Denver Health’s approach to RCM Technology Adoption

Hello. This is Jonathan Wick, Vice President of Health Insights at FinThrive, and I'm joined today by Jake Collins, the Associate CFO of Revenue Cycle at Denver Health, which is right down the street from my place of residence here in sunny but cold Parker. We're gonna be out together here in about two weeks right before turkey day at the Becker's CFO CEO Executive Roundtable, and we're gonna be talking then. But we figured we'd give you guys a sneak preview here of some of the questions. Welcome, Jake.

Glad to be here. Cool. Do you want to give us a little background about yourself and Denver Health? And then we'll dive into some of these questions. Yeah. Denver Health is a large level one trauma center epic facility, roughly 525 beds, multiple specialties, physician practices, FQHCs, all over the Denver metro area.

My responsibility there is for the revenue cycle-related components, which is what we're probably gonna talk about today. Cool. Awesome. Well, we'll dive into the questions here.

We did something called a Revenue Cycle Management Technology Adoption Model with your organization. And just for the benefits of those not familiar with it or where we're at, we based it here at FinThrive on something called an MRAM, believe it or not, which was something we're probably more familiar with the meaningful use criterion that was there with technology way back when, probably twenty years ago. That had stages one through seven and had things on it like computerized physician order entry or CPO, sharing of records between facilities, having all kinds of other electronic and portable, kind of turning, I guess, paper to plastic from an electronic medical record standpoint.

There wasn't one that we're aware of, and there still is not a technology model like that on the revenue side. My hospital, when I was running my revenue cycle, had about twenty-six or so different systems, and I used people like yourself, Jake. I picked up the phone and called down the street to Longmont or Vista or even down downtown at Denver Health to say, "Hey, who are you using for payments or eligibility or claims? And do you like them? Was the install a pain in the ass?"

And that's how we kind of assessed our technology. We've come up with this model that measures two things really. It measures one: is there value to that technological solution? So, we measure that on a standard five-point liker scale. You know, must-have, highly valuable, moderately valuable, somewhat not valuable, and, you know, not valuable at all. We threw out the bottom three and kept must-haves and high-value solutions.

And then we ask a question. The second question really surrounds: is this technology in place at your organization? And that kind of created these phases, and we'll have something on this podcast where folks can click on it and take the assessment themselves and get some background. But that's the little two-minute gist of what the model is. My first question, Jake, is just what are some initial impressions of the model?

I mean, what did you think when it was first presented to you by Jeff Becker and the team?

I was cautious, a little bit cautious about it. So, you know, full transparency, I've been with the organization about eighteen months now. Right?

So, you know, that being said, I used it as an exploratory, you know, kind of a baseline for myself, right? In terms of, you know, where we are in the organization, what technology we do have, what weak links we do have, where we need to go as an organization, almost as a, you know, a map, so to speak for, you know, my then CFO and I at the time to say, "Alright, this is where we want to go in the next, let's say, year, but not only this year, but, you know, the next two, three, four, five years out, what that needs to look like. Just from a revenue cycle perspective. So, cautiously optimistic, I would say, and filling it out.

But, you know, in hindsight after spending a little time with it and working through with the team, it actually has paid out in dividends, not only for painting the picture of where we are but you know where we need to go and how that functions within our organizational planning for the revenue cycle in the future. That's awesome. That's awesome. I'm glad that it's been valuable.

Nothing annoyed me more than the chief revenue officer doing superfluous projects for business partners that didn't jointly or mutually benefit each other. So I love to hear that there was some value.

How long do you think this is gonna take you? Like, how many phases do you, I think last time we spoke, you were right in front of my favorite seasons, web at season or budget season. I like where do you see you kind of progressing? Is it a multi-year thing? Is it a one-year thing? And are you working on everything you want to, or are there some organizational?

I would say, so this is from a revenue cycle perspective. Right? I would say it's a multi-year component for us. Right?

