Transforming Revenue Cycle Through Innovation and AI with Heather Dunn

Summary

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Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode: Transforming Revenue Cycle Through Innovation and AI with Heather Dunn
Guest: Heather Dunn, Senior Vice President and Chief Revenue Officer, Novant Health
Date: May 10, 2026

This episode dives into how revenue cycle teams can drive transformation through innovative thinking and the adoption of advanced technologies—especially AI—under the leadership of Heather Dunn at Novant Health. The conversation covers Heather’s career journey, her vision for building high-performing teams, specific transformation strategies, current headwinds, measuring success, and the role of AI in reinventing patient and team experiences within the revenue cycle.

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Guest Introduction & Background

[00:10–01:13]

• Heather Dunn describes her “accidental” entry into healthcare revenue cycle, drawn by its complexity and the rewarding challenge:

  “I fell in love with the challenges that healthcare providers and payers... have. I thought if I worked really hard, I could solve all of those problems.” —Heather Dunn [00:20]

• She has broad experience, from academic medical centers to small community hospitals, and now marks her first anniversary at Novant Health.

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Excitement & Pride at Novant Health

[01:13–02:48]

• Heather’s greatest pride is the ability to drive change creatively at Novant, leveraging a culture that embraces new technology and imaginative approaches:

  “The whiteboard of imagination is not always there, but it exists here at Novant Health... being able to do something different and approach things differently than I’ve ever had the opportunity to do before.” —Heather Dunn [01:30]

• She highlights assembling a forward-thinking team for revenue cycle transformation:

  “We’ve hired some folks that are very forward thinking... hoping to not only change the way that we perform at Novant Health, but also to inspire our colleagues and peers across the country.” —Heather Dunn [02:13]

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Revenue Cycle Transformation Strategy

[02:48–04:43]

• The transformation began with a “blue ocean” approach—asking how they would build an ideal revenue cycle if there were no constraints.
• Major steps included:
  • Whiteboarding to identify and eliminate major friction points.
  • Redesigning the operating model to create “centers of excellence” for access, clinical, shared services, back office, and transformation—each with a dedicated leader and dual focus on operational excellence and forward-looking innovation.
• On organizational structure:

  “You have to, as I say, keep the trains on the tracks at the same time that you’re laying new tracks. And those are not the same types of personalities and characteristics in leadership.” —Heather Dunn [04:05]

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Measuring Success

[04:43–06:11]

• Heather uses standard KPIs (e.g., AR days, cost to collect, clean claims) but places special emphasis on team member satisfaction—supporting team adaptation to automation and workflow changes.
• They also look at ROI from technology investments, aiming for efficiency gains, especially balancing labor costs against technological enhancements:

  “[If] it’s going to help to make you more efficient, then where are we really going to find the savings? And looking at those metrics in partnership with the other KPIs that drive revenue cycle.” —Heather Dunn [05:45]

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Headwinds & Solutions

[06:11–07:45]

• The main challenge is continuously improving efficiency amid capacity constraints.
• Notable change: They’ve shifted from a uniform revenue cycle approach to an “institute level” model, partnering directly with clinical teams to address unique specialty needs:

  “We’ve changed our medical group revenue cycle focus to an institute level... That has really provided the kind of partnership that we need with the clinical areas to specifically focus on their specialty needs.... Things are moving a lot faster. We are much more aligned clinically and financially.” —Heather Dunn [06:33; 07:21]

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Industry Trends

[07:45–09:17]

• Major trend: Patient affordability concerns as policy environments shift (Medicaid eligibility, ACA credits).
• The revenue cycle team takes responsibility for educating and empowering patients financially—through price transparency, patient estimates, and proactive discussions about financial options:

  “Price transparency, being able to give them estimates upfront, have a conversation with somebody about options for payment plans... provides a peace of mind to our patients that allows them to go through their clinical journey with a focus on their health and not so much a focus on... the financial impact.” —Heather Dunn [08:30]

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Approaching Growth

[09:17–10:20]

• Novant Health is expanding by adding hospitals; the revenue cycle team supports this by focusing on process automation, RPA, and making full use of their EPIC EMR capabilities.
• The aim is to increase capacity and maintain affordability without growing costs.

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AI in the Revenue Cycle

[10:20–12:03]

• The most exciting frontier is Voice AI.

