1 00:00:00,060 --> 00:00:03,640 Would you like to exchange best practices and ideas to improve care, 2 00:00:03,790 --> 00:00:05,520 enhance operational efficiency, 3 00:00:05,580 --> 00:00:07,960 and address financial challenges with your peers? 4 00:00:08,600 --> 00:00:12,400 Becker's Healthcare is facilitating these conversations at their eighth annual 5 00:00:12,580 --> 00:00:15,240 health IT digital health and R C M meeting. 6 00:00:15,580 --> 00:00:19,560 You can check your eligibility for complimentary attendance at the link in the 7 00:00:19,560 --> 00:00:22,040 description. We are excited to welcome you in October. 8 00:00:23,010 --> 00:00:25,540 This is Laura Dedo with the Becker's Healthcare Podcast. 9 00:00:26,160 --> 00:00:28,020 I'm thrilled today to be joined by Ashley Tony, 10 00:00:28,540 --> 00:00:31,820 director of Revenue cycle and Chief Compliance and privacy officer at St. 11 00:00:31,820 --> 00:00:34,140 Luke's Hospital, part of Atrium Health. Ashley, 12 00:00:34,140 --> 00:00:35,900 it's a pleasure to have you on the podcast today. 13 00:00:37,370 --> 00:00:39,120 Thank you. Thank you. I appreciate you having me. 14 00:00:40,060 --> 00:00:41,640 Now, I know we have a lot to talk about. 15 00:00:41,640 --> 00:00:45,200 There's so much happening in healthcare and a lot of changes in transformation, 16 00:00:45,380 --> 00:00:47,040 but before we dive into my questions, 17 00:00:47,300 --> 00:00:49,560 can you tell me a little bit more about yourself and your background? 18 00:00:50,810 --> 00:00:55,500 Certainly. I grew up in a small town in Western North Carolina. Well, 19 00:00:55,500 --> 00:00:59,260 the location is approximately, I'm gonna say an hour between most major cities. 20 00:00:59,460 --> 00:01:02,180 I was in a town where people would really get excited to have a Walmart, 21 00:01:02,840 --> 00:01:06,060 and it's also the kind of place that you can't really see its value in full 22 00:01:06,190 --> 00:01:10,700 until you're grown up. I couldn't wait to move away after college. 23 00:01:10,780 --> 00:01:13,380 I was very excited about the career opportunities that I had, 24 00:01:13,480 --> 00:01:17,100 but I quickly realized that the financial end was not lucrative enough to 25 00:01:17,180 --> 00:01:19,460 sustain living in the urban areas that I'd hoped for. 26 00:01:20,440 --> 00:01:24,220 So I began working at the local hospital system in the education department and 27 00:01:24,220 --> 00:01:26,660 installing lifelines. I never intended, 28 00:01:26,920 --> 00:01:29,540 nor did I expect that this would be a journey in healthcare. 29 00:01:30,210 --> 00:01:33,500 This position was more than just installation logistics, 30 00:01:33,560 --> 00:01:37,140 but recognizing that some people wanted to be heard or to have conversations, 31 00:01:38,130 --> 00:01:39,460 find that need and fill it. 32 00:01:39,900 --> 00:01:42,980 I learned that very quickly and have used it ever since. 33 00:01:44,020 --> 00:01:45,620 I entered into the business office, 34 00:01:45,680 --> 00:01:47,740 as it was more commonly referred to at the time, 35 00:01:47,740 --> 00:01:50,500 and was surrounded by a group of seasoned teammates that helped me to learn the 36 00:01:50,500 --> 00:01:52,700 ropes of patient financial services. 37 00:01:53,580 --> 00:01:56,860 I was able to bring my knowledge of technology to help escalate patient 38 00:01:56,860 --> 00:01:59,780 accounting, then patient access into modern day revenue cycle. 39 00:02:01,200 --> 00:02:04,500 I'm really fortunate to those who recognized that I could be an asset in other 40 00:02:04,500 --> 00:02:07,780 areas and allowed me to broaden my skillset to areas that would be 41 00:02:07,780 --> 00:02:10,420 non-traditional for someone in revenue cycle, 42 00:02:11,220 --> 00:02:13,740 I worked as a physician liaison who assisted with growth, 43 00:02:14,300 --> 00:02:17,940 strategic planning and recruitment while leading marketing for the organization. 