Latest / Off the Chart: A Business of Medicine Podcast / S1 Ep82: Practice leadership, with Kem Tolliver, FACMPE, CPC, CMOM, of Medical Revenue Cycle Specialists
Transcript
- Part of being a leader is being able to lead folks. And in order to lead folks, they have to feel that you're credible, that you're one of them looked off the chart, a business of medicine podcast featuring lively and informative conversations with healthcare experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. My name is Keith Reynolds, editor of physicians practice, and I'd like to thank you for joining us today. This episode, we're talking leadership. I sat down with Kem Tolliver, President and CEO of Medical Revenue Cycle Specialists, and we chatted about how practice leaders can translate their personal insights and experiences into measurable improvements. We talked about the importance of innovation, vulnerability and teamwork as a healthcare leader, plus how to recognize and reduce burnout and prepare for upcoming changes in the industry. Kem will also be the opening keynote speaker at the HCLA Virginia 2025 fall conference, which is held in Williamsburg from October 5 to October 7. Kem, thank you again for joining us, and let's get into the episode. Hey there, folks, today we're talking to Kem Tolliver, CEO of medical revenue cycle specialist. She'll be delivering the opening keynote at the hcla Virginia 2025 fall conference titled From insight to impact, empowering healthcare leaders to shape tomorrow's success. How you doing today? Kem, I am wonderful. How are you? Keith, I can't complain too much long weekend's coming, and I can practically smell it. Let's dig right in. So how can leaders move beyond their personal insights to ensure that those reflections translate into measurable improvements across their organization? Well, you know, as being a healthcare leader for I want to say countless years, you know, what I've found is that we all have acquired a ton of information through our experiences that are, to me, transferable in so many different ways in the projects that we're managing, in the situations that we're dealing with and that we're leading. So you know, one of the pieces of advice that I would give to leaders is to lean on your experience and to apply and share that knowledge with our teams we have gotten I know in healthcare for leaders, we many, many of us, I should say, started at the front desk, started in an entry level position, and we've kind of moved up the ranks. That's what happens in so many healthcare organizations. So kind of taking, you know, moving beyond the personal insights and finding ways to kind of translate that into measurable improvements. Take that. Take that knowledge that you've gained as a medical receptionist, as a biller, as a coder, wherever your career path has taken you. My suggest, my suggestion is that you lean into your experience and apply that. There's so many times where I'm dealing with a physician who is upset for, you know, whatever reason, and I think back to when I was a medical receptionist and how I handled situations with providers. So lean into lean into your experience and apply it all right. So what leadership competencies do you see is most essential for driving operational success? And how can leaders, you know, intentionally cultivate them? So to me, some of the competencies that I think are essential would be an interest, an interest in innovation. Those leaders who kind of feel like we've always done it the same way. We don't, you know, are a little intimidated by technology. We're not going to last. We have to, we have to lean into innovation and research and understand how innovation is going to impact our care delivery, impact our reimbursement and impact our workflows. I think another competency is vulnerability. I am so comfortable with being vulnerable with my teams, because then I'm human right. And part of being a leader is being able to lead folks, and in order to lead folks, they have to feel that you're credible, that you're one of them. So I take personal stance of vulnerability. I think the other component would be having a team mentality, right? So if you think about the team mentality, you. Uh, leaders we have, we are exposed to a ton of sensitive and proprietary information, right, that we can't, for obvious reasons, share with our team. So just by the just by that kind of standpoint, sometimes what we are elevated, right? The goal that that I have in having a team mentality is not not being above my team, but being a part of that team. So one of the competencies that you know, that that I recommend, is being comfortable being part of the team and finding ways to insert yourself as part of the team, I think the other thing is the ability to strategically apply solutions across the board. That's a key competency. So you know, with that, one of the areas that I kind of think about is the utilization, or the adoption of a patient portal. There are so many times where we're not optimizing the use of our patient portal. So as a leader, you know my competency requires me to see the lack of patient portal utilization from so many different perspectives, right? I'm looking at it from the provider's perspective. I'm looking at it from the patient's perspective. I'm looking at it from a compliance perspective. I'm looking at it from the billing perspective. I'm looking at it from the front office perspective. So having that ability to strategically apply solutions across the board using so many different perspectives, I think, is a huge component of a solid leadership competency. Alrighty, so many organizations are struggling to turn their strategy into actual execution. Can you share any examples of action, an actionable framework that you've used or seen used effectively that could help these teams implement strategic initiatives? Yeah, you know, the one initiative that comes to mind is readmission reductions. So here I'm in Maryland, and in Maryland, we're we're operating under a total cost of care model, and that care model requires community physicians and hospitals to collaborate on readmission reduction