Beyond Billing: RCM Is Not Enough Anymore Webinar

Giles: Hello, everyone. It’s Giles with Becker’s Healthcare. Thank you for joining us for today’s webinar, “Beyond Billing: Why Revenue Cycle Management Alone Isn’t Enough for Practice Success.”

Before we begin, a few quick housekeeping notes: we’ll start with a presentation and have time at the end of the hour for a question-and-answer session. Submit any questions you have throughout the webinar using the Q&A box on your screen. Today’s session is being recorded and will be available after the event — you can use the same link you used to log in today to access the recording. If you have any issues with audio or video, please try refreshing your browser, and feel free to submit technical questions in the Q&A box as well.

I’m pleased to introduce today’s speaker, Michael Ferrie, President of Laboratory and Pathology at Coronis Health. Thank you, Michael, for being here today. I’ll now turn the floor over to you to get us started.

Michael Ferrie: Thanks, Giles. Appreciate it very much. Can everybody hear me? Good.

Quickly, an agenda slide: welcome and introduction, then we’ll go through the presentation and morph it a bit to talk about what’s probably most important about the RCM world today, which is that it’s just not enough to only be billing, or only be doing RCM — you’ve got to go the distance these days. We’ll end with a page on the basics that win the day, then Q&A. Feel free to ask anything and everything.

A little background on me: Michael Ferrie, President of Laboratory and Pathology. My career in the healthcare world has been all over the place — everything from head-hunting doctors back in the day, to practice management in the pathology and laboratory world, to anatomic pathology and laboratory management. Then I started a billing company 28 years ago, almost to the day, and began this interesting ride — that’s the only way to describe it.

Michael Ferrie: Let’s start with the notion of billing. People talk about RCM, but it’s easier to talk about billing because it’s a word people understand. In theory, it’s something pretty simple. In practice, it’s made more complicated — and I want to take a moment to explain why.

I come at this from the perspective of having built and run a billing company for 28 years. It’s a full RCM cycle — it does everything. So you’ll hear this from that perspective, but everything we talk about here applies to just about any RCM or billing organization, inside any entity. It fits inside a central business office (CBO); if it’s inside a hospital, it sits inside a medical group. It doesn’t really matter where it is — the principles are the same. I know that because I’m periodically engaged doing audits or consulting with larger organizations, large CBOs — we’ve got one going right now with a major academic medical center — and I always learn it’s the same basic process, the same things we all have to do to get claims out the door and get people paid.

The complications in what we do are generally provided by the outside environment. Payers make our lives miserable on any given day — that runs the gamut from Medicare down to United Healthcare, Aetna, and small medical groups in Southern California. What’s interesting is that the complication is complicated by definition — there are all sorts of rules out there, rules you don’t always know exist. You have to understand the environment in which other people are defining your business, so you can respond to those definitions.

In a lot of traditional billing environments, everybody talks about needing to do more upfront analysis, needing more tools and more resources. But often the benefits aren’t realized, because frequently we all miss the mark on making sure those investments are expertly executed and then monitored. It’s easy to implement something and then find out you’re not really spending any time watching what you’re doing. In a lot of organizations, there’s a black-box mentality — we see it a lot when we come into new situations where clients have virtually no idea what’s happened or what’s going on. A lot of that comes down to relationships — whether you’re dealing with an external client, or you’re part of a medical group tied to an academic institution and your “client” is the radiology or pathology department. Frequently it’s a lot of unknowns, and we’ll get into why that is and how to address it.

There’s also a lot of blame versus engagement in the typical environment — it’s easier to blame why things aren’t working than to have been genuinely engaged in solid relationships with your internal or external clients. And maybe the biggest point: reports are interesting, but that’s all they are. Everybody’s excited in the first five days of a new month to see their reports — cash numbers, charge numbers, write-offs, and so forth. But the real issue is whether the reports provide information that lets departments or clients actually make decisions. That’s where we’ll start to talk about what’s different.

