At athenahealth,
we know your ambulatory practice wants healthier, a
healthier business, healthier care teams, and healthier patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters
most? That's where athenahealth can help. Our AI
native all in one solutions reduce administrative burdens,
streamline billing and payments, and deliver critical insights
when clinicians need it most. That means fewer
clicks, more time for patients, and stronger bottom
lines.
Lines. Practicing medicine is complex, but running a
practice can be that much simpler with athenahealth.
See how simpler is healthier at athenahealth.com.
This is Laura Dierdo with the Becker's Healthcare
podcast.
I'm thrilled today to be joined by Lindsay
Myers, vice president of revenue cycle and HIM
at Chapters Health System. Lindsay, it's a pleasure
to have you on the podcast today. Thank
you so much for allowing me to be
here today.
Absolutely. Now I I'm looking forward to our
conversation because I know there's so much happening
in health care, and particularly important right now
is the revenue cycle and how things are
changing, digitally transforming, and, really, you know, an
engine to making sure the health system is
successful in the future. But before we dive
into that, can you introduce yourself and tell
us a little bit about your background?
Definitely. As you mentioned, I'm Lindsay Myers. I'm
the vice president of revenue cycle and health
information management for Chapters Health System.
I've been in the industry for twenty five
years now with twenty years of leadership experience
in finance and operations,
and I've worked in a number of healthcare
settings over the years, including hospital systems, multi
specialty medical practices, and hospice.
I started my career in 2001
as a budget accountant for a large hospital
system, and then I moved into management roles
in financial planning and decision support.
And my first exposure to revenue cycle was
as a consultant fifteen years ago.
I've also been a CFO for a statewide
nonprofit
and a COO for a three forty b
consulting firm.
And I've worked with Chapters Health System in
various capacities over the last eleven years, first
as a consultant and
then as director of financial planning and analysis,
and now for the last three years as
vice president of revenue cycle and HIM.
I also wanna introduce Chapters.
We're known as the largest nonprofit hospice in
the country.
But Chapters Health System is actually a portfolio
of 30 different companies serving patients with advanced
illness throughout The United States.
We have PACE centers, our care new division,
participates in value based care. We have a
Medicare Advantage Plan, and we provided MSO and
consulting services.
We're in Florida, Georgia, DC, Virginia, Maryland, California,
Oregon, and Nevada.
And I work in the hospice division, which
is where we serve more than 36,000
hospice patients annually.
That's amazing to hear. And, you know, what
a a huge accountability
that is, to be, you know, serving patients
at that level of care,
in particular.
Given that position that you are in the
marketplace, what are some of the opportunities and
headwinds that you have in on your eye
on right
now? Value based care would be the first
one. As a hospice provider,
we receive fixed per diem payments. So we
already have decades of experience delivering high quality,
high patient satisfaction,
cost effective care in the home setting.
We've also mastered interdisciplinary
team coordination,
and hospice has always been about individualized care
and meeting the holistic needs of each unique
person.
We're able to deliver care in the patient's
home, whether it's in an urban setting or
in rural settings throughout the country.
And I think that all of these attributes
come together well and align with value based
care arrangements.
For example, some of these features make us
an ideal partner for ACOs or for health
plans, because we have extensive experience avoiding unnecessary
hospitalizations,
readmissions,
and other costs, while still achieving high patient
satisfaction and quality.
We have opportunities to
collaborate with other stakeholders
outside of the traditional Medicare and Medicaid reimbursement
structures,
and to expand the role of our care
model beyond just the final months of life.
Chapters and its care new company have been
really proactive in this space,
and we plan to continue growing in the
value based care space with an emphasis on
chronic illness and end of life care, even
beyond hospice.
And we wanna be innovative in shaping what
those arrangements look like.
Taking care of patients earlier on upstream is
also an opportunity
for less fragmentation of care and smoother and
sooner transitions to hospice.