• Heather shares a relatable story about recognizing Voice AI in her daily life, underscoring how user-friendly and effective conversational AI tools can become:

  “It didn’t dawn on me until the way that it was repeating it back to me. I thought, oh my gosh, this must be Voice AI. It sounds good. It is so much better than phone trees... It’s very conversational.” —Heather Dunn [10:44]

• Voice AI’s potential:

  • Enhances patient interaction, answers routine questions, assists with scheduling and billing
  • Provides 24/7 access and escalation routes to human agents if required.
  • Learns over time, providing consistent patient experiences:

    “This could be 24/7 access to information that our patients need at any time, any place, anywhere to have that conversation and then to elevate to another party if they need to.” —Heather Dunn [11:34]

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Memorable Quotes

• On Novant Health’s culture:
  “The whiteboard of imagination is not always there, but it exists here at Novant Health.” —Heather Dunn [01:30]

• On leadership in transformation:
  “You have to... keep the trains on the tracks at the same time that you’re laying new tracks.” —Heather Dunn [04:05]

• On empowering patients:
  “Price transparency... provides a peace of mind to our patients that allows them to go through their clinical journey with a focus on their health.” —Heather Dunn [08:30]

• On Voice AI:
  “It is so much better than phone trees... It’s very conversational.” —Heather Dunn [10:46]

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Key Takeaways

• Novant Health is embracing a technology-forward, imaginative approach to revenue cycle transformation.
• Success depends as much on cultivating bold, innovative leadership as on metrics.
• Shifts in patient affordability and policy are top of mind, with transparency and patient support now a revenue cycle priority.
• AI—particularly Voice AI—is poised to revolutionize patient communication and operational efficiency, with Novant an early adopter in the space.

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Transcript

[A]

This is Andrew Kass with the Becker's Healthcare Podcast. I'm thrilled to be joined today by Heather Dunn, Senior Vice President and Chief Revenue Officer at Novant Health. Heather, it's a pleasure to have you on the podcast.

[B]

It's great to be here. Thanks for asking me to join.

[A]

Before we begin, can you tell us a little bit about your background?

[B]

Sure. I came into revenue cycle like most revenue cycle leaders accidentally. I was. I graduated from college and I went to work for a small startup technology company a long time ago and but fell in love with the challenges that healthcare providers and payers and the whole healthcare space sort of have. I thought if I worked really hard, I could solve all of those problems. I loved the complexity of it. And so here I am several years later. I've journeyed through academic medical centers and small regional hospitals and have landed at Novant Health. So it's a little bit of my journey.

[A]

Yeah. And so you have been at Novant for just about a year now, is that correct?

[B]

That is correct. It was March 17th was my one year anniversary.

[A]

Yes. So congratulations on that milestone. And what are you most proud of in your first year?

[B]

I think, you know, part of coming to Novant Health and what was so attractive to me was really the lean that we have in technology and the ability to kind of take a blue ocean of ideas and really start to see things come to life. You don't always get that in health care. It moves a little bit slower at times. The whiteboard of imagination is not always there, but it exists here at Novant Health. And I think that has been the greatest, both challenge and the most exciting part is being able to do something different and approach things differently than I've ever had the opportunity to do before.

[A]

And so speaking of excitement, what are you most excited about right now in healthcare?

[B]

Well, I am particularly excited by the team that we just put together in Revenue Cycle for Novant Health. This team is cannot be understated enough. I can't say it's like not the most amazing team because it is. We've hired some folks that are very forward thinking, that are very bold, that are coming at revenue cycle from a very different perspective and really hoping to not only change the way that we perform at Novant Health, but also to inspire our colleagues and our peers across the country. So I'm excited about that. I'm excited that we have all of the tools and the technology and the people at Novant Health to pull off a complete transformation in this space. So I am most excited about that.

[A]

Speaking of that transformation, can you kind of give us a little bit of outline of how you're trying to transform your revenue cycle?

[B]

Sure. Well, the first thing that we did was kind of take a big step back and ask if you could do this differently and you had no constraints, what would it really look like? Where would you eliminate the friction points that you think are the biggest friction points in revenue cycle? And there's a lot of friction points that was just sort of our first step was whiteboarding. Very simply, if you could pull all the parts together from initial patient interaction right through to managing your AR and managing relationships with payers, what would, what would a frictionless revenue cycle be? From there we started thinking about all of the structures that we had to put into place to get to something that looked different than today. So we've got like sort of a multifaceted group, different priorities within each of the components of revenue cycle. So first setting up our centers of excellence and carving out transformation from our day to day operations. There's a purpose behind that and it is, you know, you, you have to, as I say, keep the trains on the tracks at the same time that you're laying new tracks. And those are not the same types of personalities and characteristics in leadership. So you really have to kind of divide that out. And so that's the first thing that we did was we went through a complete operating model redesign, put in an access clinical and a shared services and back office centers of excellence and then carved out transformation under a different leader, each of them with a focus on operations, but also on what's to happen in the next 18 months to three years.

