Amanda: ... program titled "John Muir Health and AI:
A Case Study in Managing Costs."
My name is Amanda Norris,
and I'm the associate content manager
of our finance markets here at HealthLeaders,
and will be your moderator for today's event.
Our program will be 60 minutes in length.
Note that an on-demand version of this program
will be available approximately one day
after the completion of the event,
and can be accessed using the same login link that you used
for the live program.
Today's program is sponsored by Optum.
Thank you to our sponsor, and to you and our audience
for giving us your time and attention.
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So at this time, it's my pleasure to introduce our speakers.
We have Dexter D'Costa,
Senior Director of Revenue Cycle Value Management at Optum,
and Susan Ingebretsen,
Director of Health Information Management Services at Optum
and supporting John Muir Health.
Thank you both for taking the time to speak with us today.
And with that, the audience is yours.
Susan: Thank you, Amanda, I appreciate that.
Hi, everyone, my name is Susan,
and today, we're going to talk a little bit
about John Muir Health's journey
to transform our middle revenue cycle
through technology and innovation.
So in front of you is our agenda,
and we'll be going through these various areas here
regarding cost management, some managing cost overviews,
and some of our outcomes-driven results,
and some of our key takeaways.
We're gonna start off with a poll question.
So think about what is your top pain point
in managing costs within your revenue cycle.
And so here's some options.
We have cost optimization, revenue performance,
clinical efficiency, all of the above.
Maybe you don't have any problems within your revenue cycle,
or you're not quite sure.
So any of your top pain points
in managing costs within your revenue cycle.
Okay, we'll start looking at some results here.
Looks like we've got several, about half don't know.
About another quarter percent, about all of the above.
So hopefully we'll give you some key insights here.
First, I wanna talk a little bit about John Muir Health.
It's a community-based health system
located in the San Francisco Bay area.
It includes two of the largest medical centers
in Contra Costa County, one being in Walnut Creek,
which actually also serves as
Contra Costa's only designated trauma center.
The other medical center is located in Concord,
they specialize in cardiac and stroke care.
And together, they're recognized
as highly regarded centers for the neurosciences,
orthopedics, cancer care, cardiovascular care,
and high risk obstetrics.
They also specialize in general surgery, robotic surgery,
weight loss surgery, rehabilitation, and critical care.
Both of these hospitals are accredited
by the Joint Commission,
which is the national surveyor of quality care.
John Muir also offers a complete inpatient outpatient
for adult and adolescent behavioral health program,
and they have services at a behavioral health center,
which is a 73 bed psychiatric hospital located in Concord.
So our strategic partnerships began in July of 2019.
This is when Optum and John Muir announced
a comprehensive new focused relationship
on advancing delivery of high quality care,
affordable for the patients in the Bay Area.
And the new innovative partnership was really designed
to bring an extensive set of capabilities,
including operational technologies,
analytic solutions and tools,
and administrative services expertise
to help John Muir further advance
its clinical and operational performance.
And to support this effort,
Optum would be managing key nonclinical functions,
including information technology, revenue cycle management,
analytics, purchasing, and claims processing.
Optum would also support and further enhance
John Muir's physician network,
ambulatory care coordination,
and utilization management services.
So through this new relationship,
Optum and John Muir identified a set of strategic goals
that they wanted to work on together.
One being increasing the efficiency
of administrative operations
using innovative technology solutions
to reduce administrative workload
and enable John Muir to maintain its focus on patient care.
Another key goal was to accelerate
John Muir Health's ability to deliver value-based care
and lower care delivery costs
by applying some proven approaches
to integrated coordinated care.
Third, bringing more data-driven insight to care providers
and patients at the point of care
using Optum clinical technologies
and advanced analytical tools.
And finally, some expected benefits
would be a more fully engaged,
more fully engaging our consumers in their health,
and identifying chronic conditions sooner,
and reducing overall delivery costs.