44 00:02:18,840 --> 00:02:20,660 I'm now currently with Atrium Health, 45 00:02:20,720 --> 00:02:24,300 now Advocate Health and back to my roots in revenue cycle with compliance and 46 00:02:24,300 --> 00:02:26,020 privacy duties at St. Luke's Hospital. 47 00:02:27,330 --> 00:02:29,270 Wow, that's an amazing career journey. 48 00:02:29,370 --> 00:02:32,590 It sounds like you have had so many different experiences, um, 49 00:02:32,730 --> 00:02:35,870 and I can imagine all of them really, uh, help you in, 50 00:02:35,890 --> 00:02:39,910 in your current role and just really be an asset to the hospital and the health 51 00:02:39,910 --> 00:02:43,790 system overall. Now, I know we're in a unique time in healthcare today, 52 00:02:43,790 --> 00:02:45,750 and especially looking at, um, 53 00:02:45,760 --> 00:02:48,430 where we're at financially for many organizations. 54 00:02:48,610 --> 00:02:52,230 So where do you see some of the big opportunities as well as the headwinds that 55 00:02:52,230 --> 00:02:53,063 you have your eye on? 56 00:02:54,170 --> 00:02:56,540 Well, healthcare revenue has always faced its headwinds. 57 00:02:56,600 --> 00:02:59,700 The current state feels particularly challenging. 58 00:03:00,200 --> 00:03:04,900 Payers continued to make getting paid difficult and an obstacle course it was at 59 00:03:04,900 --> 00:03:07,420 one time. If you understood how the payers lingo translated, 60 00:03:07,680 --> 00:03:11,140 you were able to get paid maneuver, the denials, denial prevention, 61 00:03:11,390 --> 00:03:13,740 being able to ebb and flow with the payers. Now, 62 00:03:13,740 --> 00:03:17,700 the process feels a bit against the grain. To me, 63 00:03:17,780 --> 00:03:21,940 the modern payer to facility relationship can feel about like whenever a child 64 00:03:22,050 --> 00:03:24,300 asks why and their parent answers the cause, 65 00:03:24,890 --> 00:03:26,500 it's vague and it's not straightforward. 66 00:03:27,080 --> 00:03:31,820 The ebbing and flowing is not there anymore or really, uh, creating unrest, 67 00:03:32,000 --> 00:03:35,020 but we are using this as an opportunity to reset our practices. 68 00:03:35,850 --> 00:03:40,260 Then you add in lingering economical constraints to say that covid has changed. 69 00:03:40,260 --> 00:03:42,540 The landscape is almost a given at this point. 70 00:03:43,010 --> 00:03:47,900 Inflation coupled with volume pressures in the unstable market is eroding 71 00:03:47,900 --> 00:03:49,580 an already slim operating margin. 72 00:03:50,080 --> 00:03:54,060 Add to the mixed staffing labor shortages and demand for higher wages. 73 00:03:54,690 --> 00:03:55,620 Without the volume, 74 00:03:55,720 --> 00:04:00,220 an organization is strangulated and cannot afford to increase wages in the 75 00:04:00,220 --> 00:04:00,920 revenue cycle. 76 00:04:00,920 --> 00:04:05,660 You must have teammates to be able to tackle the payer issues to make any of the 77 00:04:05,660 --> 00:04:07,860 remainder happen to be sustainable. 78 00:04:08,960 --> 00:04:12,910 We're all base with increased patient angst and anger from the revenue cycle 79 00:04:12,940 --> 00:04:15,390 side, and I'm not sure that this will subside. 80 00:04:15,610 --> 00:04:17,950 Social media is not helping in this area, 81 00:04:18,170 --> 00:04:22,870 but creating a platform that amplifies angst, anger, and misinformation, 82 00:04:23,600 --> 00:04:26,990 we've all seen the post where people are talking about how much their bill was 83 00:04:26,990 --> 00:04:29,670 in terms of total charges, and the full picture really is not shown. 84 00:04:30,300 --> 00:04:32,830 They failed to mention that their patient responsibility is, 85 00:04:32,840 --> 00:04:37,790 let's say $200 copay or they have a deductible that's met and the 86 00:04:37,790 --> 00:04:42,710 full reimbursement piece is not reflected at all. Instead, in their minds, 87 00:04:42,710 --> 00:04:44,790 healthcare facilities are ripping patients off. 88 00:04:45,080 --> 00:04:49,350 Other users see this and they get angered all over again for some that even 89 00:04:49,350 --> 00:04:52,310 drives their healthcare decisions off this misinformation, 90 00:04:52,730 --> 00:04:54,670 and they vow to not use the hospital again, 91 00:04:54,670 --> 00:04:57,710 if at all possible from a customer service perspective. 