That gets to the last point: are the expected outcomes the same across vendors? Absolutely not — and most of that difference comes down to engagement and the relationships you build with people. You’ll often hear the term “billers” — well, my billers, the billers, whatever the case may be. As I jokingly say, it’s not a 1960s Motown group. What’s happened over the years is that a lot of billing organizations are just trying to survive the pressure they’re under: reimbursements are going down, and costs are going up, at staggering rates. That means you have to do things differently — automate things, change processes for internal and external clients — and people get upset. That model is hard to break unless engagement and relationship-building are a priority.

There’s a lot of inconsistency in the billing world — not everybody delivers the same level of service, and not everybody intends to. Costs are rising so quickly that a lot of organizations can’t figure out how to keep delivering better service in a declining-reimbursement environment. Promises get made and go unfulfilled. It’s easy to sub-optimize, like the frog in water that’s heated slowly and doesn’t notice until it’s too late — you have to fight becoming complacent with “what is,” because what is is already over. You need a plan for where you’re going.

The vanilla version of the process is: you send claims, and you get paid. That’s the simplest version of what hopefully happens. It doesn’t work that way, of course — but that’s the baseline. The real question is how you deal with what’s “enough.”

Michael Ferrie: Here’s the first premise: it’s never enough. Whatever it is, it’s never enough. Think of Zeno’s paradox — going from point A to point B, you never truly arrive, because you always have to close half the remaining distance first. My view is that the right attitude is that you’re never complete, never finished with what’s necessary for your organization or your client.

One thing I say ad nauseam: there’s constant change. Somebody’s always trying to infiltrate your business, tell you how to run it, or get in your way. That takes you to the rules of engagement — with payers, probably the single most important and difficult relationship, but also with the organization as a whole, whether that’s your client or an upstream organization within a large medical center. Getting to “enough” comes down to relationships. It’s the most important thing you can have, whether you’re inside or outside the RCM world.

Backing up into lab operations is always critical, because the sources of most downstream problems originate upstream — that’s essential to being fully integrated with your client. Industry knowledge can never be enough, in my mind — never enough for us in the laboratory and pathology world. Being part of the conversation in the lab and path world is critical: you have to know who’s doing what, and how, down to the technologies being used. Having recently been inside a large academic center as a consultant, I can tell you that’s hard, because there are a lot of moving parts, and being tightly tied into the discipline and the medical specialty is critical to being successful.

The thing we all have to fight is conventional wisdom — the way we’ve always done things. That’s why CQI, continuous quality improvement, is absolutely essential. It’s not just quality like you’d think of with widgets; it’s quality in the relationship with the people you’re doing work for. And at the end of the day, we have to be accountable. As Harry Truman would say, the buck stops here.

So, a few points about “enough.” It has to be a holistic approach to everything you do every day — it’s not enough to just float along. Information is critical, not just analytics. Everybody talks about analytics, everybody has an analytics department, but they don’t do anything with it. I’m always disappointed by analytical output that doesn’t actually help people make informed decisions — that’s what reports should produce.

You also need functional expertise. I don’t care what you’re billing or what claims go out the door — you need functional expertise across the continuum. You need expertise in coding, and in submitting claims, and when rejections happen, you need to know why. These days rejections often aren’t for the typical reasons — a wrong medical group, a wrong payer ID — they’re because something in the CPT code, diagnosis code, pointer, or modifier doesn’t sit right with the payer, so the fight begins to get paid. And remember — we’ll talk about AI shortly — payers are really good at using AI and machine learning. They’ve used machine learning for decades, largely to figure out how not to pay claims.

Everything begins and ends with excellence.