Yep. It's always changing and your needs change. I would say even, you know, throughout the year, right? But for us, it's, okay, we're going to put the time, the energy, and the effort into this.

And, okay, these are the things that we can do as an organization this year, right? And so again, I'm speaking from my organization. There are other larger organizations that have the bandwidth to do more things or more initiatives or more projects, right? So part of it is what can we ingest this year?

What do we need to plan for next year? You know, and part of those go into build by questions as well, right? So, you know, there are a little bit of tendrils that go into that component. So, I guess we saw it as we're gonna work on it now, this year and budget this year and next year and multi-years down the road.

So, well, what types of things do you think you might or may not know, but I'm just curious what types of things do you think you might have to look at buying and what types of things that you might have to look at building or is it too early now to know that? So for a lot of us, the purchase component is around either technology. Right?

So let's go RPA specific components. Right? I've said it before, and I'll say it again. I can't automate fast enough.

Yeah. Body and hands and people are not the solution anymore. Right. And so I'll lead with that one that purchasing technology and process technology that can do some of the work that the people had done in the past.

Is something that we moved pretty swiftly into in terms of purchasing. Some of the other components are related to the middle revenue cycle. Right? You know, CDI specific, CDI coding-specific components.

But, you know, leading with that, that I'll say process component was pretty critical for us, going forward. Cool.

HFMA, I think we're gonna announce that soon probably by the time this goes is gonna partner with us on this. You're a, you and I are

both gray hairs. I like to call it no offense, but we've been doing HFMA for quite Oh, yeah. It's definitely great. Yeah.

You know, how do you, how do you think that's gonna be received by the HFMA members in that community? Do you think this is another nice kinda arrow to have in the quiver or gonna be a distraction or a little bit of both? Or how do you think the HFMA community is gonna receive this?

I would say that I think it will be more well-received than not. Right? So I guess I kinda cut my teeth when I was younger on what ITIL and all the different you know, metrics and standards and all of this stuff with that. And, you know, I think to your point earlier, you know, it's easier than picking up the phone and saying, how do you get to the next level?

Because every organization or group or revenue cycle is an n of one. Right? What my components are and what I need to get to the next level is not necessarily what my peer at, you know, x y z organization is gonna be and, you know, baselining, baselining against yourself for me is something that I would say that HFMA will probably, you know, jump at. Right? Nice. That's awesome.

Denver Health's unique. I and God bless you for all that you do. I think you're one if if not the only safety net hospital I'm aware of at least on the metro side of the front range. I think Grand Junction might compete with you a little bit and and possibly even more on Penrose down the springs, but that's it.

And, you know, what unique challenges does that bring just to your organization and and and how does, you know, your revenue cycle operations kinda reflect that and and how does that relate to this model? Well, I would say, we have to stick the land Right? We don't have the resources to use that phrase. Right?

We need to stick the landing. Right?

We don't have the bandwidth to have projects that fail or money that is not well spent or resources that are unutilized or not maximized, right?

So from us whether it's you know, Medicaid redeterminations or those kind of things. They all have an effect on us and, you know, understanding what that's gonna, gonna do your revenue cycle and what other components you need to, I'll say, account for in terms of the changing healthcare landscape, you know, that's that's pretty critical.

Cool. Awesome. What are some of your favorite, you know, kind of key performance indicators or dashboard items and how do those relate to this model?

I'm a denials guy. Right? You know, I love my denials numbers. I love my cash collections numbers.

You know, DNF I mean, we're looking at those and we're always measuring, I guess, against where we need to be. I think from my standpoint, what I appreciate about the model is that there is a maybe I'll say a benefit, right, assigned to that, to moving to the next level, right?

So if I'm a three right now, it means, you know, whatever in terms of percentage or percentage in net revenue if I moved up to a let's say a four, right, or from a four to a five or even from a two to a three, whatever it is.

