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The Power of Effective Intelligence in Addressing Revenue Cycle Challenges & Staffing Shortages [PODCAST]

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The Hospital Finance Podcast

In this episode, we welcome Matt Seefeld, Executive Vice President of MedEvolve, to talk about the power of effective intelligence and addressing revenue cycle challenges and staffing shortages. 

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Highlights of this episode include:

  • Revenue cycle challenges due to staffing shortages
  • Is healthcare recession-proof?
  • What can help practices work more efficiently
  • Additional insights

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. . We’re pleased to welcome Matt Seefeld, executive vice president of MedEvolve. Matt brings 20 years of management consulting experience in the healthcare industry. He has extensive experience in the assessment, design, and implementation of process improvement programs and technology development across the entire revenue cycle. Matt began his career with Stockamp & Associates and worked for both PricewaterhouseCoopers and Deloitte Consulting in their healthcare and life sciences practice lines. In 2007, he developed a business intelligence solution and founded Interpoint Partners, LLC, where he served as chairman and chief executive officer. In 2011, he sold his business to Streamline Health Solutions, where he then served as chief strategist of revenue cycle followed by senior vice president of solutions strategy until 2014. Recently, Matt ran global sales for NantHealth and provided consulting services for healthcare technology and service businesses nationwide, prior to joining MedEvolve full-time in January. He completed his undergraduate studies at the University of California-San Diego. He’s here today to talk about the power of effective intelligence and addressing revenue cycle challenges and staffing shortages. Thank you for joining us, Matt.

Matt Seefeld: Oh, thanks, Kelly. Every time I hear somebody read the intro, I realize I have to cut out a lot of that stuff. [laughter]

Kelly: No, you have a very extensive background. That’s a great thing. So, we’re just going to go ahead and get to it today. Staffing shortages have been impacting a lot of industries, but what are the unique revenue cycle challenges physician practices face due to staffing shortages?

Matt: Yeah, staffing. First of all, having been a part of revenue cycle for 22 years, I’ve seen, obviously– I always say I’ve seen everything, but I haven’t seen probably everything. But as it relates to the labor side that is actually responsible for going out and getting you paid for the service you delivered, that’s been under pressure. It’s been under pressure for years, but COVID brought a whole different type of pressure. One, we ended up having to virtualize, right, so we had to send people home, or at least have a pretty deep hybrid in-office and at-home model. That’s also translated into recruiting. So, if you have three job opportunities they’ll send you home, but, yeah, health system A is trying to get you to come into an office, which one will you go for, right?

And so lifestyle has changed over the last three years, too. Costs have gone up, right? If you look at inflation, obviously, higher wages now. People in our revenue cycle department, where somebody was making 16, 17 dollars an hour is now asking for 21 because they can get that at those three other job opportunities. So, you have all these macro things going on that are driving cost and efficiency in what’s already a challenge in world of revenue cycle in North American healthcare. So, what do we do about it, right? The most important thing that I tell clients is, “You’ve got to focus on how you can identify effectiveness in your labor pool.” And it’s different than production, right? I can be highly productive and not effective, but when it comes to revenue cycle, I need to really look at the effectiveness. And the challenge we run into is that the practice management in the EMR companies can’t get you there. If you’d asked me 20 years ago would they get you there, I would say, “Of course, they would.” Now I’m absolutely certain that those companies, every single one of them, is never going to capture the data necessary in a structured format that tells you labor effectiveness. And why do I bring that up? Because if you can’t understand who’s effective, then you don’t even know how many people you need. I have so many organizations that think they have 5, 10 vacancies, but in reality, they actually could reduce 5 FTEs if they have the right technology in place. And so, yeah, that’s a really, really big component of this. Why look for people you don’t need? And for the people that you do have, that you’re paying good money to now, higher money than you were two years ago, are they effective, and are you getting the financial return you expect which drives margin, obviously, for the business, regardless of what type of provider organization you are?

