signing up for it, which doesn't happen
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  automatically, but I think there's things that we
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  can do to to move that down the
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  line.
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  But
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  health care as an industry, I think, is
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  definitely behind other industries, and and consumers recognize
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  that. Yeah. Yeah. Where are some of the
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  opportunities, though, do you think, for health care
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  to speed up and catch up?
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  Yeah. And and, again, I think that this
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  is where this AI revolution
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  is gonna come into play. And, again, I
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  think we are behind as an industry
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  a lot of other,
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  industries that are moving forward with it. So
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  that's a real opportunity for us. I mean,
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  I think those that are better capitalized,
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  the bigger health systems that
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  have
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  more distributed systems and more investments in r
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  and d in some of those areas are
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  gonna leap ahead. Yeah.
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  Or or naturally, they're gonna be in a
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  better position to do that. But I still
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  think that there's opportunities for some of the
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  smaller standalone systems to partner with other organizations
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  that have already made that investments, like we're
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  partnering with Ensemble,
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  to to make sure that we're, capturing as
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  much as we can. Yeah. Okay. And what
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  about governance? When you think about AI initiatives
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  and programs,
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  there's a lot of concerns around data usage,
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  access to data,
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  monetization
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  of data, for example. Yep. How how are
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  you thinking about those? Yeah. And I I
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  think it's it's very important to start with
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  governance first.
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  And and that's part of the reason I
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  think health care has lagged is just because
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  of the the regulations,
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  around our industry, appropriately so, in terms of
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  privacy, but also because of,
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  we still have a lot of systems that
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  run on multiple EMRs
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  and and multiple interfaces, and it's difficult
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  to cut through all of that. Yeah. So
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  that's part of of the the reason why
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  we're, I think, struggling as an industry. Having
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  that governance model set up, which means having
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  thoughtful, intentional folks at the table to understand
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  exactly what that,
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  thought process is gonna be, for each organization
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  and how they're gonna implement it,
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  and just really
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  the the the mission centric focus
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  around how the adoption's gonna be for each
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  organization is an important step. Who are some
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  of the key stakeholders when you when you're
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  looking at that and trying to decide what
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  to do and what to prioritize? Yep. Definitely,
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  the the the folks that are responsible for
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  patient experience.
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  Obviously, your CMIO,
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  or your equivalent
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  is gonna be an important piece of that,
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  your your chief medical, information officer.
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  You know, I think finance has a place
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  for that,
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  a seat at the table because revenue cycle
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  is such an important,
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  aspect of that and and how AI is
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  gonna be adopted going forward.
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  So in in nursing, you know, nursing,
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  touches the patient more than than anyone in
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  the in the system. So, really, it's gonna
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  be very much, everyone at the at the
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  executive level that has to have a voice
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  in how that gets set up.
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  Excellent.
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  What what are some things that you would
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  recommend to,
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  you know, some of your peers who are
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  starting AI programs in this? Well, you mentioned
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  one of them, and I think that that
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  might be the the the most important piece
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  is that you build that,
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  governance,
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  framework. Uh-huh. And, also, you know, it's difficult
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  to dive into everything AI. I mean, I
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  think there's a tendency to,
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  you know, wanna invest in everything and take
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  a shotgun approach. I heard one quote here,
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  at the conference that says that every,
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  venture AI venture, only about 5% ever, you
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  know,
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  reach any level of fruition. So, basically, one
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  in 20 is all that's gonna be done.
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  So those that, you know, organizations smaller organizations
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  aren't gonna be able to invest in that
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  kind of r and d. So every shiny
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  new thing is probably not gonna be something
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  that's
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  gonna be appropriate for for everybody.
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  That's why it's really critically important to find
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  the right partners as you're going along that
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  journey after you've set up the governance structure
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  to identify exactly where you want it to
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  deploy that. And then last but not least,
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  I think investing in people.
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  You know, AI,
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  if it's used best, reduces friction,
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  not humanity.
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  And I think that's really the message is
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  how that gets communicated to, our associates,
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  our employees, and and our key stakeholders.
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  Fantastic.
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  John, it's been great hearing from you. Are
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  there any other parting thoughts or any any
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  other thoughts or concerns? Real quickly, you had
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  mentioned the OBBA and and, you know, that
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  that there's
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  always the the threats that are out there.
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  Some of them are immediate.
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  Some of them are longer term. You know,
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  I think the one that's that's keeping us
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  up, most in the near term
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  is the, the lapsing of the subsidies and
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  how that's gonna impact, perhaps, increase our our
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  self pay patients,
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  and and, you know, the opportunities and and
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  need that we have to engage them, on
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  the front end, pretty short order, perhaps as
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  soon as, you know, before January 1. Right.
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  So that's the the imminent threat. And then
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  the longer term,
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  issue associated with, for for safety net hospitals,
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  you know, the Medicaid,
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  reimbursement through directed payments, going away.
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  So those are things that we're concerned about.
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  You know, we have to integrate it into
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  our planning process. For years, we integrated
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  those payments into our strategic planning process. Now
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  we have to scenario plan around the fact
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  that those might not be there. Yeah. So
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  that's what we're spending a lot a lot
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  of time doing in the planning process. And,
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  hopefully, some of the innovations we've been talking
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  about can help you find some efficiencies along
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  the way
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  to adjust things on the other on the
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  other side of the scales.
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  Absolutely.
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  Yeah. Okay. John, thank you for spending time
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  with us. It's been lovely talking to you.
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  Appreciate it. Pleasure. Thank you. Thanks.