Michael Ferrie: I’ve listed seven strategies to excellence. Excellence is an overused word in a lot of respects, but the most important thing about it is that it isn’t some amorphous notion floating around — it’s something real that you do every day. It’s every report that’s generated, looked at, and converted into information that produces an excellent result. It’s working with clients, department heads, and CBOs to understand what you can do to help them make better decisions. The “E” in RCM — a little play on words, a bit tongue-in-cheek — is about transcending the ordinary. Whatever’s typical or usual, whatever anybody else has been doing, isn’t good enough anymore. It comes down to relationships: clients, internal departments, vendors, and the industry as a whole, pulled together.

Creativity is never enough — you can’t ever stop being creative, never stop looking at process and people and requirements to understand what you can tweak. I don’t know that there are home runs left in this business anymore — it’s mostly tweaks, base hits, not home runs. And management matters doubly here — it can’t be hands-off; it has to be engagement.

Strategy 1: avoid the cookie cutter. Being plain never got anybody anything. As an outsource organization, every client is a sample of one. You’d think pathology is pathology, but it isn’t — everybody does something a little differently, and those small things can make a huge difference. It’s important to listen to the needs clients express, and the needs inside your own organization, because there are always small opportunities looking for the right conditions to grow. We’re increasingly having to tailor our offerings to specific needs — not everybody needs everything. Some people just need coding help; some need coding and charge entry; some just need a consulting engagement to solve a specific problem. Check the periphery — the referring physicians, referring institutions, payers, and the regulatory world. In laboratory and pathology, the regulations are extensive. Know your periphery, know all the players in your environment, and look outside the traditional boundaries of risk and opportunity — an idea can look like an opportunity and still violate several regulatory rules, especially around referral relationships in pathology and radiology.

What we focus on isn’t really about billing, or even about RCM — it’s about finding solutions. I tell my people to assume that every day there are a thousand problems, and our job is to find the greatest proportion of those we can and solve them. Otherwise they repeat, and repetition without change is the definition of insanity.

Strategy 2: no black box. Transparency is key. It’s a complicated business, and although we’d like to think technology handles everything, the truth is it’s still about people — and people still make mistakes in the process. You can’t ever be transparent enough about what happens; part of that is owning up to mistakes and solving them, and part of it is staying keenly aware of what’s happening upstream and downstream so you can make recommendations to clients. That leads to the last point: relieve the burden with clear answers and clear ideas, before your client — inside or outside — even asks the question.

Strategy 3: integration. You have to back up to the beginning of the billing and RCM process, and work backward to find every step along the way that contributes to something not working. Over roughly the last 12 to 15 years we’ve built tools around eligibility — though eligibility is often misunderstood, misused, and too expensive for what you get out of it, because it’s not always built into the process the way it should be. Then there’s insurance discovery, one of the hottest tools out there right now. And there are upstream systems, like Epic, which seems to be everywhere and feeds everything for a lot of us in the RCM equation. The interesting thing about integration is that backing up in the process becomes the connective tissue for the whole thing — you submit better claims and do better AR work if you’ve backed up in the process and linked things together. CQI applies here too: there’s never enough you can do to remove roadblocks and improve efficiency. Just this past Monday, in our weekly meeting, someone asked an obvious question — “why do we have to do it that way?” — and I think it’s going to create a whole new efficiency in our process.

So, somewhat tongue-in-cheek, all roads lead to RCM, and at the end of the day, all roads lead to money. I jokingly tell new clients I’m only here for the money — to a certain extent, this is my job, I should only be here for the money. But that doesn’t really exist, does it? Because if you’re going to integrate with a client, you can’t really just be about the money. That’s the truth.

Strategy 4: the practice management approach. I was in practice management in pathology before I was in laboratory management, before I built a billing company — interestingly, they all fit together. What I learned is that you have to think like your client thinks: think like the chairman of radiology thinks, understand their issues and needs. That’s the most important thing you can do — act like you’re managing their business, be concerned about their business and the tests they’re running, not necessarily to be empathetic about their problems, but to make the process more efficient. If you think the way they should be thinking, you’re adding value. A lot of the clinicians and hospital organizations we work for don’t have time — there’s no fat in these organizations, no one just sitting around thinking about things. We have to be at the center of managing the practice, thinking like they either do think or should think. In combination with transparency, we’re getting behind the curtain so the clients are successful. That’s the most important thing we can do.