So as part of this very unique comprehensive partnership,
approximately 540 John Muir Health employees
were rebadged to Optum.
I was one of those.
I've been with John Muir for three years,
and then they announced this partnership,
and I rebadged to Optum.
So I've been there almost four years
as a, quote, Optum employee.
We would continue to directly support
John Muir Health's work and mission
as part of a dedicated John Muir Health business unit
within Optum.
And with access to new skill development opportunities,
and technologies, and processes at Optum,
we now have the opportunity to build on our successful work
in making John Muir Health's system
the choice for the people in the Bay Area.
I'm now gonna hand this over to Dexter
to talk a little bit more about Optum as a partner.
Dexter: Thank you, Susan.
Good afternoon, everyone.
My name is Dexter D'Costa.
Thank you for taking the time to be on this webinar today.
So one of the things we pride ourselves at Optum
is our expertise.
You see, we have more than 20 years
in the industry leading NLP business,
30 plus years in the coding experience,
as well as about 14 NLP patents.
We also pride ourself on our insight, our partnerships,
and four of five US hospitals
rely on our information and capabilities.
And last, but not least, is our success
with advanced technologies.
When you look at the volume of encounters
that are processed through our computer-assisted coding
and CDI technologies,
and the medical facts that are scanned through NLP engine.
When you look at Optum, we are truly one of those vendors
that provides end-to-end revenue cycle solutions.
Whether it's front end, whether it's mid end, mid cycle,
or whether it's the back end of revenue cycle,
Optum provides solutions across the spectrum of healthcare.
It's not just solutions, but we also provide services,
one of the few vendors that actually provides
technology solutions as well as services
when it comes to process improvements, education,
and leadership engagement,
and provider engagement, more importantly as well.
Our belief is our solutions
are here to transform revenue cycle,
whether it's the pre-admission process,
the admission process, or the discharge process,
our goal is to ensure that our Optum engine,
through a technology powered automation,
artificial intelligence, proprietary content,
and delivery and value management,
provides value to our clients and our partners.
And thus providing the results that you seek,
whether it's financial, whether it's clinical,
whether it's operational.
So let's talk about managing costs.
Managing costs is not just a coast problem,
or a middle America problem.
It's not just a problem that urban hospitals
or rural hospitals deal with.
It's not just a problem that academic teaching hospitals
or critical access hospitals deal with.
In fact, it's not just a problem
that the US healthcare systems deal with,
but a lot of other countries have the same problems
with regards to how do you manage costs
in the healthcare arena.
So let's start with a quick poll question.
Do you currently outsource your revenue cycle?
And by outsourcing your revenue cycle,
the options that you have is yes,
we outsource our full end-to-end revenue cycle services
and the technology,
we outsource just our services only,
or you do a little bit of outsourcing when it comes to,
maybe it's just your front end, or the middle,
or the back end of revenue cycle.
Or option D, which is we do not currently outsource
any part of our revenue cycle,
but are likely to explore in one or two years,
or option E, we have no plans for RCM,
revenue cycle management outsourcing,
or F, I do not know.
So let's give a few seconds before we view the results.
Okay, we've got a few results coming in,
so I'm gonna wait a few more.
Okay, let's look at the results.
So looking at the results,
you see that most of you,
48% said we have no plans for RCM outsourcing.
The second most was I don't know,
or we do not currently outsource
any part of our revenue cycle, but are likely to explore,
or you have a limited form of outsourcing,
whether it's front, middle, and back end.
And I think that's what we've seen
in terms of the clients that we've worked with
is sometimes, they question the value
and how does it help with managing costs.
And that's what we are here today
is to share the story with John Muir
in terms of what they did
in terms of helping manage the cost conundrum.
So one of the things,
we recently published a white paper wherein
healthcare executives talked about their pain points,
and it revolved around three factors,
cost optimization, revenue performance,
and clinical efficiencies.
