Introduction to Healthcare IT Today
Hey, everyone. I'm John Lin, the founder and chief editor at Healthcare IT Today. We're excited to bring you another in our series of interviews with top leaders in health IT. We're here at the HFMA annual conference, and we have three incredible guests.
We have Jeff Becker. He's vice president of portfolio marketing at FinThrive. Then Kim Waters. He's principal advisory services at Ceercore. And Mike Vigo. He is the chief revenue officer at UC San Diego Health. Welcome.
Thanks.
Thank you for having me.
Yeah. Excited for today's discussion. It's kind of an extension of one that, Jeff, you know, you and I started last year. I think it was here at HFA.
Chapter
Understanding RCM Technology Adoption Model
But tell us, you know, what's the revenue management technology adoption model? I guess it's called RCM TAM is kind of the abbreviation now. And how has it evolved since we last talked?
Yeah. Sure. So RCM TAM, revenue cycle management technology at Option Ma, we're just coming up on our one year anniversary since launching. We launched actually last year at HFMA annual, and so it's been a busy year. We started with a dataset of about thirty thousand unique data points on revenue cycle technology utilization and resulting financial performance.
We've since brought that out to, many additional organizations. So, essentially, what revenue cycle management technology adoption model does or RCMTAM is it allows any organization to come use the model to benchmark their current technology tech stack for Redcycle and then correlate that to financial performance so that they can calibrate, if the technology that they have in place today is delivering the results that it should be delivering, and then also it helps them starts to quantify the business case for modernization within rev cycle. So, we've worked with a number of health systems to bring this model out into production and start actually driving implementation of new technologies and optimization of technologies that are in place today.
Another kinda big piece that was added throughout the years that we partnered with HFMA itself to amplify the opportunity to leverage our Centimeters. It's a free, benchmarking framework, so that lives on HFMA's website. Now there's an HFMA community space where people that are interested can go and learn more.
So it's been a busy year. We're excited about what we've got in store for the rest of twenty twenty four and twenty twenty five, but so far, we're off to the race tracks.
Chapter
Strategic Partnership Insights
That's awesome. I think the other interesting part about RCM, Tim, is you just announced a partnership with c Cercor, which, you know, like, why is Cercor in front of time to get there? I think that's what everyone will be asking as they watch this video. Maybe, Jeff, you could start and then Kim chime in. Tell us about this strategic partnership between FinThrive and Ceercore.
Yeah. So I think from FinThrive standpoint, we see RCMTAM as an open source vendor agnostic model for helping health system financial leaders plan their path forward. It's consensus driven. It's based on the perspectives of revenue cycle leaders.
And so we we want any organization to use that to improve the overall, financial viability of our health systems. And so Cericore is very well aligned with that mission. They were interested in using it. They're also aligned with bringing that to market for free and taking the insights that are derived from a benchmarking study like that and then really staying with the customer and helping them execute on that modernization road map.
So we thought that was a really compelling, nice, collaboration that we could bring to the market together.
Nice. Kim, what's your perspective?
Yeah. We were very aligned culturally, I think, as well. Got to watch you guys go into action during, you know, big crisis mode, right, and what you do for the community and and how we serve clients together. So we're very aligned in how we approach clients, but also to Jeff's point, like, how we work with clients to optimize their solutions. So select, implement, and optimize solutions. We can take a holistic approach. Our same TAMs gives us a great benchmark and framework to do that, and, hopefully, we can help get that out to the market faster, gain adoption.
Chapter
Real-World Applications of RCMTAM
Nice. And, Mike, obviously, you're here as a a user, a customer that's that's impacted by this framework and could leverage this framework. So talk to us. Are there some specific examples of how the RCM TAM tool has improved efficiency and financial outcomes at UC San Diego Health?
There were two big areas that immediately were impacted by using the RCMTAM tool. Our our point of service, upfront our patient access team. I think we thought we were a little bit further ahead and doing better than we were. And to be clear, we were doing good, but I think UC San Diego has a gist of a minus is not good enough. We always wanna do better.
Something that we share as a a leadership group and a management team. So we saw some opportunities at point of service and patient access initiatives upfront, which I think brought reality to our perception. And there was a little bit of a gap there. So the tool was invaluable in showing that.
The other part was just some simple AR management. Things that, you know, as crazy as health care can be and payer issues, denials, staffing, everything we're going through with COVID coming back down. We really needed to level set, make sure we had our infrastructure in place. And the tool allowed us to see where those opportunities were, how we could better manage our AR and some of the pockets we could attack more strategically.
So the tool was instrumental, especially because I was joining UC San Diego, and I was trying to level set and understand where we're at.
So the tool brought a lot of benefits to our bottom line, but also helped bring us together in terms of what we thought our teams are doing, how we ended up actually, performing, and and the tool brought that visibility so we could get even better.
Interesting. Is that how you're approaching it, Kim, is kind of using as a tool to level set or benchmark them against the industry? And what other benefits are you seeing from RCMTAM?
