In each edition of Cycle Up, we sit down with one of the leading voices in the company. In this issue, we’re talking with Dave Frank, Vice President of Comprehensive Business Office Outsourcing, to discuss strategies for spotting and correcting a dysfunctional revenue cycle.
As a life-long learner, you’ll find Dave listening to podcasts, audiobooks and music at various points throughout his day. He loves cooking, golfing, fishing, traveling and spending time with family and friends sharing outdoor activities.
Q: Can you share a bit about your history and what you saw in Meduit?
A: I graduated with a degree in Accounting from DePaul University and started my career in public accounting, quickly finding my passion for the healthcare industry.
After 20 years in public healthcare accounting and consulting, I targeted developing technology that provides niche solutions in healthcare by solving one problem at a time through a combination of technology, people and processes.
In 2012, I founded F2 Healthcare, where we developed a niche solution that helps providers with Medicare and Medicare Advantage bad debt. We grew F2 to scale regionally, and after nine years, wanted to bring our solutions to more providers faster by partnering with a national leading revenue cycle organization.
That led us to our acquisition by Meduit. Meduit is one of a very small field of players that truly brings national depth and expertise to revenue cycle management (RCM). It’s one thing to offer some level of RCM services to the industry. It’s another to have a 2,000-person bench of expertise, technology, offshore capabilities, artificial intelligence (AI), automation and more to the healthcare arena. As the healthcare industry continues to consolidate, having the ability to bring RCM expertise at scale is a unique position that Meduit occupies. I’m excited that the F2 team is now part of Meduit’s growing story.
Q: If we think about the healthcare revenue cycle as a ship on the ocean that is susceptible to developing holes in the ship’s hull, where are the most likely places for those holes in the revenue cycle to appear?
A: Today’s healthcare revenue cycle is very complex, and I would add in a fragile state.
Lower cash collections, rising A/R and denials and net cost are significant financial holes that really change the landscape quickly.
Patient engagement and satisfaction are also critical. If RCM processes do not yield a great patient experience, providers will see broad and long-term negative results.
Q: How are providers negatively impacted by a dysfunctional revenue cycle?
A: I see three primary buckets:
- Financial – A dysfunctional revenue cycle is going to deteriorate the bottom line, preventing investment in new staff, buildings and technology. Rising A/R, growing denials and reduced recovery rates all lower the net cash coming to the provider.
- People – Employees sense and feel the dysfunction. They are often performing the same tasks multiple times manually and seeing lower yields. This kind of environment and dysfunction will not help attract and retain the best and brightest team members.
- Patients – Clearly, patients are the reason we are all here. Their primary need is getting solutions for the medical condition or challenge they are facing. As with employees, patients also feel the dysfunction if it is there.
Q: Are there signs of a dysfunctional revenue cycle that providers should be aware of?
A: These are things to look out for:
- You are not hitting the numbers you need to thrive
- Cash, A/R and denials have to be level with or beating industry metrics, or you are losing ground daily
- Higher than average job turnover
- A significant number of open positions
- Low employee satisfaction scores
- Low patient satisfaction scores
- Negative industry feedback such as from social media
- Declining numbers relative to same-store types of service lines
Q: For providers with a dysfunctional revenue cycle, is it critical to overhaul the entire revenue cycle, or can those providers simply repair the holes to get back on track financially?
A: Organizations are often overwhelmed when performance is down. Most organizations do not need a complete RCM overhaul. Many of the building blocks for a healthy revenue cycle are almost always there. However, there are very frequently many holes, and it’s important to know where those are and address them. One dysfunctional issue can lead to another, creating a snowball effect.
At Meduit, we cover the entire billing and collection process. Our nearly 2,000-member team focuses on driving healthcare dollars and performance every day across the entire revenue cycle spectrum. With many moving parts, we recognize that it is critical to adapt solutions as needed to solve the unique challenges of any organization.
For example, if insurance A/R is too aged or denials are significant, providers may outsource the entire patient liability resolution area so they can focus on other higher return areas. Most organizations can benefit from an a la carte set of solutions to achieve a healthy revenue cycle.
For those that desire a more managed, outsourced back-end suite, Meduit offers Comprehensive Business Office Outsourcing. This consolidated back-end offering covers bill drop to final self-pay payment and even Medicare bad debt. Typically, we build this solution with a combination of internal resources and external components to solidify the entire RCM process.
Q: What are the top strategies that providers should focus on to ensure a healthy revenue cycle, and how can Meduit help?
A: Target these areas:
- Financial: Develop strategies to achieve industry metrics. This involves making the right investments in people, processes and technology. Meduit works with healthcare organizations to optimize these investments.
- People: Consider outsourcing all or in part and leveraging onshore or offshore outsourcing support. We’ve seen staffing shortages in certain markets, and we are able to provide outsourced services by leaning on people in other offices.
- Technology: Tap solutions that work with essentially all the major patient accounting systems with depth in each. Meduit brings a full division of AI/automation/machine learning resources. Today, we leverage 200+ “machine FTEs” doing automated tasks for providers to drive efficiency, accuracy and cash.
- Processes: Workflows are often under-appreciated. Knowing how to work an insurance denial and having a standard appeal template are big parts of the equation. At Meduit, we offer thousands of those processes.
At the end of the day, Meduit brings national scale and industry leading insights to healthcare providers. We design the best solution to work in partnership with them to achieve a healthy, resilient revenue cycle.