← Becker’s Healthcare Podcast
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- [00:02]
A
R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 US health systems and handles over 270 million payer transactions annually. If you want to learn more about how you can transform your revenue cycle operations, Visit us at www. R1RCM.
- [00:31]
B
Hello and welcome to the Beckers Healthcare Podcast. My name is Will Riley with R1. I am joined this morning by Patrick O'. Shaughnessy. Patrick is President and CEO of Catholic Health. Patrick, welcome to the podcast.
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C
Will, thanks for having me here. It's great to be here this morning. Thank you.
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B
So tell us a bit about yourself, your role. Tell us a bit about Catholic Health.
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C
Of course. So I've been at Catholic Health now for nearly 20 years. My background initially is in emergency trauma medicine and I practiced that for about 15 ran clinical operations for the health system and now I'm about in my fifth year in the role as president and Chief Executive officer. And it's truly an honor and a privilege to lead alongside such an amazing team of professionals. Our health system is based In Long Island, New York. We have six hospitals. We have an integrated physician network of about 3,500 physicians. We have nursing and rehabilitative care centers, home care, hospice, and a robust ambulatory network that's expanding across Long Island. We care for about 25% of the Long island population extending from Queens, New York way out into the Forks and the tips of the Hamptons. As you may have heard, we are a not for profit faith based organization. So we're mission central and critical to everything we do and we're very proud to be providing best in class care across Long island with some of the top and highest quality scores and outcomes in the region.
- [02:03]
B
Excellent. Thanks for the intro. So you have a pretty diverse community that you're serving by the sounds of it.
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C
Yes.
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B
Can you tell us maybe just tell me a little bit more about that and tell me some of the, the big initiatives that are on your mind as you think about that community and how to serve them going into next year.
- [02:19]
C
We're very blessed. We, we're, we, we care for so many different populations across Long island and our programs extend really from beginning of life to to. We're connected to the communities we serve and through our ambulatory outreach, our community health programs and quite frankly our emphasis on population health. Really, how do we help our populations stay and get healthier while we still provide the very Best in disease based care. I am very passionate about bending the disease curve. So on top of all the incredible programs we do to screen patients, catch patients across the diverse communities we serve that have disease or need access to care, we're really, really out in the community really investing in programs such as Food Insecurity. How can we help people get access to good healthy food? And doing innovative cooperative programs with like as an example, another nonprofit organization called Smile Farms, where we actually work with the community and we have organic farms that we cooperatively farm and then give that food back to the community. So we're very well connected to all the communities we serve and I think we're making a great impact.
- [03:33]
B
Awesome. Okay, great. Thank you. Thank you. So I want to cover a few topics with you today. I'd like to start with technology, if that's okay. And artificial intelligence. Healthcare's traditionally moved pretty conservatively or slowly, one could say around adopting new technologies. It's been a cautious approach. It feels like that's different with AI, right? It feels like that is not the case. It's going much more quickly. Do you, do you see that? And why do you think that is?
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C
I do. And I think because for us in the healthcare industry, for us to be able to be successful, we need to innovate, we need to adapt, we need to execute quite rapidly. AI is an incredible tool that allows our healthcare teams, our executive teams, to reach the best decision quicker. And I think that's why the adoptability curve is different than what we've seen traditionally in healthcare. I mean, if you think about it, it's not all that long ago, high tech era in the Affordable Care act that we were all implementing electronic health records, right? And to various degrees of success and, or failure or clunkiness, interoperability challenges, all these things. But AI, it's kind of interesting. It's the opposite, right? We're actually now saying, hey, wait a minute, we need to slow this down just a touch, make sure we have good governance, good control over it. And at least from our perspective at Catholic Health, we're very focused on the human element. And so our, our strategy is more along augmented AI. How do we help our people perform better? Not necessarily autonomous AI, where we're replacing people. So we're very excited about the opportunities here for AI implementation in the clinical arena and also in back office and things like revenue cycle and things. So we're really taking a broad stroked approach here.