In fact, when you look at the key market divers
and industry challenges,
50% of hospitals have a negative margins this year.
The number one pain point that most CEOs talk about
is personnel shortages.
Denials continues to be a big problem
that a lot of health systems are facing.
And on top of that, you have regulation,
consumerism, and decentralization of care.
Whether it's bed and clinical resource shortages,
you look at the nursing shortage,
you look at personnel shortage in general,
or you look at the aging population
and the need for more clinical staff.
Whether it's efficiencies in workflow,
it could be the medical necessity reviews,
for those of you that work in CDI and coding,
around staffing accuracy,
or for those of you that work in authorization.
So the problems are many, and yet the solutions
tend to be focused on silos
and not so much an integrated solution,
and more importantly, how can we leverage technology
to help solution for those pain points.
Going further, you look at costs,
and you look at revenue variability,
the ever increasing problem of denials,
the appeals process, and how painful that can sometimes be,
as well as looking at the eventual gross operating revenue
continuing to decrease.
So health systems in general,
no matter where you are in America,
no matter what type of health system
or hospital you might be,
continue to face unprecedented headwinds.
And these are just a few of some of the issues
that we've tried to summarize.
So the question then be is
what can we learn from John Muir Health
in terms of what they do to help accomplish
some of the cost containment strategies
that they're gonna share with you
in the next couple of slides?
One of our beliefs at Optum
is we are here to solve middle revenue cycle
industry pain points.
We talk about the CDI coding, charging digital workforce,
and it's driven by our AI cubed model.
What I mean by that is automation, innovation, intelligence,
and integration.
There's a lot of vendors out there
that talk about automation,
there's a lot of vendors out there that talk about
having the best when it comes to BI analytics,
but there's very few vendors out there
that can truly provide all of that experience
in one integrated product.
And that's what we believe is our differentiator
in terms of solving for industry pain points.
We look at a snapshot of the typical results we've achieved,
whether you are a CFO and you're focused on revenue,
we've been able to deliver value
for the investment you've made.
Whether you're looking from a COO's perspective,
and looking at productivity and efficiency,
labor savings, and more importantly,
being able to leverage your staff for other opportunities,
expanded scopes,
whether it's hierarchical condition categories,
whether it's a (indistinct),
those are some things that we are able to provide
in terms of the labor efficiency gains that you get.
And yet, we focus on revenue and productivity
without compromising on the accuracy or the quality.
So that's been one of our big focus
in terms of its automation,
but yet, we wanna focus on data integrity
and the accuracy of the data as well.
So these are just a few snapshots
with regards to whether it's CDI, whether it's coding,
whether it's inpatient or outpatient,
initial reviews or subsequent reviews,
whether it's auditing and looking at decreasing
the amount of time your auditors spend on doing audits,
or whether it's just looking at AI acceptance
in terms of the match rates,
or the precision and the recall.
Our results tell the story
with regards to the efficiency that we bring in,
and through those efficiencies, being able to manage costs.
So without much ado, I'm gonna pass the ball on to Susan
to talk about what did John Muir do
leveraging AI in terms of managing costs.
Susan?
Susan: Thank you, Dexter.
Okay, so let's start off with another poll question.
Do you currently have an integrated and automated
coding and CDI software?
So here are some options here.
Yes, you have both an integrated and automated enterprise
computer-assisted coding, even for your professional,
or inpatient, or hospital-based.
You use multiple vendors.
You use eCAC and CDI technology, but don't use
a professional services computer assisted coding.
You use eCAC, which is your enterprise or CDI.
Lots of options here.
You currently don't have anything.
You don't have any plans for it, or you're not sure.
Let's give it a few seconds here
to read through those options.
Okay, let's see what we got here.
All right, looks like we've got a little, a mixture here.
Some have no plans, some are not sure,
they currently don't use, but they're likely to explore it,
so very good.
So John Muir faced a lot of challenges,
and so what they were looking for
was a partner that shared some common values,
and they found Optum.