Michael Ferrie: Strategy 5: technology. There’s technology on our side, and there’s technology at the client. If you’re not surging ahead, you’re already behind. If you’re fat, dumb, and happy — FDH, I’ll say it plainly — you’re already losing ground. One of the people who’s worked for me for about 18 years always makes the point that the most important time to look at your operations and understand where the problems and the tweaks are is when things are good — because when things go bad, you’re in panic mode, not thinking rationally. You have to improve every day, find the steps, and measure them. It’s done in steps, not strides — rarely giant leaps. And at the end of the day: technology, technology, technology. You have to keep investing in it.

Most people can’t spell AI, let alone define it. I was recently at a conference where AI was the hottest topic, and most people didn’t really know what it meant. I’m going to talk specifically about it using a slide I borrowed from our Chief Technology Officer, Doug Marcy — it’s the best explanation of AI I’ve seen, not just in our world, but anywhere. Every specialty an RCM organization works with has its own version of this. In pathology right now, digital pathology is where it’s at — predictions vary on the timeline, but I think in five to eight to ten years there will be a lot more people doing digital pathology. The consulting engagement I mentioned earlier, the audit we’re doing, is with an organization that’s 100% digital pathology already — it’s mind-boggling how fast that’s come along.

One of the things to keep in mind is making sure clients have access to good information, not just endless reports — information that helps them understand and grow their business. Sometimes you have to prod clients out of inertia we’re all guilty of. Being “the source” is valuable — earlier this week, on a call with a client, they made a claim about what they could do, and I had to tell them no, that’s not what the regulation means. After the attorneys got involved, it turned out they hadn’t read it quite right. Being the source clients can rely on is something they genuinely appreciate, even when you’re telling them something they didn’t expect.

On the AI slide specifically: our CTO, Doug Marcy, who has a master’s in machine learning, presented this at a corporate meeting, and I found it incredibly insightful. Everything begins with machine learning. The interesting work happens at deep learning, and ultimately at generative AI — a world I’ll admit I don’t fully have my mind around. I believe IBM Watson falls into the generative AI category, though I’m not entirely certain. For those interested in what AI really is: we’re all mostly operating in a machine-learning environment today. We’ve made some movement into deep learning. The “war,” so to speak, will be won when everyone reaches generative AI — though I’m not sure most people will get there as fast as they’d like to think.

Strategy 6: share and share alike. As I noted earlier, industry knowledge matters — knowing who’s doing what, how, and who’s involved, down to laboratory technology and how machines produce results we can bill for. Knowing the industry is crucial, because we share the best and brightest ideas across our entire client base — always checking first that nobody objects — so that clients in Florida hear about great ideas coming out of Oregon, California, or Hawaii. That contributes to the betterment of the industry, not just to ourselves. If you’re delivering service at scale in a medical specialty — whether it’s a laboratory information system or RCM — giving back to the industry is incredibly valuable.

Michael Ferrie: Strategy 7. At the War College recently, I gave a presentation titled “They’re Coming for You,” alongside three attorneys from McDonald Hopkins — including Jan Pye Wooden, who I’ve worked with for 30 years and who is unbelievable; that firm, and a lot of lawyers across the country, have done a great deal to help teach us what to be smart about. So: compliance is king. For those of you doing parts of the functional process, remember that you’re actually providing your clients with a compliance framework.

Consider this: we look at every pathology report now — Oscar, our AI technology, oversees most of the coding process, handling roughly 85% of it. The remaining reports still require a human look. Part of that is being obsessive-compulsive, but part of it is making sure everything actually lines up, because coding is one of the areas people can get in trouble the fastest. It’s also a place where, by doing this work on our clients’ behalf, they become compliant by virtue of what we’re doing for them.