with that collaboration how our hospitals in Maryland, we get a higher rate of reimbursement from CMS if we meet certain criteria. So reduction of cost, reduction of hospital acquired illnesses and readmission reduction. So one of the ways that when you think about the strategy, the strategy is to reduce readmissions throughout the state right? And how do we implement that strategy? When you think about that strategic, that strategic execution within an organization, the first thing is to set the strategy right. So what do we want to do? Our goal? You know, with readmission reduction, is to improve quality and cost scores, right? So we want to avoid, avoid readmissions. And I think the other thing that we want to think about here is translating what the overall objective is to our team. So for me, I set a percentage of reduction for the organizations that I work with, right? So we need to translate what that kind of breakthrough objective looks like. The other thing that we want to do is we want to look at ways that we can kind of Cascade those high level organizational goals into departmental and team goals, right? So we have to break those goals down, and we need to, we need to make sure that, for example, our care coordinators are following up with patients, that our billing team is billing for transitional care management. So we want to break down those organizational goals into department and team level. The other thing that we'd want to do to turn that strategy into execution is look at how we are defining the initiatives of the project, right? So for for me, what, what we do is we work with Chris, which is the Health Information Exchange in Maryland and DC, so that we are alerted when a patient is discharged, right? So we need to define those initiatives. How are we going to get the information? Then we want to track our. Performance, right? So we need to have some type of a measurement. We need to have dashboards so that we can follow up and make sure that we are capturing all the data that we need. And then finally, we need to review and adjust, right? So looking at ways that we can meet with our teams, looking at any pivots that we need to make, in any processes that that we've come up with. So, you know, those are the the ways that I would go about one example for executing a strategic plan. Say, Keith, this is all well and good, but what if someone is looking for more? Clinton, more clinical information? Oh, then they want to check out our sister site, patient care online.com, the leading clinical resource for primary care physicians. Again, that's patient care online.com. Alrighty, and we're talking healthcare in the 21st Century. So, you know, I've got a question about burnout. How can leaders, what, you know, what can they do to both support resilience in their team and also reduce the sort of structural contributors? Contributors? Ooh, that's a word. I definitely know how to say. It's a burnout. So, you know, one thing that I advise the organizations that I work with is listen to the unspoken messages. Hear that, hear that. Kate, what are people not saying who was previously engaged and they're no longer engaged? As leaders, we are executors, right? We are strategic thinkers. We're looking at teams globally. But what we also need to do is hear what's not being said. Because burnout is it doesn't typically manifest with someone telling you, hey, I'm burned out. The way that burnout manifests is with errors. It's with turnover. You know. It's with dissatisfaction, it's with disengagement. So my recommendation here is to listen for the unspoken messages in your team. In order for us to help our teams with burnout, we need to know that they're burned out, so identifying those you know those context clues so that we can provide them with the resources that they need. One of the other ways that we can help our teams with burnout, is by not creating processes that will burn them out. I mean, I, you know, I don't want to simply, I don't want to oversimplify this. But I, you know, I've seen teams, and I have teams that need to log into seven different platforms a day. Is it necessary? What? What can we do to improve their workflows, through interoperability, right through interfacing technology, through automating repetitive processes? So, you know, I won't go down the wellness track, but from the leadership perspective, listening for the unspoken messages and identifying ways that we contribute to that burnout through processes that could be modified. All right, yeah, definitely. You know, it seems it's so much, much talk of of burnout, really focuses on communication, but it's, it's very interesting. You point out that you know that pay attention to what not being what's not being communicated. That's a that's an interesting angle. Yeah, I do it all the time. I'm listening for the unspoken cues. My my, my business operations manager, and I literally just met and we added her to a huge project. And what, what we're asking her to do is something that is a little out of her comfort zone, but I want her to grow. I think she has the capability to grow, but I'm also listening, and I'm watching to see what her comfort level is taking on this new responsibility, because as a leader, I don't want to overwhelm her, but I want to give her enough motivation to grow. And so I'm just I'm listening to what's happening through the way that she's operating with the new teams, and if I see that, you know she's falling behind on other responsibilities, I'm giving her grace, because I understand that I and I just told her that because she is, she is so focused on doing a good job, which most of our. Teams are, they don't want to disappoint us. They want to do a good job. So she mentioned, you know, she she brought to my attention that I just kind of feel like I'm nervous about dropping the ball. And I told her, I said, I need you to give yourself grace, because that's what I'm doing. I know that you have other expectations and other job responsibilities. I am managing my expectations on what you are going to deliver to me, because I have tasked you with the new responsibility