Becker’s Healthcare Podcast – Episode Summary

Guest: Abigail Abongwa, MHA, System Vice President of Revenue Cycle, UW Health
Host: Andrew Kass, Becker’s Healthcare
Date: October 7, 2025
Duration: ~15 minutes

Episode Overview

This episode features an insightful discussion with Abigail (“Abby”) Abongwa, System VP of Revenue Cycle at UW Health. The conversation centers on transformative trends in healthcare revenue cycles, the evolving landscape of technology and automation, patient financial engagement, and how revenue cycle strategies are adapting to meet today’s complex margins and operational challenges. Abby also explores leadership, team adaptability, and her vision for growth.

Abby Abongwa: Background and Professional Path

(01:01 – 02:12)

• Abby highlights her nontraditional career journey, with experience in strategic planning, government/community relations, and board governance before entering revenue cycle leadership.
  • She credits her diverse background for helping her approach revenue cycle work "truly from a patient perspective" and challenging the “we’ve always done it that way” mindset.

“My entry into Rev cycle I feel was very non-traditional... It helps me look at things truly from a patient perspective versus we've always done it that way.”
– Abby Abongwa (01:27)

Top Trends in Healthcare Revenue Cycle

(02:12 – 05:46)

1. Advancements in Technology: Automation & AI

   • Major investments in automation, generative AI, and predictive analytics are helping automate repetitive/error-prone tasks and anticipate denials or cash flow issues.
   • Potential for AI in clinical documentation, appeal letter drafting, advanced coding, and diagnosis assistance.

2. Patient Financial Experience

   • A focus on transparency and front-end patient engagement as patients carry more financial responsibility (rising deductibles, copays, coinsurance).
   • Emphasis on accurate upfront estimates, flexible payment options, digitized payment portals, better customer service, and financial counseling.
   • Central theme: Simplification of both front-end financial planning and post-care billing for patients.

3. Real-time Data Analytics and Denial Management

   • Shift from retrospective data reviews to real-time, proactive analytics.
   • The use of analytic tools to quickly spot and respond to denial trends by payer or reason, allowing for earlier interventions.

“AI, generative AI and other financial experience…and then data analytics, real time monitoring and response to denial management and prevention strategies would be the top three…though there’s a lot more we’re tracking.”
– Abby Abongwa (05:24)

Current Headwinds: Financial Margin Pressures and Strategic Responses

(05:46 – 10:00)

Key Challenges

• Increased costs in labor, pharmaceuticals, supplies.
• Need to keep pricing affordable while costs climb.
• Constantly evolving and complex payer denials.
• Reduction in coverage for some populations (e.g., post-pandemic Medicaid unwinding affecting indigenous and vulnerable patients).

UW Health’s Response Strategies

• Managing the “cost to collect” through a balanced mix of internal teams and selective vendor partnerships (without full-scale outsourcing).
• Technological adoption to streamline processes and reduce costs.
• Deep dives into “controllable write-offs” to understand and prevent payment loss.
• Significant efforts in clinical documentation improvement: ensuring all care complexity is accurately captured for optimal reimbursement.

“We want to keep our prices as affordable as possible... But trying to manage these things where costs are going up and not price ourselves out of the market…is a real issue that we’re trying to balance.”
– Abby Abongwa (06:21)

Areas of Excitement: Technology’s Transformative Potential

(10:00 – 11:11)

• Abby is energized by the ability to let teams "work to the top of their license" by using technology for routine tasks.
• Recognition that tech-driven efficiency gives staff more time for higher-value work, but requires new skillsets and mindsets.
• Excitement is balanced by the need to effectively transition and engage teams during this shift.

“We have the ability to really have our teams…work to the top of their license by leveraging technology in those areas that are predictable, rote, and don’t really require the smarts of our people.”
– Abby Abongwa (10:09)

Preparing Teams for Change: Communication and Change Management

(11:11 – 12:37)

• Open, continuous dialogue with staff during technology evaluations and implementations.
• Transparency about operational challenges and collaborative decision-making.
• Emphasis on change management for smooth adoption and employee buy-in.

“The teams know we’re struggling to keep up with volumes…So the dialogue is: how are we together going to figure this out? By having the team be aware of the context…then how you involve the teams as we go through the process of making the decision…”
– Abby Abongwa (11:34)

Vision for Growth: 12-24 Month Outlook

(12:37 – 15:02)

Organizational Perspective

• Growth is rooted in access: Tackling UW Health’s “wicked problem of access,” balancing strong demand and capacity constraints.
• Exploring flexible models, including telehealth, partnerships, and efficient workflows to expand patient access.
• Revenue cycle’s critical role: Ensuring operational readiness so that growth translates into successful patient clearance and revenue capture.

Personal Perspective

• Commitment to ongoing learning and curiosity.
• Embracing her “outsider” lens to question processes and inspire continuous improvement.

“There are things I still find out after eight years at UW Health that I go, ‘Oh, I didn’t know that. Why do we do that?’…So just really continuing to be curious is my way of…being an effective support and leader for our teams here.”
– Abby Abongwa (14:25)

Notable Quotes & Memorable Moments

• “We are a well sought after institution because people recognize the quality of care. Unfortunately, sometimes our care isn’t really reflected in the documentation or the complexity of it isn’t reflected.” (09:28)
• “Technology excites me.” (10:56)
• “Access, access, access…Our CEO calls it the wicked problem of access.” (12:44)
• “When it comes to from a personal perspective, I’m just all ears. Learning, right?...Just really continuing to be curious, I think is my way...” (14:19–14:35)

Key Takeaways

• Rapid technological change and patient-centric finance are reshaping revenue cycle leadership.
• UW Health is proactively confronting margin pressures with smart vendor partnerships, technological innovation, and a relentless focus on documentation and access.
• Abby’s approach is characterized by transparency, collaborative change management, and a mindset of perpetual curiosity.