The following Q&A is a follow-up to our recent webinar: “The Revenue Engine: How Investing in the Right Revenue Cycle Talent Fuels Top-Line Growth.”
Joe Abreu is the VP and Head of Revenue Cycle at Proud Moments ABA, which uses applied behavior analysis (ABA) to drive positive outcomes for children diagnosed on the autism spectrum. Joe, who holds numerous certifications, including his CPC, CRCR, and CSPPM, has 20 years of experience in both hospitals and physician groups, with deep expertise in front-to-back revenue cycle processes.
He recently sat down with us to discuss how the fast-paced healthcare landscape is changing and what that means for building a revenue cycle team to help maintain profitability.
Question: Which changes in the healthcare space are affecting revenue cycle management the most?
Answer: There are certain factors we always consider, such as general economic conditions, changes in disease prevention, regulatory oversight, and payer oversight. In regards to payer oversight, things were pretty quiet during the pandemic, but now we’re seeing payers come back full force in terms of quoting accuracy and integrity. Medicaid redetermination is something else that many revenue cycle teams are monitoring, trying to gauge how many patients will maintain or lose coverage.
Question: How is automation affecting the revenue cycle process and which roles are enhanced by it?
Answer: Its effect is becoming more apparent. So far, our claims submission team has been affected the most. Instead of doing all of the claims scrubs, they are now assisted by an automated tool which scrubs through claims and helps them see issues or trends. For our people, that means more overseeing, project management, and problem solving. Automation has also forced us to rethink parts of our training, because certain skills required to work alongside automation simply don’t exist in today’s talent pools. And we want to connect people with automation as best we can to help us fuel growth.
Question: Given current economic ups and downs, what has been your state of the union for your organization?
Answer: We’re doing more with less. We have to explain that and execute on it. This is not only true for us, but also for most private-equity backed organizations. We’re constantly measuring if our management, process improvement, and talent acquisition decisions are positively impacting our EBITA. What’s their ROI? What’s their expense vs. margin improvement on net collection rate? And are they helping us maintain adaptability and scalability? For non private-equity backed organizations, it’s similar, but with more of a focus on their P&L statements.
Question: Speaking of doing more with less, how are you assembling a team who can do just that and help you maintain profitability?
Answer: We discovered that a hybrid model works best for us. In our niche space of ABA, which can make it a bit more complex to collect revenue, we decided to insource certain talent and outsource other talent. Generally speaking, we keep our most complex, analytical roles in-house, and we outsource roles that are more straightforward and require elbow grease. By doing this, we’ve seen a 1-2% increase in our net collection rate, which is significant for our organization’s profitability.
Question: With talent so difficult to find, how are you treating job qualifications for entry-level roles?
Answer: We’re considering compensation and benefits, plus work models, more carefully than ever. Is this package competitive? How is working from home, on site, or in a hybrid model influencing our appeal? More than ever, we’re also reconsidering some requirements for entry-level roles. While we might ask for a bachelor’s degree or a certain amount of experience, we don’t require it. We’re also looking beyond resumes and are more open to candidates who may have the right attitude, skills, and desire to learn, so that they can grow with us.
As you can see based on Joe’s answers, the revenue cycle space is constantly changing, requiring a high degree of performance measurement and talent flexibility in order to maintain profitability.
For much more from Joe, and Craig Wenrick, our own National Director of Revenue Cycle, and to get best practices that will help you fuel growth at your organization, watch our entire webinar on-demand.