Yeah. I think, oftentimes, people are like, oh, we're fine. Right? We're doing we're doing fine. We're doing great. We're on top of that.
But it's an objective analysis. Right? Somebody not not just third party, but, again, being benchmarked against your peers. So how can we really make sure that you are fine? Right? And not just fine to your point, but better than fine.
And I think it's it's an exciting thing when you can look beginning to end. Right? It it's an end to end look, that doesn't just touch your revenue cycle team. It touches, you know, on on some of the clinical aspects as well and how you're using some of that technology to do even, you know, charge capture and things like that all the way through contract management. And so it really is a complete look at your entire system. We take a look at process and people alongside our CMTM, which I think is one of the things we're excited about is technology is great. And but if you if your people aren't prepared, if your processes aren't considered, then it'll fail.
So Interesting.
Yeah. And Jeff is it seems like this tool could also be used not only to see places you could improve, but places you're doing really well. I mean, is that what you're seeing as well when you work with people?
Chapter
Team Alignment and Collaboration
Yeah. It is.
And I think that to Mike's point earlier, some of the, non obvious value that comes from running an RCMTAM is you get to identify the areas you're doing well, you get to identify the areas where there are gaps in your technology infrastructure, but that creates alignment across your full team. You really start you all sit down together for your readout. So, all of the departmental leaders are there, and they really starts to have more of an appreciation for the operational environment of their peers, what they're working against, what they are operating without. And so it does create a sense of camaraderie and team alignment around shared goals.
Interesting. So, So, Mike, as you're going through this tool, you're identifying some areas of weaknesses. Right? You know, which I think is probably good because it creates this alignment. But whether you know, what what are some of the key challenges that you encountered during this, I don't know, revenue cycle transformation, if you will, for this? And and how did you, your team, overcome them?
So the challenges for, myself and my team are not some of your traditional challenges. Like data gathering was not an issue.
Okay.
We knew how important it was. We made the time to have the interviews, the discussions, the q and a, kinda to go through the learnings.
What I think was the biggest challenge was me being a new leader coming in, trying to get, an assessment of where we're at. Once again, mention trying to get perception reality. But at the same time, I'm trying to do that with a team that I'm still trying to build relationships with. And and I don't want to, put them in the defenses.
I want them to be engaged. Right? And so we were building our relationships as a leadership team, which is great. And this tool, but I was worried at and the challenge of it was trying to get them to come in and be open minded.
Really tell me what's going on. Really give upfront, realistic answers to what's happening. And the team did that. They stepped up in a big way.
So we were able to get the raw kinda unfiltered view of how we were doing where we're at and a lot of positive, surprises, a few moments. I think the biggest success to me, and I'm gonna sound a bit like a parent. It's not it wasn't that we needed to be winning in all the categories or we needed to, you know, immediately hit all the opportunities. But and I told this to Jeff as well.
There was a moment where we were going over the findings as a leadership team, and I was kinda guiding the conversation.
And then I was gonna speak up and say something, and one of my data leaders jumped in and said something. And then before I could respond to that, my PFS leader jumped in and said something. And it took a moment where I really felt like I I was doing a good job leading the team where the collaboration began, and then these pockets, SWAT conversations started happening. And let's talk on that.
And I have a resource I can help here. And I'm like, wow. This is really building a collaborative group in a way that I did not see. So to me, that was successful.
I don't need to be a part of it. They saw it. They adopted it. They engaged in it.
And then they started to take their own action plans and move forward just reporting back to me what was happening. So the tool not only helped us operationally, but I think it brought us together and enhanced the culture that we already had in our communication as a leadership team. So that was a big success that I did not anticipate.
Yeah. Very interesting.
Chapter
Leveraging RCMTAM for Client Success
Kim, how how else is Cercor gonna use this with your clients? Is it gonna be similar to kind of what he's doing? Obviously, he was new, so it's a little different situation maybe. Or and talk to us more about that people process and technology approach and how you're gonna leverage the tool with that.
Sure. Yeah. I think going into align strategy. Right? But align your technology, your people, your process with your strategy is important to love that that was your experience with your team because oh, too often it's just quiet.
Right? You can hear a pin drop in those meetings, but, I love I love that they got engaged. So I think, you know, that's how I envisioned using this lead of going out with our our team. Like, we we definitely do all of the core platform optimization work, but taking a really holistic approach to, you know, alright.
You wanna talk AI? Let's talk AI. But if we put bad processes or bad data into those issues, we're gonna have problems. Right?
So how do we use technology, align processes? And then do you have the right people in place and right people, right seats, right, to actually make this thing successful?
And so I'm excited to have similar experiences that your team had with with several across the country.
Mike, any advice you'd give to other health care IT leaders that are looking to, you know, effectively you know, you talked to evaluate, select, implement these new technology solutions for our Centimeters and and maybe other operation needs as well.
Chapter
Advice for Healthcare IT Leaders
Oh, I have a lot of things I'd like to offer as advice because I know we're always looking for, new ideas or thoughts or support to help us with the myriad of issues we have. But I will say two things. One, need to be honest.