They were committed to, John Muir was committed to staying
as an independent health system,
but also wanted to embrace partnerships
to help them grow to serve more patients.
So some of the key challenges that we face,
especially in revenue cycle,
was the lack of integrated middle revenue cycle technology
and advanced data analytics.
We also, our existing
computer-assisted coding system and CDI solution
was really intended to address ICD-10 transition
versus renewed focus on labor productivity,
improving our review rates, workflow, and revenue uplift.
This is kind of a nice little,
a quote from the then CEO of OptumInsight in 2020, Eric.
I mean, basically, this partnership vision
was an opportunity by John Muir
to bring John Muir's exceptional skills and knowledge
together with Optum's advanced technologies
and analytical solutions to improve patient outcomes
and reduce our total cost of care.
And we feel we've done that,
and hopefully we'll talk a little bit about
what that looks like.
So as part of our partnership,
we embarked on five cost management strategies.
The first would be our technology workflow integration,
which was essential.
So pre-Optum, our pain point was
we had lack of collaboration
between our coding and CDI team.
They basically worked independently on the same cases.
They didn't use,
the CDI specialists didn't use coding as much,
they were just beginning to use coding.
They were pretty much focusing on CDI concepts.
So the solution that Optum brought was a single platform
enterprise computer-assisted coding, and computer-assisted
clinical documentation integrity solution,
which we implemented in March of 2020.
The result of that is we improved
our CDI and coding collaboration.
They now could see each other's reviews.
The reconciliation was a very seamless communication
between those two teams.
They could preview code assignments, and working DRGs,
and communicate with coding,
which has really helped improve our coding turnaround time,
and really reduced our discharged not final billed days
from about six days to four.
So that was a pretty significant improvement.
Currently, our discharged not final billed days
are actually under five,
and they remain between probably four and five.
And we continue to be in the top fifth percentile
in the Epic Financial Pulse, which is a national dashboard,
if you will, for Epic clients across the country.
And we lead in coding days at 0.1,
and our coded final days at 1.3.
So we actually are a diamond,
which is your top of the class in those areas.
Higher employee satisfaction.
Our CDI team used to have, didn't have such good engagement.
And so prior to new leadership and transformation,
or since that, sorry, the new leadership and transformation,
we've got a higher employee satisfaction.
So some really good results there.
A second cost management strategy
was enabling AI technology.
One of our pain points is our CDIs were missing case reviews
due to staffing issues, due to workflow.
We were only focused on Medicare/DRG payers.
There were some missed opportunities
due to our review rates and that type of thing.
So the solution was
Optum provides this clinical language intelligence engine,
which actually kind of scans 100% of the charts.
And then what it's looking for and highlighting
are clinical markers, and these identified
possible query opportunities.
And the highlighting of these indicators in the record
are really based on clinical and coding algorithms.
And so they get presented,
these cases get presented to the CDI staff
that helps them to prioritize their workflow.
And the results were, we had an improvement of 22%
of our average monthly review rates,
and we didn't have to hire any additional staff.
So same staff, higher review rates.
Our career rate is meeting and exceeding
our established goals.
We saw improvement to that query response rate,
and our agree rate also improved.
And our CDI reviews are of higher quality today,
and to improve and adjust existing staffing
to improve and include weekend coverage.
So we basically, we're now able to expand our coverage
to six days a week and not increase our staffing,
so that was a nice cost saving strategy.
A third strategy was collaborative physician engagement.
And prior to our Optum partnership,
we had limited physician support.
We had physicians that were designated
to support the program.
We had recently entered a contract with two physicians,
a hospitalist and a surgeon,
she's actually chief of surgery,
to be our physician advisors.
And we didn't have a clear escalation policy.
So once we had this partnership,
we were able to optimize the provider workflow.
We implemented a query workflow
that was part of actually Epic,
which was really nice for the physicians.