People get creative about how far they push the envelope — my advice is: don’t push it too far, and make sure you have a good network of attorneys who can tell you when you’re pushing too far, because you can get yourself into real trouble. I had to stop a physician last week from doing something that violated two statutes — simple as that. Creativity will always be key to your success, and there are plenty of ways to be creative on behalf of clients without running afoul of regulations — that’s actually a small part of where creativity makes the biggest difference in your clients’ lives, or your CBO’s, for that matter.

A few areas that have come up, some more specific to my world than others: federal programs — at least once a week I hear about someone getting asked questions about HRSA. Not a surprise, given how much money was spent as a country on HRSA relief funds, and now the government is auditing all of it and asking why things exist. Medicare is becoming more proactive rather than reactive — they’re doing more audits than before, relying increasingly on whistleblowers and people who raise issues, and I’m seeing more RAC or RAC-like audits coming out of Medicare, some of it driven by their own data correlation — whether or not it’s machine learning, they’re certainly asking, “why is Doctor X always billing these three codes together?” and picking up on that.

Medicaid organizations are one giant slippery slope — you’d think they’d be similar across the country, but they’re not; what happens in California is completely different from Florida and everywhere in between. You have to watch state Medicaid rules closely — Connecticut, for example, has a very unusual most-favored-nation rule, so you have to know what payer terms you’re accepting and how they interact with state regulations, because it can get you in trouble quickly. And it’s not just government and payers coming after you — for those in competitive environments, competitors are watching too. The number one slippery slope, if you think about it, is employees — they’re the number one source of whistleblowing situations, so how you handle current and former employees matters a great deal.

Commercial payers were ahead of the government in using machine learning to deny payments, betting that people wouldn’t appeal so they could keep the money — but they’re becoming more regulatory now too, leaning on federal rules as they try to claw money back. You always have to watch for that, and sometimes payers simply stop paying until they get their way — that’s not uncommon.

One more example from my world: GI pathology has its own set of rules about what you can and can’t do. Recently a payer issued denials and a stop-payment because the documentation in a GI pathology report was identical across a huge number of examples — something like 99% of them. The problem is that over time, the AMA and national specialty associations have encouraged the use of templated reports so documentation looks consistent. But then a payer calls that same consistency fraud. Reconciling those two pressures is sometimes next to impossible.

Michael Ferrie: Because we’re getting close to the end: it’s not enough to be competitive — you have to be ahead. You have to look beyond, almost live on the horizon trying to figure out what’s next. Conventional wisdom isn’t good enough; you have to find a way to get ahead of it, because reimbursements are going down and costs are going up. Your competition is watching how you’re doing things versus how they’re doing things, and you have to stay ahead of them.

Unfortunately, technology doesn’t always keep up the way it should. As an example, the billing system we started with in 1997 was called NextGen — it was revolutionary at the time, the first truly relational database, genuinely cool. Now, if we’re being honest, most legacy systems are in collection mode — gathering revenue without reinvesting much. That’s why systems eventually get sunset; it’s rare for a long-standing system to go through a real transformation rather than having new features bolted on top of old technology that only looks new.

The truth is the underlying technology rarely advances much. We’ve made progress with AI, though — the coding AI I mentioned earlier, and AI for AR, which has been an amazing tool for the back end of the business. It’s allowed us, across many practices spread nationwide with different Medicare Administrative Contractors and different everything, to look at CPT codes and diagnosis codes and see the trends — the forest, not the trees — which lets us take corrective action.

Early in our use of AI for AR, about six or seven years ago, the first run surfaced five or six huge issues that no individual AR rep could have seen — but aggregated through machine learning, they were unmistakable. That’s good news and bad news: the bad news is realizing how much was being missed; the good news is we could fix it. We told clients what happened, and some of them spent a year and a half asking, “are you sure we get to keep this money?” — because the change in process led to real, sustained revenue gains. There are more tools coming that will make this even better, especially as they link back upstream to things like insurance discovery and benefits coordination.

