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Becker’s Healthcare Podcast
AI Automation, Revenue Cycle Innovation, and the Future of Hospital at Home with Michael Zwetschkenbaum
00:12:28
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- [00:00]
A
This is Scott Becker with the Becker Healthcare Podcast. I'm joined today by a brilliant leader who spans the sort of efforts between revenue cycle, software, accounting and a lot more. We're joined today by Michael Swetzenbaum and Michael's going to tell us about what he does about his company and a lot more. Michael, can you take a moment and introduce yourself and tell us about what you do?
- [00:28]
B
Absolutely. Thanks, Scott. You said my last name so well I'm not going to have to say it again. My name's Michael. I was formerly a hospital cfo, then a regional cfo and then a corporate health system cfo, and now I own RCM Healthcare Solutions. We develop software. It plugs the holes that I found throughout my career as a cfo, and specifically the holes that impact the patient. So in short, when a patient would, or a community member, or even a doctor would complain to me as a cfo, I always jotted it down and I compiled a huge list of gaps in health care. And in 2014 I created MCM, which was a claims management solution. And then since then we've really built it out and worked with AWS, Amazon on creating our patented ProActivate AI. We call her Shakira and she works with hospitals, doctors, ASCs and she's a coder, she's a case manager, she's a nurse, she's a hospitalist, and she's a rev cycle specialist, all in one. And our newest Shakira powered agent is a digital lockbox and that's now bridging the accounting functions with the revenue cycle all through automation.
- [02:06]
A
Remarkable. And take a moment on what are some of the trends you're watching? How quickly is this AI healthcare world evolving? Where are you seeing the impacts? Tell us a bit about what you're watching.
- [02:21]
B
Great question. So our mission is to level the playing field for the patients. So naturally, patient satisfaction is absolutely something we look at and now bridging that to AI. What we're seeing, especially with the big boys, is that there's a lot of work cues happening and a lot of workflows that go with those work queues. And the AI is pushing different documents and information into these work queues and they're sitting and the patients are affected because their bill is now in ambiguity land and there are more phone calls, there are more non payments because when a patient is insured you don't get the patient responsibility and there's less community engagement with the hospital and that has a real tailwind effect to hit your headwinds and it slows down the revenue cycle and interrupts your yield. It really degrades yield. So we've been watching that who's doing what in these work queues and it's led us to really develop our offshore AI. So instead of offshoring where a lot of the risk is happening right now, a lot of these work queues are being handled by offshore folks. We've, we've created Shakira to handle that because the, the oracles of the world are trying to catch up with epic and in the meantime there's a lot of storage of information and that information is not getting utilized. The, the other piece that kind of lends towards this because of the automation and the ability for a physician to start managing their own information. Their individual practice management is really the hospital at home that's patient centric, giving dignity back to the patient. It helps physicians hang shingles again also which is a complete reversal of the last 30 year trends. It's basically having a doctor, having another doctor with business acumen helping to manage their practice. And a lot of those trends are starting with ambient listening. So there doesn't have to be a whole group of staff helping to document correct and then submit ambient listening along with AI agents helps to do that. And we're watching those trends and, and the goal would be to bring healthcare closer to the home again and take
- [05:06]
A
a moment and talk a little bit about sort of this hospital at home and how you see that evolving. Because I see lots of great things and lots of challenges and I'd love to see hear your thoughts on hospital at home and what's going on there.
- [05:19]
B
It's a great question. Funny just to kind of go back for a second. Fifteen years ago I created a telehealth platform because that was one of the gaps that I saw when I started with RCM Healthcare Solutions. I sold that and the reason being is there was no reimbursement, there was no buy in from the payers. And so without that it was a complete drain on resources and it wasn't being adopted. Hospital at home healthcare at home is right now in that phase. It took Covid to get telehealth reimbursed. Right now we're going to need a triggering event like Covid to have the reimbursement bodies understand the true benefit of giving dignity to the patient at home.