It made things much more efficient on the physician side.
We collectively, let's see, we used our BI Power reports.
We were able to develop, give the provider,
the physician advisors information
that they could talk to the physicians
to leverage our query escalation policy,
and to also give them information
to provide just-in-time training.
So as a result of that streamlined provider query workflow,
the physicians were able to answer queries much easier.
The physician query response and turnaround time
was increased due to the ability
to have good valuable conversations
with the physician advisors and the providers
regarding unanswered queries.
The fourth cost management strategy was using,
having the ability to have intelligent reports
and dashboards.
So prior to our partnership, we really lacked
some real-time data analytics
to drive our operational changes,
or to even provide information and feedback
to the physicians.
And we needed to have some dashboards and reports
that would allow us to customize and drill down
for any kind of action planning.
So as part of the solution,
we had access to what they call BI Analytics,
and this is ad hoc reporting.
It's customizable, it's drill down, it's real-time.
We established a monthly performance management program.
It's a meeting that we need to review metrics,
identify opportunities, gaps, those types of things.
And as a result, we had a very robust
performance monitoring mechanism
that was now supported by these analytics.
And this governance structure really gave us an opportunity
to report on key accomplishments and challenges,
and it was a data-driven report then.
And it allows us to have information
for justification of a business case.
Like if we wanted to, if we wanted to add more staffing,
or just do a process redesign,
we now had data to support that request.
And finally, the fifth one
was professional fee service coding
and risk-adjustment innovation.
So prior to implementing the system, or the partnership,
our JMH provider group were doing,
they had their own staff doing the coding,
or they were doing their coding and charging.
There was minimal process standardization,
and we lacked a enterprise-wide
professional coding trends and reporting.
So we weren't even really able to monitor anything.
So we implemented what they call
professional computer assisted coding, PCAC,
in December of 2020.
And this then did standardize our coding workflow.
It gave us some reporting capabilities,
and it also supported
the HCC risk-adjustment capture methodology.
So that was new.
We didn't really have any trends for that as well.
The result of that was standardizing the workflow
across all specialties.
We are still in the process of,
I think there's a couple of specialties left.
We have multiple specialties that we were transitioning,
but we do have less edits.
The work-queue volume for the office is reduced.
We have education now available to the providers
based on real coding trends,
and we are working towards minimizing physicians
doing their own coding.
So letting them do what they do best,
which is caring for the patients.
Okay, at this point, I think I'm gonna hand it back over.
Oh, we have one poll question,
and then we'll hand it back over.
So does your computer-assisted coding or CDI technology
provide ad hoc or customizable data analytics, reports,
and dashboards?
So let's see what some of the questions we have here.
You have them, you have canned reports,
you don't currently have any tools,
but you're going to explore that,
you don't have any plans for it, or you're not sure.
Give a few seconds here.
Okay, so it looks like
most have ad hoc or customizable, well, 30%,
and 30% have canned reports with some customization,
and 30% are not sure.
Okay, nice little variety there.
Ah, yes, let me talk a little bit more
about our value impact.
So how it all started, again,
we started back in transitioning our coding
and our CDI teams to Optum in March of 2020.
We implemented the eCAC and our CDI 3D system.
And we restructured the coding workflow,
and we really got our physician advisor engagement on board.
So some of the metrics,
just to compare the then and the now.
At the time, our baseline prior to this, the partnership,
was our commercial capture rate,
baseline performance was just about 48%.
And as of quarter 2024, 2022, sorry, Q4 2022,
we had about a 10% increase, so about 58%.
So a really nice increase.
That impact of that change is about $17.5 million.
So a huge win for us at John Muir
in terms of financial impact.
In terms of the physician performance,
that's a physician metric, when you see JPI,
that's our John Muir performance indicator,
the query response rate was about 91% back at our baseline,
and we finished quarter 4 2022 at about 98.4%.
So good employee engagement.