- [05:22]
B
Excellent. I'd like to dig into a bit of those in a minute with you. I'M curious about how you're approaching some of that innovation in healthcare. We hear about sort of two archetypes, right? Incumbents, the largest payers, the large providers, the large technology vendors who have the data and the control the infrastructure. And you hear about insurgents, up and coming new technology companies or other kinds of companies who are taking a much more disruptive approach. How are you thinking as you think about those two archetypes, how are they playing out for you?
- [06:00]
C
It's interesting. I think it's a mix of both. I think we're really looking to form more collaborative partnerships with, if you will, both archetypes because of our position. We're about a $3.6 billion health system, so we're by far not the biggest, but we're also not small and relative to the market. And I would say we're looking at both types of solutions, but really leveraging our biggest investment, technology wise, we've made to date, which is our electronic health record and so many of these companies. And we work with our payers and we work with independent spin offs that have best breed type bolt on technologies. But if you're not careful, you wind up building a Frankenstein that does not necessarily achieve your mission objectives and it costs you a lot of money not just to just install it, but then to maintain it with all the operating agreements. So I'd say we're taking a combination approach and it's mixed, it's aggressive, but also at the same time cautious and trying to be fiscally responsible as to using what we've already implemented and turning on those switches and activating it, and then involving our administrative leaders and our clinicians to say what are the best solutions that we have today? And if we don't have it, let's go to these partners and see what we can do to innovate and bring these technologies to our health system.
- [07:20]
B
Yeah. Okay. Can you tell me a little bit about some of the things that you've been doing? You mentioned some clinical use cases, you mentioned some administrative use cases.
- [07:28]
C
Yeah, sure. So one of the biggest, I'll say on the clinical side, one of the biggest negative feedbacks we still hear, and we're not naive in electronic health record implementation. We've been at it for nearly 20 years, 18 years now. We've, we've been electronic paperless, so we still hear from providers. You know, despite all the optimization, despite all the workflow changes, it's still clunky and it, and it, and it takes too much time. So ambient voice AI technology is one of the things that's been a game changer. So we've been able to implement technologies and we're rolling this out now in select service lines and areas across the health system where literally just like as we're having a conversation here today on your podcast, our providers in the rooms, when ambient AI voice is activated, the conversation with the patient is recorded. It is actually then tailored specifically for the medical encounter and placed in the medical record. So it saves a tremendous amount of time and it also I think leads to higher satisfaction with the providers in our health system. On the administrative side, when you look at the back office functions such as revenue cycle and what we can do more effectively to work with our payers to reduce denials, make sure we have good revenue integrity, we've had additional technologies that we've put in place that automate a lot of that function and actually we'll work with our payers using AI to help make sure that we're getting reimbursed appropriately, which is still a big, big issue in our industry, as you know, in terms of denials and the amount of money we spend to recover money that is rightly owed to our health system.
- [09:09]
B
You mentioned that these projects are sort of proliferating and draw a contrast between like previous eras of technology. It's interesting. This stuff just seems to work. Yes, it does, doesn't it?
- [09:20]
C
Right.
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B
And people see it and they're like they want more of it.
- [09:22]
C
Yes, it does. You know, it's interesting. I'm also a pilot and I think a lot of times about the way that avionics have changed the aviation industry and there's a lot of glass cockpit flying as you would want and expect. But you also can't lose your human skills. You have to always have the person integrated with the technology. And I think that's been our approach at Catholic Health. You know, how do we make our people better, but also how do we make sure that we are doing what's right morally, ethically, always foundationally as a mission central organization and making sure we're improving the health and outcomes of the populations we serve. So this is where I think governance is critically important and how we're looking at the application of these technologies beyond installation and what the impacts are on outcomes of care. Are we really bending the disease curve? Are we getting to patients sooner in their disease processes? Are we delivering the best in quality evidence based care quicker for them, getting them down their diagnostic path sooner? That's our goal. And I think without strong governance around purpose first, why are we doing this what problem are we trying to solve? And then making sure you have the right people around the table, people that are not afraid to say, hey wait a minute, we need to pump the brakes here. This says, this is something that doesn't look right, feel right. I think we should go in a different direction.
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B
Yeah. Have you set up new sort of structures in the C Suite or around the C Suite to help you manage that? Can you tell us about it?
