Blog, The Hospital Finance Podcast®

2023 Recap and Looking Ahead to 2024 [PODCAST]

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In this episode, we’re pleased to welcome back BESLER’s President and CEO, Jonathan Besler, to provide us with his thoughts on 2023 and his 2024 outlook.

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Highlights of this episode include:

  • Highlights from 2023
  • Challenges we faced in 2023
  • What Jonathan is excited about for 2024
  • Challenges for the industry in 2024
  • How to best keep up with our ever-changing industry

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back BESLER’s President and CEO, Jonathan Besler. In this episode, Jonathan will provide us with his thoughts on 2023 and his 2024 outlook. Welcome back and thank you for joining us, Jonathan.

Jonathan Besler: Thank you so much for having me back, Kelly.

Kelly: Well, let’s jump in. So, what were some highlights from 2023, not only from a company perspective, but from the industry as well?

Jonathan: Sure. Sure. Absolutely. So, 2023 was, I think, an interesting year. For many of the clients that we work with, and certainly that I’ve spoken to from a C-suite level, a lot of them said that 2023 really felt like a return to, quote-unquote, “normal.” Pre-COVID operations seem to be stabilized, patient volumes. 2022 was kind of a return to that. But by 2023, I think providers really felt like this is what the future might look like and really kind of settling into the new normal, so to speak. Patient volumes in 2023 really returned to pre-COVID level, and in some cases, even outpaced 2019 levels. And so I think the industry saw a high level of stabilization, certainly from a workforce perspective as well, although nursing staff ratios and shortages are still prevalent across the industry, and there are certain areas where workforce just isn’t there. But like I said, I think return to normal, I would say, was one of the biggest highlights of 2023.

Certainly from an industry perspective, there were a lot of things going on across CMS. One big issue was that some major drug companies finally agreed to price negotiations with the US government. There are still some pending lawsuits within that as the drug companies are fighting some of those price negotiations. But it’s a very positive step for the Medicare program overall, and that covers approximately 65 million people. When this is fully implemented, it really could be a considerable savings for the government, as well as taxpayers alike. Final prices aren’t expected to be out until 2024, and most people won’t see benefits until sometime in 2026, but it really is a positive direction for the overall industry. And this was part of the Inflation Reduction Act back in September, and CMS even named the first 10 prescription drugs to go into effect. And again, for the first time, Medicare will really be able to directly haggle with the drug makers over prices over some of those costly medications. So, I think for providers as well as patients, this is a very positive step in the right direction.

And then lastly, from an industry standpoint, we’ve heard a lot about artificial intelligence and machine learning, and certainly the acceleration around that. The use of bots and that terminology has been around for a little while, but it felt like in 2023, there was an embrace of this technology, and really, throughout the healthcare delivery ecosystem. This includes really anything from the front end of drug discovery and predicting outcomes of clinical drug trials, all the way through analyzing medical imagery like MRI scans and using algorithms to spot early warning signs. And again, all the way through the back end of coding and billing. And this isn’t necessarily a new thing for some of the folks that we work with in finance, but using those bots to really help with some of those rote tasks has been maybe not necessarily fully embraced, but again, certainly more normalized. And I think providers have become accustomed to trying to do more with less, and using machines to do that has certainly become much more part of the conversation. We certainly use technology on our side as well to help shorten the delivery cycle of some of our services as well. So, machine learning and AI, I think that’s a big ticket item in 2023 and should continue to grow in the future as well.

Here at BESLER, we did have a lot of what I’ll call milestones in 2023. I’ll start and I’ll certainly pat you on the back here, Kelly. We experienced a number of significant milestones, specifically within our award-winning podcast. And as of the date of this recording, we are set to have over 100,000 listens in this year alone, which is a tremendous milestone for us, and really continues to be a value-add for our customers. We know that what we do and its impact is far-reaching, and we welcome new listeners who tune in weekly. And thank you all for tuning in weekly as well. And Kelly, thank you to you and your team for putting out a wonderful program. BES does a lot of industry education, and we took a big step this year and continue to provide CPE credits for the folks that tune into our education. This year alone, we issued over 4,600 CPE credits to all of our attendees, and we certainly anticipate that growing as well in 2024, as we already have over 20 webinars scheduled for our education calendar.