We have two amazing, and I can brag about this,
two very amazing physician advisors.
One is a hospitalist.
The other, as I said, is a surgeon.
So supportive of this program.
We are very, very fortunate.
So when we look at today, are we still sustaining this?
And the answer is yes.
Obviously, everything ebbs and flows,
but basically, our outcome,
we have improved our productivity turnaround time.
We're above our peer group.
So part of this monthly performance management meeting
we have, we get compared to our peer groups,
and we continue to be above
for inpatient and ED productivity.
Our career rates have maintained very strong,
just about 24% query response rate
compared to initially, where we were just under 20%.
We've had a nice shift in physician engagement.
Again, at the first quarter, 2023, 96%.
Our query, or sorry, our physician response rate
really kind of ranges between 96 and 98%.
So it's a pretty strong response rate,
and our agree rate remains very strong as well.
We also saw an improvement in our CMI, which today,
continues to be above our peer group
for both of our campuses.
And also our risk adjustment scores
continue to be very, very strong as a result of all of this.
From a process and people-centric improvements,
we've got our performance management program,
where we're looking at key operational metrics.
We have continual staff education opportunities.
So we've got coding webinars, product release training.
It's just, it's constantly moving and ongoing,
which is really, really great.
And then we have interactive user groups.
So our team has an opportunity to find out
what are our other Optum clients doing.
And some key takeaways from this whole process.
What are the lessons that we've learned?
This is a, some of our,
our key takeaways is basically,
we were able to control some costs
through integrated platforms and workflows,
easing workforce challenges through automation
and innovative approaches.
We were able to simplify costs
through improved collaboration,
streamlined physician engagement,
and intelligent reports and dashboards.
We were able to incorporate change management strategies
to drive accuracy and productivity
using robust BI Analytics reports and dashboards.
And finally, allowing the physicians
to do what they do best,
and that's caring for our patients
while establishing accurate Profee
and HCC coding automation.
I think another big thing that we learned
is really leveraging a single partner
to help us connect our revenue cycle silos
and really drive innovation.
And I think the hallmark of a strong,
it's the hallmark of a strong partnership
versus just a vendor.
And we have built this partnership.
It's been a very comprehensive,
very connected end-to-end revenue cycle,
bringing revenue cycle technologies and services together.
We're very client-centric,
and we are very outcomes-based,
and are committed to the success.
Okay, I think I'm gonna hand this on to Dexter
to talk about innovation today, tomorrow, and beyond.
Dexter: Awesome, thanks, Susan.
So we at Optum believe that
we are not just gonna rest on our success today,
but we want to constantly innovate for today, tomorrow,
and beyond.
We've got some amazing technologies
that are coming out by the end of this year.
If you are an existing client of ours,
we'd love to talk to you about it.
If you are not a client of ours,
we'd love to still talk to you about what we have to offer.
So one of the first things that we have coming up
is Optum Mobile Query.
This is a physician-centric mobile solution
for your query process.
So you don't need the physician
to necessarily log into the EMR,
but the query comes to them through the telephone.
Another product that we have that will be coming out soon
is Optum Integrity One.
This is, you're talking about
within the middle revenue cycle, CDI coding,
whether it's enterprise,
whether it's professional, charge capture,
audit and compliance, analytics, all within one platform.
It's more than just a single sign-on,
but it's about ensuring the integrity of what you do
within one integrated platform,
and that's why we call it Optum Integrity One.
Another big exciting change, talking about change,
is a recent acquisition of Change Healthcare,
and the power that it brings in terms of InterQual
and Denials Assurance program.
So all of these, Mobile Query, Integrity One,
the Change acquisition are things that we believe
is gonna help innovate for today, tomorrow, and beyond.