when, I mean, I could see her shoulders drop when I said that, she was like, okay, all right, I'm okay. It's going to be okay. And that's, you know, that's, that's a part of our leadership is to make sure that our teams feel, that they feel that we're supporting them. You sound like a great boss. Kim, so moving on, you know, again, healthcare in the 21st Century, let's talk data, so as more of it becomes available to leaders in healthcare, what's your advice for using that information wisely and balancing analytics with you know that that gut human judgment so the data, there's so much data that we have access to, right? We have data we have access to data for coding. So I'm a certified professional coder, and when I look at coding data, I'm looking at a few metrics. I'm looking at accuracy, right? And I'm comparing providers documentation and code selection accuracy to national benchmarks. So Nash, AAPC, American Academy of Professional Coder, has a 90% accuracy rate with for coding and documentation. Now what we also have to do is add context to the data that we're that we're looking at right? So would I apply a 90% accuracy rate to an organization that does not have a clinical documentation improvement program that has not had coding and documentation training since 2020 that does not do regular training and education on documentation and coding, no, right? So I think part of what we want to do when we're looking at data is to treat data as a compass and not as a map, right? So we need to, we need to make sure that the way that we're using the data is in alignment with what the goal, the ultimate goal, should look like. So for organizations that I just mentioned that don't have all of those bells and whistles in place, not going to benchmark them at a 90% accuracy rate, right? That's going to that. That needs to vary. I think the other thing that we want to do when you know as we're looking at data is to prioritize the key performance indicators, or KPIs, that align to directly to our strategic plan. So as I look at data, I kind of go down a rabbit hole, right, which many of us probably do. What we want to think about is what data is important to us. The other data, it's it could be considered incidental or secondary. Maybe it's something that we want to look at later on down the road, but what I like to do is focus on the KPIs that are going to align strategically to my goals. So days in AR, the you know, the cash flow velocity. So how quickly does it take us to get paid? What is our what's our clean claims rate? So how you know, how successful are we in submitting a claim the first time and having it paid, right? So it's really important that we're looking at the data that is important to us, because we need to use that data to make decisions, right? I think the other thing here with data is to identify the story that's being told by the data that we're receiving and compare it to the frontline insights from our team members. So there are times where I'm getting data, and when I reach out to the folks who are, you know, boots on the ground, that data is not reflective of their experiences. So I want to come back to that data to make sure that I'm interpreting it the way that it should be interpreted. So I could go on and on with data, but I'll leave it there, because I'm sure we have a cut off time. Yeah, definitely. You know, data is the, it's the it's the buzzword of the century at this point, I. I do believe. All right, so let's I'm gonna ask you to pull out your crystal ball here. We're not gonna ask for any specific predictions. But what do you think these healthcare organizations should like? What sort of steps should they take now to prepare for what's coming in the next, like five years? So ensure interoperability. I could not stress that enough. And when I say interoperability, if you have a, you know a an EMR practice management software, understand that your EMR practice management software may not be the only platform that you need to you and your team need to rely on today and you know over the next several years why we need to understand the why. Why is that the case? Why do we have other platforms that we need to rely on that is going the answering the question of, why is going to help us prepare ourselves for the future? So part of that, why is advanced analytics and AI right our practice management and EMR software has a specific duty to us, right? It can't be everything to us. So what we need to do is start thinking about ways that we can use other platforms to stack onto our EMR practice management software and find ways to connect those technologies, and I'll give some examples. So as a billing team, we we are responsible for reconciling payments, posted payments received, right? That's a manual process that takes time, time that my team could be using doing so many other critically important tasks. There is technology out there that can do that reconciliation for us, electronically and automatically and accurately my team, we're human. We're actual people. We have blood and veins, and we're going to make mistakes. So I would rather, and I invite the you know, the the leaders out there, to allow our teams to use their critical thinking skills as opposed to data entry, right? So my advice there would be, ensure interoperability and adopt advanced analytics. Our team's time is precious there. There are innovations out there that are going to help our teams, not necessarily replace our teams, and that's where I think it's going to be super important for us, because that is reshaping operations, if we allow it, if we don't allow it, to reshape our operations. Our teams are going to be behind the eight ball. We're going to have poor performance. We're going to have interruptions in cash flow and revenue, and that's not something that we you know, we want to look forward to in the next several years. So there, folks. My name is Keith Reynolds. I'm the editor of physicians practice, and this is the p2 management minute. Here are two ways to avoid drowning in data and actually use it. Number one, demand smarter data, not more data. Fatigue kills