And just to stay with some of our customer engagement successes, we continue to receive top scores for testimonials and through our relationship with our KLAS scoring system. And the feedback that we get from our clients is really top-notch and helps us continue to deliver what they expect and hopefully exceed their expectations. In terms of some of the innovation that we’ve pushed for here, we continue to strive for better, faster, and moving our services and the industry forward. So, for example, within our reimbursement integrity service line, we took a big step this year to disrupt the industry a bit and became CMS approved for submitting the cost report form set 2552-10, which was a tremendous step for us and a significant technology breakthrough and a regulatory effort on our team’s part. And really, what this means for our clients is that they can complete and submit their 2552-10 cost reports all within the same program. BESLER OMNIA, which is our new cost reporting platform, took a big leap forward this year with that CMS certification. We worked very, very diligently with CMS to meet that strict criteria and make sure that CMS was getting what they needed from our customer base to process those form sets.

And in terms of feedback from our customers, many of our customers have– we’ve received positive feedback from the few that have adopted that program already and have worked that into their processing efforts. Within our revenue integrity service line, we more than doubled our DRG validation recoveries from January through November alone. So that was a significant milestone. And across all of our revenue integrity services, we recovered over $45 million for our customers. And so we know that what we do adds value, and sometimes we lose sight from a day-to-day basis of just what we’re doing because it becomes just the fabric of how we go about our business. But when we take a step back and we look at the tens of millions of dollars that we recovered, not even through the end of the year, but just through November alone, it’s significant. And that builds into the over $3 billion of recoveries that our firm has been able to recover over the lifecycle of our four decades in business. And so, again, we know what we do is important for our customers, and I think it’s a tremendous accolade for our team who works diligent all day, every day to dig for those dollars on behalf of our customers.

Kelly: Well, 2023 certainly was a very exciting and busy year. What were some of the challenges that we faced in 2023? What did you learn?

Jonathan: Yeah, that’s an excellent question, because I think with every opportunity, there’s a challenge that presented itself either directly before or maybe even throughout the process. And so success certainly does not come without challenges. And 2023 continued to put strains on the industry and certainly aspects of our business as well. And not for anyone’s doing or outside of anyone’s control or anything like that. And I’ll just give you one example, which I think is a real– I’ll call it a plague to the industry because it does not seem to be relenting in any way. And that’s data breaches. Not that we experience anything here, but what we see with our customers, and not just through the healthcare industry, although I think the healthcare industry is particularly targeted for the sensitivity of the data, that data breaches continue to be a big challenge for many in the industry as clients face bad actors across, whether they’re foreign or domestic. And there’s opportunistic criminals out there who are intentionally attacking the healthcare delivery system along the way, hoping to grab hold of someone’s data and hold it hostage and look for a payday, which is a real shame because we know that our provider clients in the industry in general is out for helping people. And so it’s a real shame when they’re targeted.

And so that’s a significant challenge that we saw pop up quite a bit in 2023, and unfortunately anticipate that that will be just part of how we have to do business going forward. And so certainly from our standpoint, we take our data very seriously, have become HITRUST-certified, and do take all of the protocol associated with that very seriously, with all of our compliance efforts and our testing and everything that goes into being HITRUST certified. So that’s what I would call a significant challenge, as well as it presents the opportunity candidly for all of us to just step up our game and do better and make sure that patient data is protected. 2023, from a financial standpoint, we also saw a lot of inflation and just the cost of doing business driven up across the board, whether they’re salaries from a provider standpoint, recruiting and retaining excellent staff, which again across the industry seems to be a challenge as well as an opportunity for folks to grow into different roles, sometimes making a move for a better opportunity elsewhere. And so keeping and retaining team members is certainly a challenge in 2023.