And speaking of Integrity One,
so this is just a visual with regards to
whether you are inpatient or outpatient,
professional or facility,
whether you are charging, or coding, or CDI analytics,
auditing compliance,
or you're looking for artificial intelligence,
we provide all those solutions in a singular platform,
and that is what we believe
is what's going to help you manage costs
based on the success stories that Susan just shared
around the five case studies around John Muir Health.
If you are interested in more information from Optum
on learning how our revenue cycle solutions
can help contain costs, please let us know.
We are happy to answer any questions.
We will have a Q&A round after this,
but it doesn't end over here.
If you happen to be at HFME, we have,
come visit our HFME booth, 1019,
as well as any other conference.
And feel free to reach out to us.
We are here to help solution for you
and ensure that your pain point gets to a level one,
and not a level seven, or eight, or nine.
All right, so with that, we are at the Q&A round.
Amanda: Great.
Thank you both once again for an excellent presentation.
This now brings us to the Q&A portion of the program.
So we would now like to invite you
to ask live questions of our speakers.
As a reminder, to submit a question,
click on the Q&A widget at the bottom of your screen.
It may be open already
and appear on the left side of your screen.
Please note that your questions will remain anonymous
and will not be viewable by other audience members.
Our first question is,
"What was the competitive advantage of outsourcing
both MRC services and technology?"
-: Susan, you want... -: (indistinct)...
-: Go ahead. -: Yeah, I wanted,
I'm sorry, could you repeat the question?
Amanda: Sure, the question was,
"What was the competitive advantage
of outsourcing both MRC services and technology?"
Susan: From my perspective, I'm middle revenue cycle.
I believe that it allowed,
because Optum was able to bring
more technology solutions for John Muir Health,
they were not able to really bring those solutions.
And I think it was a good partnership
that they could lean on
to help drive forward with technology
and really allow the hospital
to focus on the clinical care.
Dexter: Yeah.
And I can add to it, Susan.
So I think one of the things we've seen in our experience
is a lot of times, hospitals or health systems
work with multiple vendors.
The vendors on the services side,
whether it's process improvement, change management,
are different than the vendors on the technology side.
In fact, the two of them don't talk.
So I think what our experience has been is
when you marry the two together, services and technology,
it ensures that the process improvements
that you bring about in workflow
are embedded in your technology
as well as the technology changes that you're implementing
align with your workflow.
And that, again, helps with employee satisfaction,
retention.
Again, going back to the,
how do you reduce costs by reducing the staffing turnover,
or for that matter, having to get extra staff.
Amanda: Okay, so how does HIM, CDI, and coding
help with managing cost for the health system?
Susan: Well, I think what we do is we're able to...
I think getting our coding done faster,
getting bills out the door quicker,
having complete and accurate records for coding.
I think we've seen an impact without having to add staff.
We've really been able to achieve
some pretty high cost saving measures
just in terms of I think the financial impact,
if that makes any sense.
Our capture rates,
all of that has been a nice incentive and financial impact.
Hope I answered that properly.
-: Good, next question. -: So are all...
Yep, are all of the providers employees,
and what steps did you take to increase provider engagement?
Susan: So not all the employees, sorry,
the physicians are employees.
We do have a medical group
called the John Muir Medical Group,
and that is mostly a lot of our hospitalists,
but they're community-based physicians.
And I think honestly, one of the big successes
for us to have with physician engagement
was our two physician advisors.
They have excellent rapports with the physicians.
They've got data, and documents, report trends to, again,
to communicate and educate.
It's been, I think honestly
having good, strong physician advisors
is one of the keys to your program's success.
Amanda: Why was the emphasis on having
an integrated middle revenue cycle technology solution
versus best-in-breed standalone tech solutions
in CDI and enterprise professional coding?
Susan: Well, I think what we wanted to do
was to have an integrated system
so that there was communication across the continuum
of these technologies.
So I feel that...
I mean, I do think best-in-breed
is always a good thing for something.
In this case, the integrated solutions
just allows a seamless workflow and communication.
Keeps everybody definitely on the same page.
