Change Healthcare: Accelerating Revenue Cycle Transformation

In this Business Profile, Jason Williams, vice president for strategy and business analytics, Change Healthcare, discusses the importance of technology and technology-enabled services in reinventing the revenue cycle.

How do you help healthcare organizations?

Change Healthcare is passionate about the revenue cycle as a key component in our vision of inspiring a better healthcare system. As one of the largest independent healthcare technology companies in the United States, we offer end-to-end revenue cycle software, analytics, and services that enable smarter decisions, helping our customers anticipate and respond to evolving market dynamics. Our expansive customer base gives us a wealth of knowledge and experience we can tap into, enabling unique insights into what’s happening in healthcare delivery from a financial standpoint. We leverage our provider and payer knowledge to help customers navigate the continuous stream of revenue and cost disruptions, and we support organizations in managing costs, speeding cash flow, driving revenue, and enhancing the patient experience.

What are some of the biggest challenges you see affecting healthcare organizations?

The majority of healthcare organizations may deliver a quality clinical experience, but they often struggle to consistently achieve a good overall patient experience. A patient’s interaction with a healthcare organization may start days or weeks before a clinical encounter, and it could stretch to weeks or months after the date of service. So, even if the clinical interaction is positive, if things happen before or after to frustrate or anger the patient, it could negatively affect the individual’s perception of the organization and his or her propensity to pay for the service. To maintain or improve patient satisfaction, healthcare entities must work to effectively manage the broader arc of the patient experience, including setting financial expectations up front.

Another challenge involves preserving patient revenue integrity. Because of the rise in high-deductible health plans, there are many insured patients who are almost like self-pay patients because they are deep in the annual deductible and paying out of pocket. Healthcare organizations need to better identify and work with these individuals to ensure they can meet their responsibilities and the organization can collect all the money that’s due.

In addition to watching patient revenue integrity, organizations also must find ways to safeguard overall revenue integrity as they pursue different payment models in response to value-based care. These models can require an organization to fundamentally rethink how it approaches the revenue cycle, which can be a daunting prospect.

Underlying these challenges is the fact that organizations are being tasked to do more with less because of the cost reductions that are universal to every provider. Innovation can sometimes be expensive, so organizations must seek approaches that cultivate change while keeping costs in check.

How do your products and services address these needs?

As an end-to-end software and service provider, Change Healthcare can help organizations with all of the abovementioned hurdles. For example, we deliver technology that enables sound patient communications and collections, smoothing the patient experience. We also provide robust data analytics that proactively identify improvement opportunities at the front end of the revenue cycle to prevent issues on the back end, such as denials. With regard to revenue integrity, we draw from the largest revenue cycle data set in the industry and have strong engagement with a diverse customer base, enabling us to find opportunities to better manage revenue under both fee-for-service and value-based reimbursement. We collaborate with our customers on what they need as they move toward value-based care, which tends to differ across geographies. Our national coverage gives us detailed insights into how we should customize our solutions to particular markets. Lastly, our service offerings enable providers to augment their limited full-time staff, so they can collect patient revenue that they don’t have the in-house bandwidth to pursue. This can be a lower-cost option for driving revenue. In some cases, we have ongoing relationships with providers, and we work on a project basis with others. Regardless of the nature of the engagement, we assist with managing the flow of revenue cycle operations.

What are some key considerations for healthcare leaders when choosing this type of product or service?

Knowing a vendor’s track record of satisfied customers is important, but you can’t stop there. You should maintain a long-term perspective when selecting a vendor. What investments are they making for the future? Are they still focused on solving yesterday’s problems, or are they future-focused and working with their customers to resolve tomorrow’s issues as well? At Change Healthcare, we’ve invested in both technology and other solutions aimed toward the future. On the technology front, we’ve made significant investments in hardware and data analytics capabilities, and we are committed to exploring next-generation technologies, such as blockchain, machine learning, and artificial intelligence. From a solutions perspective, we’ve made substantial inroads to address consumer engagement, as well as value-based reimbursement and bundled payments. We’ve also recently taken steps to help our customers more meaningfully leverage our extensive network, facilitating virtual and face-to-face peer interactions.

As healthcare organizations implement and use your products or services in their day-to-day operations, what advice would you offer so they can set themselves up for success?

When implementing any large-scale initiative, there is an opportunity to redesign bad processes. If you don’t seize this moment, you are automating poor workflow and accelerating the backlog of junk. Take time to redesign—examine and rethink workflows that have stymied forward progress. By doing so, your organization can take full advantage of the technology or solution it’s implementing.

Organizations must also avoid onboarding a solution and then resuming business as usual. Systems today often have analytics capabilities, and you must commit to using that information to bring about change. Leveraging data must be a cultural norm and a habit that occurs as a matter of course. You must examine what’s coming out of your system and how users are applying that information, watching for trends of concern and new opportunities. Otherwise, you are not going to get the true value out of the technology, and your forward progress may stall.

Are there any educational materials you would like to share to help healthcare providers in these efforts?

Change Healthcare hosts a comprehensive website, healthyhospital.changehealthcare.com, which includes many timely resources for providers working to engage consumers and move toward value-based reimbursement. More specifically, the website provides insights into best practices from our broad range of customers, as well as benchmark capabilities and market research. For example, in the past month, we’ve posted a value-based reimbursement analysis by state, which shows how each state is approaching value-based care and what that means for healthcare organizations in different geographic areas. We’ve also done some research on consumer engagement, in which we talked to payers, providers, and patients about the various consumer engagement initiatives under way—and whether those programs are working. Our goal with the site is to make information more available, aiding organizations in addressing the prevalent challenges they face. We firmly believe that this is our role as a leader in the industry. Not only do we build strong relationships with our customers, but we facilitate information transparency across entities, so everyone in health care can appreciate the evolving dynamics and work to nurture the best-possible patient outcomes and experiences.

Change Healthcare is inspiring a better healthcare system. Working alongside our customers and partners, we leverage our software and analytics, network solutions, and technology-enabled services to enable better patient care, choice, and outcomes at scale. As a key catalyst of a value-based healthcare system, we are accelerating the journey toward improved lives and healthier communities. Learn more at www.changehealthcare.com.

Content for this Business Profile is supplied by Change Healthcare. This published piece is provided for advertisement purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions of those profiled are those of the individual and not those of HFMA. References to commercial manufacturers, vendors, products, or services that appear do not constitute endorsement by HFMA.