Blog, The Hospital Finance Podcast®

Revenue cycle employee engagement during mergers [PODCAST]

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The Hospital Finance Podcast

In this episode, we are joined by Jennifer Collier, Vice President of Revenue Cycle for CHRISTUS Trinity Mother Frances Health System, to discuss some best practices for maintaining employee engagement during mergers.       

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Highlights of this episode include:

  • What are some common assumptions made by hospital leaders during merger and acquisition transitions?
  • Some best practices for communicating with employees during mergers and acquisitions.
  • What should providers consider when thinking about how to reduce turnover?
  • Why culture is so important and why providers should address cultural considerations.
  • And more…

Mike Passanante: Hi, this is Mike Passanante and welcome back to the award-winning Hospital Finance Podcast®. When health care providers join forces through a merger, acquisition or consolidation, there’s the potential to unleash enormous value. However, the dynamics of rapid change in these circumstances can cause employees to feel uneasy and uncertain if not managed carefully. To share with us some best practices for maintaining employee engagement during these situations, I’m joined by Jennifer Collier, Vice President of Revenue Cycle for CHRISTUS Trinity Mother Frances Health System. Jennifer, welcome to the show.

Jennifer: Thank you. I’m glad to be here.

Mike: So, Jennifer, you’ve spoken about these issues in the past, so let’s start off. Why don’t you start by telling us about the assumptions that leaders make during periods of rapid transition after a transaction?

Jennifer: Sure. So anytime you’re talking about a merger, consolidation, acquisition, you always have to remember that there’s two sides. There could be a larger organization acquiring a smaller one. There could be two organizations of the same size merger. You could have an outsourcing going on. And with that, I’ve experienced all those different scenarios, and there seems to be some common assumptions that happen in those scenarios. And so one of those things is don’t make assumptions about the other organization’s revenue cycle. This goes both ways. Sometimes the larger organization coming in assumes they know how to do it better than the smaller organization. Sometimes the smaller organization thinks standardizing means that that’s not going to be as good as maybe the way they feel they handle it internally. But at the same time, you can’t assume that your organization’s way is the only way to do it. So you have to be really open-minded in going into it. And you have to be prepared that the merger or the acquisition that you’re involved in right then may not be exactly the same as when you’ve been in it before. Sometimes senior leadership, based on the organization, the needs, what they find out with current metrics, it may be different than ones before. So sometimes organizations will come in and just assume they’re going to cookie-cutter something, and that may not be the case. And then the other thing is, particularly when you’re on the side of you’re being acquired, or you’re being purchased, or you’re being transitioned, don’t assume it’s going to be a negative thing. Going in with that open mind. And then on the other side and you’re the one coming in, don’t assume that people won’t be on board with the change. Sometimes they think, “Oh, well, they’re with the other organization. They’re never going to get on board with us or be committed to us.” And that’s just not always the case.

Mike: And communications are so important when you’re going through transition, really any transition, but particularly many of these large transitions when hospitals get together. So what are some of the things you should and shouldn’t do when you’re communicating with employees during that time?

Jennifer: So communication is key. And so many people think, “Oh, it’s easy. I’ll send out this memo. I’ll send out this announcement.” Of course, we’re going to communicate, but communication is so much more than just the formal organization announcements. And so the number one thing is to be sure that you are honest with your communications. If you don’t know the information or can’t share it yet, don’t try to make something up to appease the crowd. I mean, you want to be honest that that is not defined yet, that that is coming. You don’t want to make promises that you can’t keep. And you don’t want to blame the C-suite or them, the other organization; you want everybody to be cohesive and communicating together. And with that comes– you want to be open to suggestions on both sides for a smooth transition back to that not making assumptions. A lot of times frontline staff have some great ideas, and they can help you with the two-way communication that you have going on. If you promise to follow up on a question, then follow up. One of the worst things you can do is have the staff ask a question that maybe you think is trivial, but it’s really important to them, and you tell them you’ll get back to them, and then you don’t. And then try to set deadlines. Try to set expectations of, “We expect to have this information in six months or nine months or a year.” But be sure that you’re not over-promising those deadlines. Don’t commit to deadlines if they’re not solid yet. It’s better to give a further out date and then have the information sooner rather than commit to a time frame, and then it go past that several months.

Mike: Absolutely. And when you think about transactions between systems, turnover is always a big risk factor during those times. What should providers consider when thinking about how to reduce turnover?

Jennifer: So the first thing to do to prevent turnover is, of course, the open and honest communication we just talked about. But there are also creative ideas you can get into. A lot of times, when people think about retention plans with bonuses, they think only at the executive level, they think at the higher level, but I’ve actually seen this executed down to a staff-level really effectively. When you’re looking at if you’re going to have legacy run out AR, if you’re looking at having to onboard a new system, or you have a core group of staff that you know you want to keep them on board because they’re high performers, giving them– and it doesn’t have to be large, but giving some incentive for staying six months post-transfer or acquisition, one year past acquisition. It really relieves the burden off of them of having to sit there and think, “Do I have job security? Should I consider looking somewhere else? Are the things they’re telling me is true.” And it really allows them to just focus on their job. That’s what I saw with people when we did that. It was a monetary bonus that, frankly, it wasn’t a huge amount that would keep them from necessarily taking another job, but it really just gave them the relief that, “Hey, they do want me here. I am here, and I don’t have to think about this. I’m committed for the next X amount of time.” And it can be really good to give your staff that time to acclimate to the new culture, to acclimate to the new processes, that they’re not constantly questioning if they’re going somewhere else because they’ve committed to your retention plan, and they want that bonus.

Mike: You just mentioned culture, and office culture’s one of those items that doesn’t always make the top of the list of transition issues when you’re thinking of the things that you need to check off to make the operation successful, but it is really important. Jennifer, why is culture so important to pay attention to and what can providers do to ensure that they address cultural considerations?

Jennifer: Culture is significantly important. And I do see this happen where you have two organizations with strong cultures, and they’re merging, or one is being acquired. And a lot of times what can happen is the incoming organization wants to just impose their culture directly onto the other organization. And there are some things you have to do with branding and some policy and procedure alignment and things like that, but there are things down to the staff-level that staff are very passionate about. And these are things that often don’t seem necessarily important to the executives. They’re worried about the high-level things of the organization and the finances and the strategic planning, but the staff down on the frontline, they’re worried about things like holiday celebrations they get to do and how they recognize employees and when they get to decorate the office, and do they get to wear jeans or not? I mean, these are all things that are very important to them. And so one of the things you want to do is have a transition plan for some of those things. What things will they be allowed to keep? What things will align with the other organization? How do those line up? If you’re taking away a benefit, what benefit are you giving in return? And then the main thing is don’t just come in and tell them this is your culture; you want to come in and show them. So if you come in and say you have this open communication culture, and you’re full of energy, and you guys are going to have fun, and you believe in empowering all the employees, you have to come in and do that. You can’t just come in and say it; you have to actually demonstrate it in your actions too and give consideration to some of the celebrations that might be unique to their community. Some communities have a local celebration whether it’s a big county fair or a big fiesta parade or whatever it is that might be going on that might impact that office differently than one of your offices in another state or another location. And so while you want to standardize as much as possible, you also want to recognize kind of the some of those big regional things that could be really important to your employees.

Mike: Great insights. Thank you for stopping by the show and sharing them with us today, Jennifer,

Jennifer: No problem. Glad to be here.

The Hospital Finance Podcast

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