And it allows the teams to communicate
and actually educate each other.
So it's been really good for coding
to be able to respond to CDI in a review, saying,
"Okay, this is why I would query,"
or, "This is why I wouldn't have queried,"
and vice versa.
So it's really opened up that nice continuum.
Amanda: Great, so I have another similar question.
How are your Optum systems connected to better support
the various patient financial support programs
from manufacturers?
Susan: Hmm.
Well, I'm not sure.
That's a good question.
I think I have to think about that one.
Dexter: Yeah, I can jump in.
I think the key thing is,
the good thing about Optum is
we are not necessarily just front, or middle,
or back, right?
So we are constantly looking at with our partnerships,
no matter who it might be,
whether it's channel partners, or even beyond.
So the goal is it's not just in the provider space.
We are also looking on the peer side of it.
So we wanna make sure that at the end of the day,
what can we do to help solve problems
for the health systems?
And it's a work in progress.
So if we do not have a solution today,
we will have a solution tomorrow, and the key thing is
making sure that we are constantly innovating.
Amanda: Great, thank you.
So how have changes in technology or improvements
impacted the coding profession?
Any decrease in numbers of full-time employees needed?
Susan: Actually, no,
it hasn't decreased any of the numbers
of full-time employees needed.
In fact, it's allowed them to do more.
So the technology has been actually a positive impact.
It hasn't replaced any,
you always hear about it replacing coders,
but it really is just helping them focus in
and drive down, deeper dives into these charts.
Dexter: Yes, and I think that's an important point is
what our technologies enable to do
is allowing you to do more with less,
or allowing you to do more with what you have.
So tomorrow, if you were to have a team member
that were to leave,
you're still being able to be more efficient,
or as we like to call it, work smart, not hard.
So that's the key thing of,
in terms of it's not just automation,
but it's intelligent automation,
in terms of redefining how we do workflows,
and being able to ensure that we are able,
whether it's beyond just peers, being peer agnostic,
it's being able to look at it
not just from a financial standpoint,
but also from a clinical and a quality,
or more importantly, from a risk-adjustment standpoint.
So those are just some of the ways
in which the technology helps, and as Susan indicated,
it's not about letting go of coders,
but more about what can we now allow our coders
or CDI members to do above and beyond
than the traditional way of doing business,
and that's what we are not about,
but more about how can we kind of think outside the box
and do the things that we've never been able to do
limited by technology in the past.
Amanda: Great, so what are some ways
that finance or revenue cycle executives
can help to streamline technology implementation like this?
Dexter: I can take that, Susan, or do you wanna go first?
Susan: No, go ahead.
Dexter: Yeah, no, I think the first thing
is to ask the right question, right?
You wanna pick...
It's more than just picking a vendor
versus picking a partner.
Someone that understands your pain points
is able to capture that.
Someone that is able to solve, not just in silos,
but being able to look at the big picture,
or what we would call the end to end.
Someone that's not just looking at,
here's the technology that's gonna solve your problem,
but here's the technology and the services
that actually work together and align,
so there's common messaging to the staff.
And more importantly, someone that's looking at
being able to bring in efficiencies,
bring in innovation, bringing the integration
and the innovation, as I've talked about.
So I think that's what we will look for
when we talk to our client leadership
in terms of the C-suite
is looking to them to tell us what they want,
but also being able to ask those tough questions
to ensure that we are not just able
to solve our problems for today,
but be able to solve our problems for tomorrow and beyond.
Susan, anything to add?
Susan: Nope, nothing to add to that.
Thank you.
Amanda: Okay, great, thank you.
Well, this now brings us to the end of our program.
That's all the time we have for questions.
So I wanted to thank our presenters once again
for an excellent presentation.
I also would like to thank our sponsor, Optum,
for making today's program possible.
Finally, thank you and our audience for participating today,
and we hope you'll join us in the future
for another HealthLeaders webinar.
This concludes today's presentation.