The one other thing that I’ll just say on this topic, too, is that the cost of training, the cost of recruiting, the opportunity cost of having some of your seasoned revenue cycle professionals train the new employees, it’s really, really, really expensive to do, right? Right now, I’m getting the sense that people are looking for jobs, not careers, which is very scary in revenue cycle because whether it’s a call center, it’s an insurance biller, it’s pre-registration staff, it’s clinic front office, whatever it is, if you have high turnover, that’s going to cause a whole lot of stress, especially if you’re in a smaller organization. And so we’re feeling the pressure. That’s why a lot of organizations are outsourcing their revenue cycles now because they just can’t deal with the headache anymore of trying to find people, keep people, retain people, train people. And so that’s been a big theme that I’ve seen specifically over the last 18 months.

Kelly: That’s some great information. Thank you very much, Matt. How do you anticipate the looming recession will further impact practices, and do you think healthcare is recession-proof?

Matt: That’s a great question. Well, first of all, I mean, the inflation looks like it settled down a little bit, so maybe we’re not headed to a recession. But all jokes aside, yes, I mean, the economy is making a turn. I do think it’s going to have a dramatic impact on healthcare. Do I think healthcare is recession-proof? It’s recession-proof in that we will still consume healthcare as individuals in society. The problem is we may not pay for it, right? And so when I think about the biggest risk points for, especially, health systems that have emergency rooms or urgent care centers, is that people will continue to consume, but are they able to pay, right? And we’ve seen that over the years, right? I mean, years ago it didn’t matter because only, say, 5% of provider income came from the patient, but now I’ve seen stats as high as 50-60%. I mean, I personally have a very high deductible plan, which I haven’t even met. So, every time I or my wife or my children go to the doctor, yeah, I’m out of pocket. And so, you think about what does in a recession. When people are going to pay for food, they’re going to pay for utilities, they’re going to pay for $7 a gallon gas, healthcare is going to be the last bill, right? It’s going to be the last bill that gets paid. So, it’s very, very scary if you’re a health system, hospital, or critical access all the way up to the academic medical centers.

On the independent physician side, there’s also concerns, right? What I’ve learned over the last five years working here at MedEvolve, where we primarily work with independent physician groups, surgical specialties, larger ones, is that they’re not good at asking for money from the consumer. They’re just not. The amount of money that I see coming through these revenue cycles for patients who already owe balances, but you still see them again, it’s astronomical. It’s millions and millions of dollars. And so for the independent physician groups, you have to estimate the liability that you need to collect for the service you’re about to render. But more importantly, you got to collect what’s already owed before you schedule that patient. And so the reason I’m focusing on the patient side is the high deductible plans matched with a recession where people are going to be very careful on what they spend their money on–it could be the start of a serious perfect storm for healthcare. So, I do see that. I also see one other thing I want to bring up, and this goes back to what I talked about earlier around effectiveness, whereas right now, it’s hard to find people, in a recession, you’re going to have too many job applicants. So, the question is, how can you quickly assess who is effective once you hire them and who is not? You can’t afford to hire ineffective people, right? And so that’s another area that comes back to how do I measure that? You got to measure it with structured data that’s not going to come from your PM and your EMR, so you got to look at workflow automation technology that actually can deliver that to you.

Kelly: You make some really good points, Matt. Thank you. What are some strategies physician practices can use to work more effectively with the staff and resources they have? And then, how does data insights and effective intelligence help practices work more efficiently?

Matt: So, I think the biggest thing that I’ve seen over my 22 years in this industry is this misnomer that people, process, and technology are independent of each other. I often go to trade shows where vendors have great technology. They’re promising big results. But the provider organization doesn’t understand that they will likely have to make material changes to adopt that technology to get the results that are being promised. So that’s the first thing that I would tell any of the listeners out there, is that you got to understand who’s doing what and how is it being done and what technology do you already have and is it even being maximized, right? That’s a big, big gap in this industry, and that’s why consultants continue to make all the money, right? I mean, think about the amount of billions of dollars– actually, trillions of dollars a year that gets spent on consultants to come in and do that for these organizations. So that’s something that I would definitely caution.

Now, where effective intelligence comes in – this is a theme that we created here at MedEvolve recently – is that I’ve watched data analytics mature over 20+ years, and it kind of went from big data to business intelligence to dashboards to X, Y, and Z, all these different things, but there’s two components that have always been missing. One is that you have to know what you need to be looking at that’s going to drive the financial performance and the outcome you expect, right? That’s not easy to know, right, so you can’t just have open source analytics that just says, “Hey, I wonder what I want to look at today.” No. You need to have templates that are already built that says, “I either have a problem or I don’t.” And you need to be able to assess whether you have a problem or you don’t in a minute or two over a cup of coffee every morning. I mean, that is where we are today. I mean, we are a highly dynamic workforce. We have to be operating like every other industry out there, okay?

