Intermountain Healthcare chief financial officer Albert Zimmerli cut to the chase on Sunday when evaluating hospitals’ track records with revenue cycle: they’ve done a lousy job, but there’s a huge opportunity to get it right.
Zimmerli made those remarks as keynote speaker at the Healthcare Finance Revenue Cycle Solutions Summit held Sunday at the HIMSS15 conference in Chicago.
According to Zimmerli, the problem comes down to how well organizations and providers answer these questions for patients: How much does this cost? And how do I find financing?
“In most businesses, they demand answers to those questions,” Zimmerli said. “It’s really unacceptable that in something as valuable as healthcare, that is so important to our families, we can’t.”
[Also: How consumerism is changing revenue cycle]
Zimmerli said Intermountain, which operates 22 hospitals and 200 clinics and has 2,670 licensed beds, launched a host of initiatives designed to revamp and improve its communication and revenue cycle processes. For example, Intermountain sets a goal of a 48-hour turnaround on financial aid applications for patients.
Zimmerli said the organization also makes sure to balance patients’ financial needs with Intermountain’s fiscal responsibilities. To do that, the organization staffs about 1,800 people who work on some part of the revenue cycle process, representing a major investment, Zimmerli said. Intermountain also supports four regional offices focused on billing and account follow-up and six call centers supporting pre-registration and scheduling.
Follow Healthcare Finance on Twitter and LinkedIn.
All of this has helped Intermountain cut its bad debt -- which Zimmerli called a failure of the system -- and successfully shift patients who truly qualify for charity care to that designation. For those who can afford to pay, however, that extra communication about financing is making a difference.
“Everyone should pay something, no matter how small,” Zimmerli said. “It gives patients a sense of self-worth, and they usually follow through on protocols for the rest of their care.”
Jeff Hurst, vice president of finance at Florida Hospital, agreed that patients who can pay, should pay.
Hurst, who also spoke at the summit, also agreed that clear communication with patients is key.
“The conversation does not always have to be about collection,” he said. “It has to be about resolutions.”
Hurst said Florida Hospital has turned to several vendors to help the system focus on improving accuracy and timeliness of estimates, automation and audit reconciliation. That meant having Cerner manage the bulk of its revenue cycle processes.
The hospital also completely revamped its patient estimate forms to more clearly highlight a patient’s financial responsibility for treatment.
Hurst also targeted hospital chargemasters as focusing on maximizing hospital revenue over price transparency. Florida Hospital’s charges are currently 22 percent net-to-gross, which means the systems essentially charges five times more than they are reimbursed. The goal is to get that closer to 50 to 100 percent net-to-gross, he said.
Going forward, Hurst said Florida Hospital wants to build value in its revenue cycle processes by becoming the patient’s advocate in helping them secure all forms of available financial assistance.
“I want us to hold patients’ hands and help them navigate through the complexities and intricacies of the healthcare system just like a physician holds their hands and helps them navigate the clinical intricacies of the system,” he said.
Building value is also a high priority for Intermountain, Zimmerli said, which means investing in innovation and picking the vendors that are going to improve the process for both the organization and the patient.
And above all, communicate while you innovate.
“What really is the value we bring to patients?” he said. “Too often we sit back and get criticized for what we don’t do. It’s time to tell our story.”
Twitter: @HenryPowderly