92 00:04:57,810 --> 00:05:00,630 By the PA time a patient calls, they're fired up. 93 00:05:01,250 --> 00:05:04,350 Now I'm very passionate about making sure our patients and families are taken 94 00:05:04,350 --> 00:05:07,270 care of, so please don't misunderstand that. However, 95 00:05:07,540 --> 00:05:10,830 when customer service hears these patients beyond angry, 96 00:05:11,320 --> 00:05:12,590 every single workday, 97 00:05:12,690 --> 00:05:17,030 it is taxing and teammates question their career decisions. So yes, 98 00:05:17,090 --> 00:05:21,430 we have headwinds, but that is also an opportunity. What might not have worked, 99 00:05:21,620 --> 00:05:23,790 what might have worked at one point might not today, 100 00:05:24,010 --> 00:05:28,710 but let's mourn that change and move on to trying what might work now. 101 00:05:29,450 --> 00:05:33,150 Try these things look creative, and most importantly of all, 102 00:05:33,150 --> 00:05:34,550 figure out how to pivot quickly. 103 00:05:36,180 --> 00:05:37,240 That's such a great point. 104 00:05:37,440 --> 00:05:41,040 I know Pivot quickly has been really the name of the game for the past couple 105 00:05:41,040 --> 00:05:42,520 years. I in mm-hmm. 106 00:05:42,560 --> 00:05:45,320 responding to a lot of what's happened in the healthcare 107 00:05:45,320 --> 00:05:49,640 landscape. So, um, really just, I love your analysis here in, 108 00:05:49,660 --> 00:05:52,160 in looking at some of the headwinds, um, 109 00:05:52,380 --> 00:05:55,760 for the organization and for revenue cycle in particular. You know, 110 00:05:55,760 --> 00:05:59,900 those aren't things going away and, and so I love the idea of being able to, um, 111 00:05:59,900 --> 00:06:03,620 figure out creative ways to solve the challenges as they come in and, and, 112 00:06:03,620 --> 00:06:06,500 and be able to move quickly. Uh, from your perspective, 113 00:06:06,840 --> 00:06:10,020 how are you thinking about growth and development as well as adding value to the 114 00:06:10,020 --> 00:06:13,180 organization? What does that look like for you and the teams that you work with? 115 00:06:14,690 --> 00:06:17,330 I think we're gonna have to be on offense and defense. 116 00:06:17,520 --> 00:06:19,690 This is not an worse situation anymore. 117 00:06:20,350 --> 00:06:23,330 How can we tackle our issues with while growing our facilities? 118 00:06:23,590 --> 00:06:27,210 How do you grow the volume? I realize that this is an old question, 119 00:06:27,350 --> 00:06:30,010 but slice and dice it differently to view it at a different angle. 120 00:06:30,520 --> 00:06:33,130 Customize your plan for your facility and your community. 121 00:06:34,000 --> 00:06:37,890 Make sure there's the parts of your strategic plan that can be shared are so 122 00:06:37,890 --> 00:06:42,290 that teammates can keep this in mind and to know where to focus their efforts at 123 00:06:42,290 --> 00:06:46,450 a focus group on growth with the key players involved and held accountable to 124 00:06:46,450 --> 00:06:49,090 analyze data, to think about and solve solutions together. 125 00:06:50,050 --> 00:06:52,210 Although I realize that this can be labor intensive. 126 00:06:52,420 --> 00:06:55,450 There is tremendous value here. Are your resources, 127 00:06:55,450 --> 00:06:58,210 vendors and systems working for you? If not, 128 00:06:58,510 --> 00:07:03,410 how do you maximize this focus on provider onboarding to make sure that the 129 00:07:03,410 --> 00:07:05,210 process is as seamless as it can be? 130 00:07:05,670 --> 00:07:08,890 The last thing you want is for a provider to have a sour taste before they ever 131 00:07:08,890 --> 00:07:10,650 start practicing at your facility. 