You know, you can identify and say, "Alright, this is the amount of work that's going to go into it. And yes, while the work is is going to cost x y z, you're going to, you know, you may necessarily see some of the I'll say benefit related to that, as you move up the maturity model. That's good. Yeah.

We're that's one of the places we're kinda leaning into is to understand, you know, we've surveyed about a hundred organizations. We're trying to have them kinda test to baseline metrics most revenue cycle leaders or experts like yourselves can rattle those numbers off if I asked you what your NFP was or your denial you'd know it and, and you'd know if it was getting better or worse or staying the same. And, if you're there's it's kinda intuitive, right? This isn't like an earth-shattering.

You know, aha moment with more application of technology, I would argue more more attention being paid to workflow and and issues that exist or even just measuring the KPI. I found that at my organization, you're gonna improve on it because you're talking about it. You're looking at the investments that you've made, and where things are at. So that's great that that that's there, and and we're doing as you're looking at that improvement, you know, we all have our bosses if you will.

You know, what? How's the CFO and the CEO and and you, I realize you're still kinda new, but what does that look like? You know, as you're using the model and you're planning, what's those conversations? Is this model making that process easier?

Is it making it somewhat more challenging? Cause you're having to document along the way? Is it a combination? Or I would say it's a combination.

Right? It's documentation along the way. So, you know, we've been through a senior leadership change.

Throughout the course of the model to now. So some of it is revisiting it. But, you know, the other thing that the model does help with is that it's a I hate to say a crib sheet. It's kind of like a crib sheet of this is where the organization's been. This is, you know, if you believe in the model, right? This is where the organization is, is going to go with, you know, with our direction over the course of the next three, five, seven years.

You know, and the metrics I'll say tie into that component, you know, and help make the case. Whether it's, you know, you're in budget meetings, which we're all going through right now or at least we are, So, yeah, it's it's it's all good. Good. That's a that's a great segue into my next question. Just what are things that the model doesn't consider? And I have some ideas, but, you know, when I used to have to deploy technology, I had to have meetings with the IT department and my finance department to kinda understand that you mentioned that you're within budgets. What are some considerations outside of the model that leaders like yourself need to consider as you kinda plan on these three, five, seven year strategic planning using the model as kind of a true north metric?

I would say, you know, for us, spinning up and developing a robust or more robust now, vendor management team, right, and vendor support team, right? Anytime you have some kind of additional vendor service support, you're gonna need a liaison or somebody to work with that organization or handle either whether it's files or questions or day-to-day operations that that's a pretty big piece for us is understanding what our, what our team can do and then how many more I'll say individuals or groups we need to have in-house to help assist and facilitate with that. That's awesome. That's awesome. That's a great answer.

I think, you know, that's most of the big questions I had.

What are some parting thoughts you might have for folks listening to this or in Chicago in a couple weeks that you would like to leave people with regarding just RCM strategic planning and the model in general.

I'll say so I'll leave I'll I guess I'll leave everybody with this. You get out what you put in just to just like if anything. Right? So, for us, I think the harder conversations happened on the front end with do we have this?

But it's not just if you have that functionality. It’s it is it running? Is it productive? Right?

So, a lot of people can have the functionality of say some of the things that's that are on the model or required. But is it, is it fully implemented? Is it, you know, is it optimized to where it's providing value to the organization and we had to have, I'll say, some of those conversations early about, okay, we have this, but it's really not fully optimized. So while we may be in a specific, I'll say, tranche or level for, for our technology adoption model, you know, there are times when I feel like we're not even there, you know, at our, at our adoption model because of some of the technology or the functionality is not fully either ingrained into the workflow ingrained to our processes or updated within our system practices.

Sounds great. Well, I'm Jonathan Wick again, the VP of Health Insights here at Finthrive, and and I've got with me Jake Collins from Denver Health.

Next time we see each other in Chicago, but thanks so much for your time today and, go check out the model at finthrive dot com, adoption model and, and, let me know what you think. And thanks again, Jake.

Thank you