Now, where effectiveness comes in is effective intelligence. I can be intelligent, but not effective with it. And what I mean by that is, am I actually doing anything with the intelligence that I have? Am I doing the right things? Am I re-looking at people, process, technology, okay? So, we create these things called EIQs, which is effective intelligence quotients, which is taking a lot of rich, structured data. And it’s from practice management systems, from other systems, and, most importantly, from our workflow automation system, and we’re bringing that all together to start telling storylines around where humans are having to get involved. So, the thing in revenue cycle is that right now everybody’s talking about robotic processing automation. They’re talking about AI. They talk about machine learning. They talk about all these cool buzzwords that sound good as hashtags on LinkedIn, but here’s the problem with that, is that these organizations don’t actually know with certainty where and why humans are having to get involved with the claim lifecycle, right? If a claim goes out clean, and not a single human was required to get it paid, that’s a good thing, but I have not seen an organization that we work with that’s better than 60% on that. So, for the 40% or more where humans are having to get involved, you got to have what we call them is these EIQs to tell you where in the revenue cycle are humans getting involved. Then you can ask the question, “What do I do about it?” And potentially, RPA could solve for it. Potentially, AI could solve for it, right? Potentially, just a change to process could solve for it. So, you see what I’m getting at, is that there’s a very consultative approach has to now be taken. It’s always needed to be taken, by the way, over 20 years, but what COVID has brought is a much more urgency because of all the macro things going on in this economy. And the fact that we’ve got all these things that are putting pressures on profit margin, which includes declining insurance reimbursement and, obviously, more dependence on the patient reimbursement, all these macro things are impacting your profit margin. So, you’ve got to figure out what you control. And you control the labor cost if you do it right, but you got to have the insights to do it right, and that’s where effective intelligence comes in.

Kelly: That sounds great. Great insights. Thank you. Is there anything else you want to add to today’s conversation, Matt?

Matt: Yeah. Probably just a couple of things. I did a couple of recent videos on these topics. One is to talk about really price shopping. One of the things that I’ve noticed over many, many, many years, and even now, which is a bit crazy to me, is how many organizations go straight to, “What is this going to cost me?” before they really understand the return on investment and the changes that they would need to make to get that return on investment. I use the analogy of my jeans. I bought a really, really nice pair of jeans about 10 years ago. I spent way more money than I ever thought I would pay on jeans. But guess what? I still have them. They fit great, and they look practically new. I used to be the guy – and I won’t name the vendor – that would go and buy the cheap jeans, and every six months, I would replace the cheap jeans. So over 10 years, how many pairs of cheap jeans did I buy? And by the way, they never probably looked good, but nobody told me about it.

So the bottom line that I’m trying to get at, because I have a forum for this, is that when you’re out looking for software or services– or technology-enabled services, whatever, and you’d say that your objective is to drive profit margin for your organization, which is reducing labor costs and improving your net collection rate, don’t start with price, because at the end of the day, if you get the right vendor, and you’re willing to make the right changes to your organization to align with that vendor, technology, or service, you’re going to get far more out of it than you would just going with the cheapest option. So that’s one thing I just wanted to get out there because I do think it’s a lot of mistakes, and I see too many clients that bring on tech, then they uninstall tech, then they put another tech in, and all the IT resources, it’s all cost, when in reality they really should have gone with the right vendor out of the gate.

Kelly: Completely agree. Thank you so much. And we really appreciate you coming on today, Matt. If people want to get in touch with you, how can they do that?

Matt: Yeah. Absolutely. I love talking about these things. You can certainly hit me up on LinkedIn, Matt Seefeld, so I’m on there. That’s probably the best way to reach me and then go from there. If you guys want more information on MedEvolve, has got great resources as well. A lot of thought leadership, provocative ideas for your organizations that are listening to consider, to improving margin, improving revenue cycle, and also put up some defenses against this economy that we’re in and where it may go.

Kelly: Fantastic. Thank you so much for joining us today, Matt.

Matt: Thank you. Appreciate it.

Kelly: We appreciate you all 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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