132 00:07:11,280 --> 00:07:15,250 Your providers can be your ambassador and you have a part in this. 133 00:07:15,880 --> 00:07:18,330 There's so many fires to put out at this point, 134 00:07:18,590 --> 00:07:20,770 and that certainly dominates time and resources, 135 00:07:21,510 --> 00:07:25,130 but I would challenge you to intentionally look beyond the fire and look at 136 00:07:25,130 --> 00:07:26,610 those things that are not on fire. 137 00:07:27,020 --> 00:07:30,330 While part of a firefighter's job is to put out fires, 138 00:07:30,610 --> 00:07:35,130 a significant portion of their job is to assess the whole situation. Overall. 139 00:07:35,390 --> 00:07:38,930 I'm not looking to graze the top only for low hanging fruit, 140 00:07:39,430 --> 00:07:42,690 but to make sure we dig deep, to continue to strengthen our core, 141 00:07:43,530 --> 00:07:47,290 maximize our resources and work toward correcting our issues to help maximize 142 00:07:47,750 --> 00:07:51,770 the operating margin to be able to serve our community now and in the future. 143 00:07:53,540 --> 00:07:55,160 Wow, that, that's really great insight. 144 00:07:55,240 --> 00:07:58,800 I love that analogy of the firefighter and putting out the fires, but just, 145 00:07:58,800 --> 00:08:02,360 you know, really assessing the whole situations and looking beyond, um, 146 00:08:02,420 --> 00:08:04,440 the what's in front of you. I think that's so important, 147 00:08:04,490 --> 00:08:07,680 especially tying back to, as you were talking about, being creative, 148 00:08:07,690 --> 00:08:11,960 being able to pivot and, and really leaning into that innovation mindset. 149 00:08:12,960 --> 00:08:16,280 I, I know that, um, from, you know, 150 00:08:16,750 --> 00:08:19,680 many hospitals and health systems are facing challenges, 151 00:08:19,680 --> 00:08:24,120 whether it's staffing shortages or some of the financial issues that we've been 152 00:08:24,120 --> 00:08:27,040 talking through in other, um, headwinds, 153 00:08:27,460 --> 00:08:31,800 but still important to be thinking about how do we continue to invest, um, 154 00:08:32,100 --> 00:08:36,480 and wanna be successful in the future. So for those who have limited resources, 155 00:08:36,480 --> 00:08:39,800 what do you think is one investment or risk that's still worth making this year. 156 00:08:41,450 --> 00:08:44,750 To identify? How can we stand out and then to take the action? 157 00:08:45,730 --> 00:08:50,150 All the things that we've been doing all on quality, patient care services, 158 00:08:50,410 --> 00:08:52,230 et cetera, they're all important, 159 00:08:52,690 --> 00:08:56,020 but at some point they become a bit of a baseline when we're making healthcare 160 00:08:56,180 --> 00:09:00,100 decisions. So think about it like this. When you go to the restaurant for, for, 161 00:09:00,560 --> 00:09:05,460 for the first time, you expect a good sanitation score, a visa atmosphere, 162 00:09:06,000 --> 00:09:10,850 and nice people at the least. But what makes you come back, I guess, 163 00:09:10,850 --> 00:09:12,850 would be that you would not pick the restaurant again, 164 00:09:12,920 --> 00:09:15,370 only because it had a good sanitation score, 165 00:09:16,010 --> 00:09:17,850 a decent atmosphere and nice people. 166 00:09:18,550 --> 00:09:22,410 You would go because of something that stood out for healthcare. 167 00:09:22,410 --> 00:09:25,970 Maybe focus on differentiating or adding a service line. 168 00:09:26,300 --> 00:09:29,410 Maybe it is a program to increase patient's knowledge of healthcare, 169 00:09:29,900 --> 00:09:31,650 their insurance, and how everything ties. 170 00:09:32,990 --> 00:09:36,210 And if you can tackle an issue you have and stand out, 171 00:09:36,240 --> 00:09:39,610 then even better patients and families won't feel special. 172 00:09:40,110 --> 00:09:44,890 How can you con how can you do this while continuing to provide the excellent 173 00:09:44,890 --> 00:09:48,290 care you already do? Incorporate your community and be intentional. 