If anything that we’ve learned in this, I’ll call it, COVID and slightly post-COVID environment is that we have to– as an industry, and certainly we do at BESLER, is continue to be adaptable. And our team members have really faced these challenges head on. And in the past four decades, granted, we hadn’t seen COVID before, but certainly, we had seen a lot of ups and downs and turmoil and recessions. And candidly, what I have really come to appreciate about our team and just the culture that we’ve created is that we don’t flinch when we’re faced with adversity, whether it’s a client issue or an industry issue or inflation or whatever it is. I like to think that we’ve seen at least some version of it before. And we’ve made significant strides to meet those challenges. Again, adapting with the times, becoming HITRUST-certified, continuing to process our technology forward and making sure that our teams have the right tools at the right time to execute on behalf of our customers. And this really allows us to work with like-minded organizations who really don’t accept the, quote-unquote, “good enough” approach. One of our core values here at BESLER is excellence. And that’s what we strive for, whether it be with a client delivery, keeping data secure, staying on top of industry information, providing that information via education to our customers. We really do try our very hardest to execute on those client commitments.

Kelly: Thank you for sharing those challenges with us. Jonathan, what are you excited about for 2024?

Jonathan: There’s a lot to be excited about for 2024. Obviously, with a new year, new goals, new opportunities. And I think 2024 is going to be a very interesting year for providers, as well as us here at the firm. At BESLER, we’re going to continue our journey to make BESLER OMNIA a comprehensive reimbursement platform. Like I said, we’ve taken some significant steps in 2023, and we’ll continue to grow and deliver on those commitments and promises and really bringing a lot of tools under that single platform. And so I’m really excited about what we’ve been able to build thus far, and thus far the accomplishments have only broadened the horizons of everything else that we can now do and now deliver on, and really focus on growing that to be an even more advantageous tool for our customers as well as our internal team, and using that as a foundation to become a system-wide solution for hospital reimbursement needs. And the future of the product is very, very bright. Client feedback has been very positive, and I can’t wait to continue to roll that out.

Within our revenue integrity service line, we continue to get more and more efficient as we strive to find more missing dollars for our customers. So, I gave you a couple of highlights on the dollar values and the improvement that we had in this year alone. And as our team and our customers continue to work with the technology and process more and more data, our team is constantly adding and refining our rules on a more consistent basis. And so we’re adding efficiency to the process. We’re having more positive finds than false positives. And using that data to really learn and process improve. And again, on our continued journey of excellence, it’s really incumbent upon us to take what we know, bake it into the next cake, and continue to grow and develop in that regard. And so our revenue integrity service line is experiencing a lot of efficiency, and I can’t wait for 2024 as we’re onboarding new customers, as well as new team members as well. Something else that I’m really looking forward to in 2024, and this sort of builds upon what we did in 2023, we onboarded 16 new team members in 2023 alone. And we’ve got a few more starting in the early part of 2024. I’m really looking forward to seeing these new team members grow into their roles within the organization. And it’s always interesting to me to see the evolution of how team members not only join our firm, but then grow within it.

With any new person and any new role, there’s some early excitement…sometimes a little overwhelming as folks are getting used to each other and working with new team members. And really moving from that early excitement into becoming a contributor and leading in their respective disciplines. And so, I love that our team is comprised of true professionals who not only care about what they do, but welcome our new team members when we really do act as a team because we want everyone who’s on the team to succeed. And then what we do for our customers, most importantly, is then take that and cascade it out to our customers. And so they know that we are executing on their behalf. And I can certainly say that, having been on different teams in the past, what I really appreciate about our team is the genuine interest that our team members share about our, I’ll call it, team-first approach. And even though we’ve got our respective responsibilities and disciplines within the organization, our team are really apt to help each other out when needed. And we truly succeed together. And I’m excited to see more of that in 2024 and see these new team members not only embrace that, but succeed in that environment as well.

Kelly: Yes, we really do have an amazing team, and there’s a lot to look forward to in 2024. Please tell us what you think will be some challenges for the industry in 2024.