efficiency. Configure your EHR to surface only what matters when it matters. Real Time flags for rising ER visits, duplicate meds or unchecked labs without a blizzard of pop ups, pick three to five KPIs for a weekly 10 Minute huddle, no show rate open tasks, turnaround time and build role based dashboards so front desk Ma's and clinicians each see their essentials, nothing extra. Number two, Delegate data collection, not clinical care. Doctors shouldn't be your light, your lead data gatherers use standardized intake in standing orders, so Ma's capture vitals, quality metrics, SDOH and pre visit questionnaires before the clinician enters templates and checklists, shrink charting time and clear bottlenecks so physicians focus on decisions, not data mining, filter hard, Delegate smart. That's how you stay out from under the data. Pile more bite sized practice tips and tricks. Make sure you visit physicians. Visit physicians practice.com. Thanks for watching, and I'll see you Monday on the p2 management minute. So after having you look forward, let's take a look back, looking at your own leadership journey. Were there any pivotal moments where reflection, resilience or innovation directly impacted your. Organizational success? Oh, yes. Moving on. Next question. Kerry, to expand so there are a couple. There have been a couple, several pivotal moments. I think the the pivotal moment that comes to mind right now for me is the moment where I realized that my that my I should not project hems way onto my team. I have a way of managing a schedule, speaking to a patient, running reports, analyzing reports, completing tasks. Excuse me, what I think I learned and what's what was pivotal for me in my leadership journey is to coach my team to be their best, not Kim's best. So each individual on our team has had their own unique journey and brings their own unique expertise and lens to a task or a project or to an organization, and rather than forcing my way down everyone's throats, I realized that I actually get a more diverse think tank by encouraging my team to think independently, obviously, using my structure, using my direction, using my expertise, but giving them the creative freedom to make mistakes. And that's scary as a leader, because I see I've seen the direction that some of my team members have gone, you know, in the past, and I'm like, oh, no, don't do it that way. You're, it's, it's gonna, it's gonna take longer, allow that, obviously, with boundaries, but that was a pivotal moment for me, is that it's okay that everyone on my team doesn't have the same passion as I do and and that's hard as a leader, right? We want them to have passion, we want them to have loyalty. We want them to have dedication, but it needs to be theirs. So what can we do to instill Samantha Gerard, whoever to instill a level of dedication and passion to what they're doing that is true to them, that will be sustainable for them. Alrighty, alright. Last question, if the attendees of the HC la Virginia Conference, which is taking place in early October, if they walk away with only one actionable leadership lesson from your keynote, what do you hope it will be? Oh my gosh, lead where you stand. That just lead where you stand. I'm going to go back to when I was a medical receptionist. I I told this patient, and I don't know why I remember this, I told this patient, I'm just a receptionist. And she said, No, you are not just a receptionist. You are the person who is connecting me to my physician. You are actually very important. So in some organizations, you know we may depending on what your role, what your title is, you may feel like you're just something you have, you have a skill set that is important to your organization. So whatever the role you play in your organization, own it, be confident in it, and lead from that position. And I encourage medical assistants, billers, anyone who doesn't have a leadership title, I always encourage them to lead where they stand. So that would be the the one takeaway that I hope that folks get from me is lead from the position that you're in. Feel confident in the position that you're in. You don't have to own the practice to lead the practice. All right, now I said that, that was the last question, but reporters are liars. Let this be a lesson to us all. Is there anything you think I'm overlooking, or anything that you'd like to add? Well, so in addition to the keynote presentation, which I'm really excited about, I'll also have a breakout session. The breakout session is. Build revenue cycle oversight through analysis and workflow mapping. I love looking at the revenue cycle as a whole, which is something that we will do in that session, but mapping the workflows that are typical in a healthcare organization to successful outcomes of a revenue cycle. So looking at the revenue cycle from the varying components that are included in that revenue cycle, and mapping it to your workflows, and mapping it to technology and best practices. So that's another area that I'm looking forward to digging into. Sounds riveting. All righty, Kim, thank you so much for your time. It's been an absolute pleasure talking to you. It's been my pleasure. All right, take it easy. Take care. You. Keith, once again, that was a conversation with Kem Tolliver, President and CEO of medical revenue cycle specialists. My name is Keith Reynolds, and on behalf of the whole medical economics and physicians practice teams, I'd like to thank you for listening to the show and ask that you please subscribe so you don't miss the next episode. You can find us by searching off the chart, wherever you get your podcasts. Also, if you'd like the best stories, medical economics and physicians practice, published or delivered straight to your email six days of the week, subscribe to our newsletters at medicaleconomics.com and physicianspractice.com off the chart, a business of medicine. Podcast is executive produced by Chris Mazzolini and myself Keith Reynolds, and produced by Austin Littrell, medical economics, physicians practice and patient care online are all members of the MJH Life Sciences family. Thank you.