Step-by-step, Methodist Health System cured the pain points within the revenue cycle

Jeff Francis is vice president of Finance and CFO for Methodist Health System.

Photo: Courtesy of Methodist Health System

Methodist Health System, headquartered in Omaha, Nebraska, went all-in on automating the revenue cycle, starting in 2018 and going live in 2019.

The health system worked with Alpha Health, now called AKASA, for unified automation in the revenue cycle that tied into its Cerner EHR.

"Our director of patient financial services was interested. We knew there would be opportunities down this path," said Jeff Francis, vice president of Finance and CFO for Methodist Health System. "We went all in. It wasn't a hard buy-in."

Methodist started with what Francis called the "pain points" in the revenue cycle and continued until automation over human intervention no longer made sense.

"We were learning with them as we jointly determined where the pain points were," Francis said. "It was more step-by-step." 

The work resulted in a reduced cost to collect, a higher yield and an improved patient financial experience. 

Francis, and Amy Raymond, head of Revenue Cycle Operations for AKASA, will talk about the journey in "How Automation Can Improve the Patient Financial Experience," at HIMSS22 in Orlando, Florida. The session will be held on Tuesday, March 15, from 4:15 to 5:15 p.m., in Room W300 of the Orange County Convention Center.

Francis and the team began by addressing staff about how automation could affect their jobs and the potential for some positions to be eliminated.

"We were very up-front about that," Francis said.

But no one lost their job, he said. Instead, revenue cycle personnel are now working on the more difficult accounts.

Automation has taken over the repetitive tasks. Staff people no longer have to spend seven minutes to see the status of a claim, make the notification and update within Cerner, he said. Responses to claims denials are now automatically sent to payers.

"We knew that we had an issue taking staff time and not adding value on time," Francis said. 

The team then expanded robotic process automation and machine learning to every possible aspect of the revenue cycle.

"We had a narrow focus, knowing we could broaden it," Francis said. "We were finding new use cases in the front end and mid-cycle. We've continued to find new areas."

The health system has now about reached the limit of what automation can do. There are claims denials too complicated for machine learning to take on, as opposed to what an employee is able to understand at a higher level, he said. Though that's not saying machine learning couldn't get there, he added. 

The automation has also been leveraged in the addition of Fremont Health, which joined Methodist in 2018. Fremont came onto the Cerner platform for clinical and accounting services.

As more hospitals and health systems have automated their revenue cycles or want to, Francis advises that the first step should be to review their options for a third party partner, based on what pain points they want to solve.

"This is a learning field," Francis said. The areas identified by Methodist, he said, "may not be the same pain point for another health system."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com