It’s also important to invest in a data lake or data warehouse if you haven’t already. Systems on their own produce okay reports, but you need a repository where you can work with that data enough to produce genuinely valuable insight. And anything you can do to improve data ingestion, then aggregate and focus that data around specialization, makes a real difference — the outputs get much stronger.

Michael Ferrie: At the end of the day, the basics win. You have to execute the fundamentals well, and find ways to be the best in RCM — no matter what it is or where you are. That comes not just from doing the job, but from building and maintaining relationships that reflect and strengthen the work you’re doing for your client or organization. Managing process is nice, and having measurements and statistics is nice, but marrying those together so you have control of the entire process is critical — and I don’t see that done enough. When I go into new organizations, part of the gap is that people don’t have time, and part of it is that the skill sets for the technology aren’t there, because it isn’t their primary job.

We talk about reinventing everything every day — that’s a bit extraordinary, but it’s the mindset that counts: constantly looking for ways to improve, because margins are eroding and we have to find ways to do things better and cheaper. At the end of the day, whether it’s an internal client or an external client, we’re only here for the client — that has to be the focus. I was on a call earlier this morning where a few divisions were wrestling with how to handle something, and I said, why don’t we just focus on it from the client’s perspective — what would they want? The answer became immeasurably clear very quickly. Never forget the client, whether it’s a clinical department or an outsourced one — that’s where the ultimate leverage exists. And with that, I’m done.

Giles: Excellent. Well, thank you, Michael, for a wonderful discussion today. We will now begin today’s Q&A. Please feel free to submit your questions via the Q&A box on your screen. Let’s get started with the first question.

Michael Ferrie: I’ll start off by saying I’m probably not smart enough to fully solve that one. But one thing I do know about the current environment is that it’s full of inefficiency, turmoil, and challenge. The one thing it still has — maybe it’s just my fundamental view — is a sense of competition, which challenges all of us to be better, because the next guy might get better. Small practices are a very interesting challenge in our business — we’ve had clients as small as a single pathologist on the north side of Chicago, and groups as large as 40 or 45 pathologists. They both face tremendous challenges, but the smaller ones are increasingly difficult, because it takes so much to survive in this environment. We make sure we do everything we can to help our smaller clients survive and flourish, but the honest answer for small practices is probably about aggregating with like-minded groups. If I were putting on my practice-management hat, in a small practice trying to figure out how to re-flourish in this environment, I’d encourage them to aggregate with others so they have the ability to invest and grow. Whether you end up in-house or outsourced really comes down to what fits best for that larger, aggregated environment. I hope that does some justice to the question.

Giles: You did — great advice for smaller groups. Next question: how do you address or help clients with underpayment recovery on closed-out accounts?

Michael Ferrie: I’ll assume a closed-out account is one that’s gone to collections because every attempt to collect has failed. Part of the answer involves the steps before that point. About 12 years ago, we started making phone calls to patients. Interestingly, most of what we’d historically had to write off involved full balances — and after research, we found the reason was often the insurance information we’d received, since pathologists and laboratories are downstream: if you’re at a hospital, you have no control over what information comes in. So we tested calling patients to see if they’d provide updated insurance information, or if we could answer any questions — since most people don’t know what a pathologist is, let alone who “Dr. Smith” is. We found that we increased our recovery by roughly 26 to 27% — a simple phone call made all the difference.

The other change we’ve been implementing since last fall is electronic statements. I’ll admit I was proven wrong on this one — my own bias was “don’t send me a text message, I’m not paying you that way.” Turns out I’m not like most people these days, because we’re now bringing in more than double the cash from patients, mostly via text message, some by email. That’s how people are paying now, which is mind-boggling to me but exciting at the same time. It doesn’t come without some pain — like anything else, there are good collection agencies and agencies that need help with their own processes, and selecting the right one is hard these days. But there are still agencies out there doing genuinely good work on accounts that have to be written off. I hope that addressed it properly.