- [06:12]
A
Talk about the varying qualities of hospital at home, which is one of these I'm concerned about because all these hospitals have a really hard time getting people discharged from the hospitals they they dearly want to be in the hospital home environment, but still broad differences in how well you could staff and take care of people at home. How do you see that sort of evolving? Any thoughts there?
- [06:35]
B
I think the tools that are being created have to create visibility and transparency and information. And there has to be real, real validation of the agents that are being utilized to monitor the different devices that are now being able to utilize at home. And so it's going to take time and as each modality becomes safe and secure and the information is transparent and visible to the parties that need it, think these two things. Think hospice, home hospice. Hospice was evolved to be able to be cared at home. Now the end result is not what health care is always looking for. We look to get healthy, not end of life. That's one of the reasons hospice was able to be pushed to the home. But now we have dialysis and we have very efficient dialysis at home. So the, the movement is happening. And as the tools are, for lack of better words, perfected in their information gathering, the communication to the subject matter experts that need to be available for it and for the proper caregivers to be available for it, which there is a model with home health. That's what's being put together right now. And the big boys like Kaiser are investing heavily in it and rightfully so. It's the right thing to do for a patient.
- [08:23]
A
No, I completely hear you on the need and desire for it. There's still some real gaps in the ability to cover a great number of patients through appropriate hospital home for more acute, challenging issues. But let's hope it gets there because the nation's hospitals need that relief as well. And to get people through ers, we're going to need to have to do it too, and so forth. So agree with the premise, but it seems like there's a long way to go.
- [08:51]
B
Stig, I think what you're talking about, even hearing you say it, I think when the reimbursement models are built, because there's not real reimbursement models built, it has to be built by modality, by service. Because as the services are perfected, just like we have with dialysis and hospice, as service lines are created, meaning we have the tools, we have the personnel and we have the workflow, that's when the reimbursement models need to be in effect and there needs to be a technology adaptation and reimbursement tie in. And right now reimbursement is completely excluded. People are working on the, on the technology and the workflows but the separation for the reimbursement is creating a slow adaptation.
- [09:52]
A
Very, very much. Talk a little bit about Michael. What are you most focused on and excited about this year?
- [09:59]
B
So, you know, it's really end to end automation, bringing care back to the patient. As automation happens, like I said, the ability to be able to provide care in different settings starts taking place because the care just has to take place and the rest of the healthcare cycle can happen without it. So we're excited about that. And if you look at the last 30 years, driven by need, doctor and hospital consolidation hasn't stopped. And that was never the original intention. It was always care for the patient when and where it was necessary. So as our ambient listening, our AI agents continue to grow, it should allow the trend to reverse itself. A single doctor can have an army of agents once they're comfortable. And that's what we're excited about because adapt adoptions starting.
- [11:05]
A
No, I think that's. I think that's fantastic. It really is. It's moving in that direction. It's in a lot of work to get there to do it. Yes, it really needs to be done for patient quality and safety, depending on acuity of patient and depending what resources the patient has at home. Couldn't agree with you more, Mike. A last question. Advice you would give to emerging leaders. What do you try and tell people that you mentor that are emerging leaders? What advice do you give them about leadership?
- [11:33]
B
Right on. Yeah, good question. I would say accuracy in tone and meaning is the key to good results. In the AI era, you have to find an issue that needs resolution. You have to create a visionary solution and you can't stop until you resolve the issue. And in this AI era, you have to capture all variables that impact your scenario. And those that understand all the variables will be the ones that succeed. In the AI era, you have to become a subject matter expert, and that's the advice I'd give.
- [12:10]
A
And Michael, what a pleasure to visit with you today on the Beckers Healthcare podcast. Thank you. Thank you for all you do and all your leadership and very exciting to watch how it evolves. The home and health area, the hospital home. Thank you so much for joining us.
- [12:24]
B
Thanks, Scott.