- [10:53]
C
Yes, of course we have. We've built an IT executive board that actually will govern not just a day to day lights on operations and things, but then innovation and an innovation subgroup that actually meets where AI lives for us and really will help us guide the right decisions for the health system. What we're going to optimize, what we're going to buy, best of breed, what we're going to roll out and when and specifically what is the indication for doing what problem are we trying to solve? And it's worked well. I think, you know, without that governance structure, I think it's a little bit of the wild west and certainly people in my position, my cfo, my COO would get inundated with requests for best of breed spin off technologies and I think it becomes quickly unsustainable.
- [11:42]
B
Yeah. Okay. Ok. Okay. You mentioned revenue cycle and you the promise of sort of cleaner claims, let's say, how do you think that's going to change the dynamic with payers and what, maybe what is, what's been the payer dynamic for you over the last couple of years? And is it changing? What's the role of technology in that?
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C
You know, unfortunately I, I don't know that it will change.
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B
Okay.
- [12:04]
C
I think it's still a little bit of cat and mouse and I think at the end of the day, unfortunately we still have between 1 in 3 and 1 in 4 cases be denied in our health system and yet our win rate approaches 70%. So you know, it is incredibly frustrating and I think the two things that unfortunately payers and others are using ar for is how do we increase denials, how do we deny more care? And I think the pre auths and denials are two things that are problematic and I think, you know, all of my colleagues would agree. And how do we get to better fairer tactics where we're leveraging right level of care, right level of pay. We're working on our end to actually be as transparent as possible and to make sure that we're doing everything we need to do to make sure that the medical record substantiates the level of care that was provided, that it is medically necessary and then that we receive timely payment. But unfortunately I don't believe that the outcomes are going to change much. And I think the tactics on the payer side unfortunately are more to deny care and then we have to fight to recover the monies we're owed to.
- [13:10]
B
Okay, okay, now let's, let's end perhaps with a nod to patients because we've talked a bit about some of these new technologies being received so well by physicians. Right. We've talked about administrative potential. How do you see the future from a patient experience perspective?
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C
So I think one of the things that we're very passionate about is going outside of our industry, and me in particular, and learning from other consumer based industries. I am obsessed with, with being the number one consumer oriented health system in our region. And I think we as an industry in healthcare have a lot to learn. Think about how you order your meals, think about how you experience a hotel experience or travel. And so we've actually personally connected in with folks, I'm grateful to them at Delta Airlines as one example about how do we create a better employee engagement initiative to connect our people better to the care. The Delta app, if you've seen how they navigate through and there's a lot of ease of use for consumers to book a service. We've actually taken some of that and implemented that into our digital program at Catholic Health and then also looking another company like American Express and that digital experience. And if you can think about how a bot that you're chatting with, you have really an incredible experience, you get the end result you need and in a matter of seconds and how do we adapt that into our workflows. So you know, we've been very passionate about this going outside industry, thinking about how we look at best of breed companies and what they've done and to say, hey, why can't we learn from them and bring that into our system? And we're doing that now, which is really exciting.
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B
Awesome. Okay, great. Patrick, we're approaching the end of our time. Is there anything else that you wanted to that's on your mind that you want to share?
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C
I think unfortunately today's conference and the conference here, it's a great conference. I think we're going to hear a lot about the fiscal cliff in healthcare that we are on. And I think we're continuing to navigate down a very, very slippery slope as I fear with the current cuts and challenges that we're all facing fiscally, we're going to have additional substantial pressures to just even maintain many of our operations across the entirety of the industry, which means those that are disadvantaged and not have access to care are going to really unfortunately take the brunt of some of the challenges we're facing. So I am confident though in that healthcare administrative leaders are some of the most talented women and men in the industry. We're always engineered to think about how we do more with less and that each and every day we get up out of bed in the morning with the, with the mission and goal which is what really lights our fires. We're here to serve the patient and to serve our communities and all people. So I think despite the challenges we're facing, we'll navigate through. But it is going to be harder in the, in the coming weeks, months and years if things don't change.
- [16:00]
B
Patrick, thank you so much for spending time with us.
- [16:02]
C
Thank you so much.
- [16:03]
B
Thanks. Thanks.