Giles: Some great advice again. Next question, on the tech side: how real is your use of AI, in quotation marks? What is AI really about?

Michael Ferrie: That’s easy — let me go back to it for a second. The first part is the machine learning involved in coding. A lot of people are doing this now; our system was built from the ground up starting about eight or nine years ago, and it’s taken a long time to get where it is. The neat part is that we didn’t just learn how to evolve coding — we learned how to integrate it with charge entry, which substantially reduced the cost of delivery in both areas. That’s been huge. You do have to be careful, though — we’ve evolved something that works well, but I recently walked into a situation with a solution that just doesn’t work and isn’t delivering what it should.

The next piece is AI for AR, which has been transformative — it’s made a real difference in our efficiency. The exciting part is that it doesn’t just give you a list of things to do today, it gives you the probability of payment based on everything the system has seen before. It’s learning, understanding, and developing its own rules, and it comes back and tells you where you need to focus — sometimes even where to look specifically. That’s genuinely exciting technology, and that’s where things stand right now.

Giles: Excellent. And a listener wrote in to clarify his earlier question — he said his underpayment question was about payers not paying against their contracts, not about patient underpayment.

Michael Ferrie: My apologies for not interpreting that correctly the first time. Underpayment from payers is critically important. There’s a slowly evolving industry of people who do nothing but underpayment recovery, and some of them are getting quite good — taking client data, combining it with their own, and using machine learning to pinpoint the problem spots. One thing that’s always served us well is putting rules in place at the point of cash posting to catch these issues. For example: you bill five GI biopsies with specialty testing attached, and the payer decides not to pay some of them, or pays only three of five. If your system isn’t watching for underpayment and flagging it for you, you won’t catch it fast enough — in some cases you only have 30 days to appeal — and more often than not, it just gets missed entirely. The systems you use are crucial to knowing whether you’re being shorted by payers. There’s a fast-growing industry of outside specialists doing this kind of recovery work, and I’ve seen some solid results from a few of them. But at the end of the day, you can avoid a lot of this simply by having a system tooled to find these issues and let you pick up the phone and challenge payers on whatever rules they’re applying that are keeping you from getting paid.

Giles: Thanks for addressing that. Next question: as an outsource organization, how does this apply to central business offices?

Michael Ferrie: I hope I’ve touched on that already — I’ve worked both inside and outside CBOs and looked at many across the country. The fundamentals are the fundamentals, no matter where you are. Everything I’ve talked about applies, even the notion of relationships with clients. If you think about it, a CBO I’ve been in recently is responsible for certain medical specialties within its medical group — that’s the client. I don’t think that mentality ever changes. If you carry that mentality, you’ll be successful.

Giles: We have about a minute or two left, and this next question is a great one to close on: what other practical examples can you give of how to make this happen?

Michael Ferrie: First of all, “excellence” — talking about excellence is a lot like talking about quality. There’s a tongue-in-cheek idea that quality is assumed in healthcare — I’m not sure that’s actually true. You have to go looking for excellence, on a kind of hunting expedition through your processes, your people, and the information your reports create. When you find it, it starts to change how you look at the world. Finding excellence in cash posting, for instance, can lead you directly to the underpayment issue we just discussed. Pulling the systems, the process, and the informational analytics together in service delivery gives you a teachable moment on that specific issue — and it opens your mind to ask where else that same discipline applies, regardless of the function. That’s how excellence becomes episodic, and eventually becomes cultural.

Giles: Well said — and that is all the time we have for today. I’d like to thank Michael for an excellent presentation, as well as Coronis Health for sponsoring today’s webinar. Thank you for joining us today. We hope you have a wonderful rest of your day. Thanks, everybody.