How Intermountain Healthcare CFO Albert Zimmerli is rethinking the revenue cycle
Finance leader says it's the questions your team asks now that shape future systems.
Good managers don't live in boxes. And at Utah's Intermountain Healthcare, it's pretty much mandated that they break out of them, especially when it comes to improving revenue cycle management.
Good managers don’t live in boxes. And at Utah’s Intermountain Healthcare, it’s pretty much mandated that they break out of them, especially when it comes to improving revenue cycle management.
That’s straight from Albert Zimmerli, chief financial officer at Intermountain for the past 12 years, who said his health system uses that approach to drive innovation.
“We expect our managers to know what the best practices are in their area. And if we’re not following them, and in many cases we won’t be, managers need to have a plan to get there in 5 years,” said Zimmerli.
For the Intermountain revenue cycle team, that has meant looking beyond the healthcare industry to see what companies like Amazon do from a customer service standpoint, or how the hospitality industry runs its billing processes so that customers leave with a complete understanding of their bill when they check out.
[Also: What CFOs think about revenue cycle]
Obviously, the costs tied to a 3-day hospital stay and a 3-day weekend at Disneyland are different, but that doesn’t mean those best practices can’t be applied in healthcare to make for a better patient experience. That’s the innovation Zimmerli is after, the kind of change that has him hopeful that he’ll see a “single-bill” become standard practice by the time he retires.
One thing his team has changed was its approach to charity care. Intermountain has run a financial assistance program since 2007 that has provided aid to patients struggling to pay for the costs of their care. Recently, however, the health system sought to improve the aid application turnaround time for these patients.
“If someone submits a financial assistance application, our goal is to get that turned around in 48 hours or less,” Zimmerli said. “I challenge some of our clinical people and say, ‘our goal is to be better at turning around this than you are at scheduling some specialist appointment.’”
[Also: How consumerism is changing revenue cycle]
Zimmerli, who will keynote Healthcare Finance’s Revenue Cycle Solutions Summit at the HIMSS 2015 Annual Conference in April, said his team is constantly asking questions as a means to drive improvement. Specifically, how well can the finance team perform and how can costs be held in check?
“We in revenue cycle operate as a system with no unnecessary variation and waste,” he said. That means Intermountain works to make sure its billing, coding and other revenue cycle processes don’t deviate across its integrated system.
As it stands, Intermountain runs 22 hospitals and 200 clinics and is one of the major reasons Utah has among the lowest per capita healthcare costs in the United States, Zimmerli said
“Revenue cycle can play a key part in helping healthcare become more affordable,” he said.
Constant regulatory changes and compliance mandates, including the upcoming switch to the ICD-10 coding system, present just as big of a revenue cycle challenge to Intermountain as it does to other health systems. But Zimmerli said you can’t hide behind excuses if innovation is your goal.
“We’re in the midst of great change in healthcare care right now,” he said. “We’re moving from volume to value, we’re moving away from fee for service. That’s a great challenge in terms of aligning incentives and we’re probably farther down that road than most.”
[Register for the Revenue Cycle Solutions Summit]
Zimmerli said that leaders must know how to pace their teams when innovating systems.
“This may sound counterintuitive, but incremental improvement is the enemy of major improvement,” he said. “For instance, if we set a goal to reduce our costs by 30 percent, you can’t get there with incremental improvement. You’ve got to fundamentally rethink your business.”
Everything comes back to Zimmerli’s one-bill dream, he said, which on first glance seems improbable when you consider all of the different procedures, diagnostic tests and provider encounters that can occur during an average hospital visit.
But Zimmerli remains confident.
“The thing is, most of the technology is out there to do this,” he said. “There are regulatory and lots of other challenges out there, but our vision has to be [a single bill]. It just has to.”
Twitter: @HenryPowderly