And when, ultimately, when you get patients into
hospice earlier, it's a win win for everybody,
because it gives patients and their families more
time to get the full benefit that hospice
has to offer.
The patients get to maximize their quality of
life, and their relationships with their families.
And it also helps us improve our length
of stay and margins. And of course, as
a non profit,
we're fortunate to be able to put that
back into the organization to further its mission.
The other area of opportunity is affiliations.
And in the last several years, Chapters has
been strategically
affiliating with community hospices all over the country.
For example, Cornerstone in Florida, Capital Caring Health
in the DC area,
more recently, Willamette Vital Health in Oregon,
Nathan Adelson Hospice in Las Vegas,
and Hospice of Santa Cruz and Hospice East
Bay in California.
And it's been a little bit of a
whirlwind, but as our CEO has said, our
pace is really determined by market forces.
So in addition to the economies of scale
that come from a shared services model for
revenue cycle, finance, IT, and compliance,
Another benefit of that consolidation
is that Chapters has been able to amass
a lot of intellectual capital through these affiliations.
And that's put us in a position to
be able to offer consultative
and MSO type services to other providers.
As far as headwinds,
some of the challenges that we're actively managing
are
an anticipated increase in unfunded patients.
So as a nationwide health system, especially in
revenue cycle, we deal with the nuances of
multiple different state Medicaid programs.
And as a nonprofit, we serve patients regardless
of their ability to pay.
And we all know that the one big
beautiful bill act is ultimately going to impact
Medicaid coverage for a lot of people.
It's difficult to quantify the exact impact that
these changes are going to have in each
of our various markets, but the bottom line
for us is that Medicaid changes mean that
the number of unfunded patients is likely to
increase and these people are still going to
need care
and that's likely to take a toll on
our operating margin.
My team in revenue cycle is going to
continue to collaborate with other departments upstream to
make sure that we're optimizing our workflows to
maximize revenue.
And we're also implementing technology to increase collections
to help offset the impact of
increasing charity care and bad debt.
For example, our IT department has helped develop
timely reporting that allows us to identify trends
and take action more quickly.
And we're also exploring more automation in the
area of eligibility, which is gonna be important
with frequent Medicaid changes.
Another headwind that we're dealing with is workforce
shortages,
labor price inflation,
and the mass retirement of health care staff
at a time when population trends are driving
an increase in demand for hospice services.
So across the hospice industry, we have labor
shortages and we also compete with hospitals, staffing
agencies, home health, and other providers for the
same staff.
So even though this is a major challenge
and a headwind,
we do have an advantage and that the
incoming workforce
wants to feel a sense of purpose and
a connection to mission.
And as a nonprofit that's well established in
the communities that we serve, we're able to
offer that sense of purpose.
Plus, we have a culture that's earned numerous
awards and recognition.
I have over a 130 FTEs on my
team, and we have a very diverse workforce
that's spread out across the country.
We've also just gone through multiple murders, so
it's a testament to the great culture that
we've developed that everyone is so aligned with
our mission and that we have such cohesive
teams.
We're able to attract and retain top talent
and minimize turnover costs.
That's amazing to hear and, you know, really
valuable information when you're thinking about how to
head into the future and,
see where where you can provide the most
value to patients as well as the organization.
Now, how are you thinking about growth and
really adding more of that value? What does
the future look like for you and how
are you,
providing that strategy to your teams?
In my role, we've had to scale rapidly.
We have doubled in size in just a
few years.
So when I think about growth in my
role, I'm primarily occupied with making sure that
the revenue cycle and the HIM infrastructure
are in place to expand rapidly,
while not having cash flow delays or falling
out of compliance.
So my focus has been primarily on systems,
processes, and automation.
And there's so much that impacts collections that
happens upstream from revenue cycle. So our success
depends a lot on our collaboration with other
areas like intake and admissions and clinical teams
and medical services.