174 00:09:50,030 --> 00:09:51,640 That makes a lot of sense. You know, 175 00:09:51,640 --> 00:09:56,000 and it is really helpful to understand and have that mindset going into any kind 176 00:09:56,000 --> 00:09:57,960 of new project or, um, 177 00:09:57,960 --> 00:10:01,600 initiative that you're doing in really knowing that it'll make sense, um, 178 00:10:01,620 --> 00:10:05,800 for the overall organization and improve that experience and improve, um, the, 179 00:10:06,020 --> 00:10:10,430 the experience for both patients as well as the staff and team members. 180 00:10:10,930 --> 00:10:14,350 Now, before we wrap up our conversation, I wanted to ask you one more question. 181 00:10:14,440 --> 00:10:17,630 Where do you see some of the best opportunities for growth in the future for 182 00:10:17,790 --> 00:10:21,150 yourself, um, as well as the teams that you work with closely? 183 00:10:23,290 --> 00:10:25,790 I'm gonna have to go back to standing out. 184 00:10:26,730 --> 00:10:30,030 In the past I've spoken with Becker's about personalized healthcare and I do 185 00:10:30,030 --> 00:10:31,710 still feel like that's a big opportunity. 186 00:10:32,440 --> 00:10:34,030 Don't forget about the resources you have. 187 00:10:34,340 --> 00:10:37,990 Sometimes I think it's easy to automatically shift to try to go big, 188 00:10:38,610 --> 00:10:41,630 but be cautious to make sure that you keep your base sturdy, 189 00:10:42,180 --> 00:10:45,270 continually analyze trends within your organization and your community. 190 00:10:46,510 --> 00:10:47,470 Recognize your demographics. 191 00:10:48,490 --> 00:10:51,670 Do not forget the value of positive personal interaction. 192 00:10:52,450 --> 00:10:55,070 Why do the large referrals source drop off? Go talk to them. 193 00:10:55,560 --> 00:10:59,310 Thank the people for what they do and mean it. Write handwritten notes. 194 00:11:00,110 --> 00:11:02,710 I know a lot of times it said, well, maybe you're at a small facility, 195 00:11:02,710 --> 00:11:04,950 maybe you have more time at this point. 196 00:11:04,950 --> 00:11:08,910 Nobody really has more time than another. It's just a different fire. 197 00:11:09,920 --> 00:11:11,870 Don't let the size of your organization stop you. 198 00:11:12,220 --> 00:11:15,190 Your plan for positive personal interaction might look different, 199 00:11:15,450 --> 00:11:18,870 but there is still an opportunity and potentially more resources. 200 00:11:19,440 --> 00:11:23,790 There are opportunities in the little things and sometimes those things are what 201 00:11:23,790 --> 00:11:24,790 can make all the difference. 202 00:11:27,090 --> 00:11:30,660 Fantastic. Well, Ashley, thank you so much for joining us on the podcast today. 203 00:11:30,660 --> 00:11:34,060 This has been a really fun discussion and I look forward to connecting with you 204 00:11:34,060 --> 00:11:35,060 more in the FU future. 205 00:11:35,320 --> 00:11:38,580 And I'm excited as well to meet you in person at our Health IT Digital Health 206 00:11:38,580 --> 00:11:42,660 and Revenue Cycle event, um, in October. I know it'll be a lot of fun, um, 207 00:11:42,860 --> 00:11:46,380 a lot of these big topics being discussed and really a, 208 00:11:46,540 --> 00:11:49,460 a space where we'll be able to connect and network and, um, 209 00:11:49,570 --> 00:11:51,900 grow and learn from each other. So I'm looking forward to that. 210 00:11:53,450 --> 00:11:56,270 Yes, I'm looking forward to it as well. Thank you so much for having me. 211 00:12:00,980 --> 00:12:04,190 It's so important for leaders at the top of organizations to keep learning, 212 00:12:04,380 --> 00:12:06,070 stay sharp, grow their networks, 213 00:12:06,500 --> 00:12:09,430 help our audience better do this in a more simplified, personalized, 214 00:12:09,430 --> 00:12:13,630 and meaningful way. Becker's Healthcare has launched my bhc, 215 00:12:14,100 --> 00:12:17,110 it's your trusted Becker's healthcare experience and more with content, 216 00:12:17,140 --> 00:12:19,470 connections, events and learning opportunities. 217 00:12:20,140 --> 00:12:24,990 Join the community free of charge@www.my dot becker's hospital 218 00:12:24,990 --> 00:12:26,830 review.com and we'll see you there.