Jonathan: Well, I would love to end on a positive note. And so challenges maybe aren’t always seen as positives, but I try to look at every challenge and see the opportunity within it. And so I’ll try to blend that as much as possible, and hopefully it’ll make sense and inspire the challenges that everyone sees. And these are just my thoughts alone, and I’m sure many of you out there have your own things that are keeping you up at night and weighing on you. But if I had a crystal ball, I would say that 2024 will continue to be a financially challenging year for many of the hospital industry. And not just within the acute care space, but also subacute, post-acute, all the different modalities. Because candidly, Medicare, I’d like to believe that they’re doing their best to fund the commitments that they’ve made, to keep the program viable and healthy for generations to come. And it’s tough. It’s a tough business to be in, especially when inflation is high, when there’s a lot of financial investments, both from a property, plant, and equipment, as well as technology investments that providers have to make. Candidly, things aren’t getting cheaper out there. And I think not only from an industry standpoint, but certainly from a personal standpoint, folks can certainly appreciate.

And so with costs increasing and more and more enrollees enrolling in the Medicare program each year, the government and then subsequently providers are strapped for resources, not just financially, but I also mentioned workforce resources as well. However, I believe that providers are truly adept at doing more with less. And candidly, it’s just become almost like an industry mantra. Again, Medicare is doing their best to fund. Providers are constantly at odds with their commercial plans. And there has to be a way to make it all work. And I’m very confident that when the industry pulls together and tries to solve collective problems, that there’s enough smart people in the room to figure it out and get it done. Because candidly, as much as folks might like to think that, well, maybe we’re on opposite sides of the table on this particular issue, I think overall, we’re candidly sharing a meal together, and there has to be enough to go around to share in that and make sure that the whole table stays healthy, so to speak, to continue that analogy.

And so I do see that providers will be challenged in 2024, but I think there is a real opportunity for innovators out there who can meet some of those restraints head on with creative solutions and solutions that either increase margin through efficiency, whether it’s AI or bots or revenue recovery ideas, or technology ideas, and candidly just processing data more efficiently and getting paid correctly, on time, accurately, managing denials. I mean, there’s a whole series of opportunities out there and real solutions that I think can help the industry overall.

Kelly: I think you have a great way of looking at it, Jonathan. It’s going to be challenging, but that’s going to be pretty exciting as well. So, do you have any tips for our listeners regarding how they can best keep up with our ever-changing industry? How do you keep up with everything that’s going on?

Jonathan: Well, that’s an excellent point. And I think it is daunting because there is a lot of information out there. And I think sometimes there’s misinformation and people can decide what sources they like best. I’d love to make a plug for the things that we participate in. I mean, certainly, I know that I can vouch for all of the content that we put out, certainly from a podcast perspective, as well as our white papers, the education sessions that we host, both individually as a company, as well as participating in industry groups like state, local HFMA chapters. So, I do think that there’s a number of good sources out there. I’d like to think that you can never have enough information to really make the best decision and come to certain conclusions. But to your point, it could become overwhelming with all the information out there. So I guess my tip without plugging too many other industry groups, I would say, find four or maybe six sources that really speak to you within your, not only subset of the industry, but also your respective roles. And so a lot of the organizations have CFO-directed information, or they might have a patient accounting directed team. And plug into those. Use the industry as best as you can.

I know a lot of the local chapters try to get people together, either monthly calls or quarterly calls, to just share ideas. And then find some trusted resources, some friends in the industry as well. They might not work at your particular facility, but maybe you worked with them in the past and really trust their perspective. And so I do think that this industry has a tremendous propensity to share information and really share it freely, which is something that I really enjoy about the healthcare industry. In general, it seems like everyone wants the tide to come in so all boats rise. And so find those people. Hold onto them. Share information with them as much as ask them for information as well. I think there’s a lot of people out there that are willing to help, and I can certainly attest to the folks on our team who field a lot of calls and answer a lot of questions, and we’re certainly happy to do it.

Kelly: Well, thank you for those great tips. And thank you so much for joining us, Jonathan, and for sharing your insights from 2023 and your 2024 outlook.

Jonathan: Thank you very much, Kelly. I really enjoyed it. I appreciate it. And I’m looking forward to a wonderful 2024.

Kelly: Fabulous. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of the Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.


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