Also, in hospice,
we have sequential billing requirements,
which means that if we have one claim
that's held up, the subsequent claims are held
up too.
So one bottleneck and process can hold up
huge amounts of money.
And also with growth comes additional complexity.
So as we continue to merge and integrate
with new affiliates,
there's a lot of process mapping and evaluation
and standardization that takes place, as well as
learning new state regulations and new service lines.
So we are constantly expanding our capacity in
terms of both volume and expertise as well,
in order to handle all the growth. As
far as value,
the value that the revenue cycle brings is
financial stability and sustainability,
so that we can continue to deliver care
to chronically ill and end of life populations.
And I think that value comes from continuing
to innovate and automate processes to upscale our
people and, to collaborate with all the stakeholders
who can impact the revenue cycle.
That's fascinating to hear. You know, I know
revenue cycle is such an important engine for
a health system right now and has a
lot of,
importance there, but, you know, many hospitals and
and systems across the country and providers in
any,
aspect of the continuum are looking at some
financial challenges in the next year. So from
your perspective, what do you see as being
one risk or investment that's still worth making
even though, you know, potentially, purses are tightening
across the board?
We're investing in our people.
And because we are the biggest nonprofit hospice
and because of our aggressive growth over the
last few years,
we are constantly needing to identify and implement
scalable process improvements.
So being so large, there's often not really
a template to follow. We tend to be
fairly unique.
Therefore, we're relying on the agility
and the innovation of our team members to
design new ways of doing things.
And the risk is that if you under
invest in people, turnover rises, morale drops, the
quality of care suffers, and ultimately, the financial
performance is going to deteriorate.
And that's why our mission has been taking
care of patients and taking care of those
who do.
We've earned the, the great places to work
designation for eight consecutive years now.
We've been recognized by Forbes and by USA
Today, and we've received numerous other awards and
recognition for our culture.
And,
one of the aspects of investing in people
is also investing in technology.
So I know a lot of people would
respond to that question about investment,
with AI.
So I would just add that AI has
tremendous potential to streamline workflows, especially in revenue
cycle and HIM.
But when we look at AI, the idea
is to liberate our teams from the mundane,
repetitive,
and administratively burdensome tasks,
so that they can focus on connecting with
patients and connecting with families, which is something
that, you know, AI can't do and redeploying
them to higher value tasks.
Got it. That makes a lot of sense,
you know, and, it is really interesting to
think about how you can leverage technology and
and, really become more efficient there. Before we
wrap up, I am curious. Anything else you
wanted to mention in looking at some of
the best opportunities for yourself professionally when you're
looking at growth in the future?
We're going to continue to grow and innovate
in the value based care space with the
emphasis on chronic illness and end of life
care.
And also our collaborations and affiliations with other
providers continue to transform the organization
and bring in new talent and ideas, as
well as the economies of scale.
So I think the opportunities are new payment
models that are well aligned with the delivery
models that we've developed,
and continued strategic affiliations with other organizations that
have similar values.
In revenue cycle, that's, you know, a double
digit growth industry, and I would say that
our opportunities
are to enhance our analytical capacity and our
processes to support those things.
Absolutely. I know double digit growth is a
huge, huge goal, and so it'll be
great to to see how you tackle that
in the next year and truly come out,
you know, on top. Lindsay, thank you so
much for joining us on the podcast today.
This has been a really great conversation, and
I look forward to connecting to you again
soon. Thanks so much, Laura.
At athenahealth,
we know your ambulatory practice wants healthier,
a healthier business, healthier care teams, and healthier
patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters most.
That's where athenahealth can help. Our AI native
all in one solutions reduce administrative burdens, streamline
billing and payments, and deliver critical insights when
clinicians need it most.
That means fewer clicks, more time for patients,
and stronger bottom lines.
Practicing medicine is complex, but running a practice
can be that much simpler with athenahealth.
See how simpler is healthier at athenahealth.com.