Trying to hide the issue or to not really bring it out into the light is key. So bring your data, bring the the team, answer the questions. So, I mean, you really gotta just be honest with yourself and your teams. If you really wanna get the best results and truly see what's happening in your operation.
And then the other part is make sure that you have the right conversations with your leaders because it's gotta be something you do in concert, not a dictative order that you give out.
The those were the two big big piece of advice I give to people going into it. The other part is that it's very rare in the industry where you really do have this tool that can give you this transparency, and there's no strings attached. It's not a gotcha. It really is there to help support.
And from there, you can make informed decisions and take the next step. I I do wanna say one of the thing that I learned that I also wanna give advice for was when I was talking about my perception that also changed my strategy. So if my area was doing well, but I was seeing costs in this area, we're having staffing issues, whatever the topic was, we immediately agreed and had a mid fiscal year strategy session, and we realigned our road map, our resource scheduling, and timing so that because we thought the fires were bigger in some areas than they actually were. So it it allowed us to pivot and move back.
So my advice would be use this tool, get your assessment in, and take a moment, pause, and look at what your priorities are. Maybe use that opportunity to shift them around and reschedule. Interesting.
And to that point, like, we're this isn't a onetime thing. Right? I think this is something we see being done on an annual basis. Where are you?
What have you where your wins, like, were you still having gaps, and, you know, how can you get there? And I love that there's just, like, a strategy on a page. Yep. Right?
There's a a really clear vision, not just for your team, but for leadership, for your boards, like, whatever you're needing to do. You can really go tell your story and make your case, especially during budget time. Right.
It's just it's another good point.
It's actually a very it doesn't take a lot of explaining to people that are not in revenue cycle. Right. You can very cleanly explain where, the benchmark is where you're at. And then after having discussions, the steps that are needed to get there, which translates very quickly to whether it's budget, finance, your clinical departments you need engagement from.
That was another huge benefit that kind of level set, so it's translatable. A lot of times revenue cycle does not translate across. People think they get it. They just bill it.
That's all I signed up bill it and you can't bill it. So, this helped the level set for the organization, made our budget to schedule as much easier.
I was gonna say, it's interesting. I would have thought it for budget, but for clinical alignment too, that's, that's an interesting way to use it.
Yep.
Yeah. Jeff, I think AI is the topic does your health care, especially health care technology.
Chapter
Future of RCM Technology and AI Integration
How do you keep this framework up with everything that's happening with AI and these evolving technologies? Does it stay up with it, or how are you approaching kind of that?
Yeah. Well, that's the sixty four thousand dollar question is how often do you update in an adoption model? We have examples from our industry where adoption models were introduced and then never touched again, and the industry took to those incrementally to drive sort of systemic improvement. The HIMS MRAM is the the big example.
We've had a lot of follow on discussions with the organizations that are using RCMTAM, and it really centers on two things. One is how often do you want to re benchmark your organization, and then two, how often do you want us to recut the results and publish a new framework? The beauty of our SIM TAM is that the more organizations that take it, the larger that data model itself becomes, and so we have we create opportunities to uncover new areas that maybe weren't seen as mission critical two years ago, but they've evolved and they're just delivering much more value now. And we would say that that's our responsibility to carry that story out into the market.
So, we're still having conversations. We're thinking every year, we'll update that model maybe every execute on a modernization road map that you set for yourselves. But there is pushback for or there's feedback from the industry to republish, reanalyze, and republish quickly so that those new technology areas do bubble up to the surface, and they can prioritize their next year's road map based on what that might look like rather than prior year's data.
Interesting. And, Kim, how do you think these benchmark frameworks like RCM TAM are are gonna influence trends in RCM technology adoption or even just in continuous improvement in general?
Yeah. I I think, nobody wants to be the first, but nobody wants to be the last for sure. Right? So, all all the early adopters, like, kudos to you for jumping in.
But I think at at some point, this is just gonna be the standard. Right? I think your your your boards and your leadership are gonna be asking, hey. Where where do we stand?
What stage are we in? Right? And it's gonna be your job as a leader of a health system to know what stage you're in, just like, you know, just like the the other models previously. So I think it's gonna become it's gonna become the standard.
Yeah. Interesting.
Chapter
Future Directions for RCM Frameworks
Jeff, as we close out, where do you see this going? What's next for it? How do you see the framework evolving?
So there's some things we can't do that we wanna do, and I think that that's where we will go. So as I said, the more organizations that go through the RCM TAM assessment, the bigger that the underlying dataset gets. So with more data, we can start to segment and we can start to benchmark against peer groups. Organizations can really start to see how what they look like as compared to another other Epic shops or other Meditech shops or other Oracle shops or they can start to see what they look like as compared to other safety net hospitals or critical access hospitals. So there's a lot of interesting second layer segmentation that we want to be able to do. And as the data model continues to grow, we're gonna start bringing those kinds of that kind of analysis out as part of the readout.
Chapter
Exploring Technology Utilization and Financial Performance
The other areas that I think are interesting today, we benchmark your technology utilization and your financial performance.