[A]

And how will you measure the success of this transformation?

[B]

Well, there's a couple of outcomes. The typical revenue cycle KPIs always hold true. You know, you have to manage to your AR days, your cost to collect, you know, keeping your accounts flowing through the system. So measuring your, you know, discharge, not final build and looking at things like clean claims. So that's really not anything different than everybody is sort of measuring in the industry. But the one thing that we started to also measure is our team member satisfaction and to really lean in on are our staff within revenue cycle getting what they need from not only just changing workflows, but supporting them through transitions in this automation. So that's one of the major metrics that we look at. The other thing that we're looking at is, you know, from a cost to collect perspective. Technology right now can be very expensive, but if you're thinking about how you're managing your labor versus how you're managing your technology and where you're going to get the biggest leverage. That is really kind of the return on investment that you're looking for. So we've really been leaning in on if you're going to invest in technology and it's going to help to make you more efficient, then where are we really going to find the savings? And looking at those metrics in, I guess in partnership with the other KPIs that drive revenue cycle.

[A]

In the revenue cycle, what would you say is the biggest headwind you're facing right now and how are you tackling it?

[B]

It's not new, but we're always looking for how do we be most efficient and grow and to be able to provide the same level of service to our organization and to our patients as we have capacity constraints. So we want to grow, we want to do things differently, we want to keep up. So it's really a matter of being able to morph within your own revenue cycle. And I can give you a good example of that. We've changed our medical group revenue cycle focus to an institute level as opposed to just one big revenue cycle, one big bucket of accounts. And that has really provided the kind of partnership that we need with the clinical areas to specifically focus on their specialty needs within our revenue cycle. So we're sort of like adopted that team of teams approach and partnered with each of those clinical institutes and started to manage their AR along with them in the way that they needed to. And that was just a small fraction of some of the bigger things that we've done, but has had a massive impact to not only the relationships, but also just the health of the ar. Things are moving a lot faster. We are much more aligned clinically and financially with those institutes. And that has just been one small change that we made, but that had major impacts.

[A]

And so what are some of the top trends you're following in healthcare today, either in the revenue cycle or just in the larger healthcare space?

[B]

Yeah, the impacts to the big beautiful bill have been pretty significant. I think all healthcare is concerned about patients who are no longer going to qualify for Medicaid or who are no longer going to have credits on the ACA program. And I think we're trying to figure out how to bring that affordable care to them where they need it, closest to their home, and still be able to provide what they need, even if they don't have the financial means. And part of that is a responsibility on our revenue cycle to educate patients about what that's going to look like as they embark on their clinical journey with us. And this revenue cycle at Novant Health takes that very seriously. The relationship with the patient is not only clinical, but it's also, from a revenue cycle perspective, a financial one. Understanding costs, understanding options to help them afford their care is very important to us. And so price transparency, being able to give them estimates upfront, have a conversation with somebody about options for payment plans, interest free payment plans, how long we can put them on a payment plan for what that really looks like, I think provides a peace of mind to our patients that allows them to go through their clinical journey with a focus on their health and not so much a focus on, you know, the financial impact sometimes health care can have.

[A]

How are you thinking about growth over the next 12 months?

[B]

Growth within revenue cycle is we are starting to have additional hospitals come into the Novant Health system and really revenue cycle is capacity management. Right. We are highly focused on doing things like including rpa, automation, process efficiencies, workflow redesigns. We use EPIC as our emr and we are leaning very heavily into making sure that all of the enhancements that we can possibly take within our EPIC instance are turned on and functioning and are usable. And I think that's going to help us to absorb the capacity as Novant Health continues to grow and to bring affordable care to our patients where it's most convenient for them without having to increase costs. That's been our focus over the last year, is sort of lining up the technology, lining up additional resources for our teams so that we can meet that capacity demand.

[A]

And the last question I had for you is, how are you using AI in your revenue cycle?

[B]

I think the most exciting AI initiative that we are working on is really around Voice AI. You know, it's funny, I ordered a pizza from Domino's the other day and I, I was talking to Voice AI and it didn't dawn on me until the way that it was repeating it back to me. I thought, oh my gosh, this must be Voice AI. It sounds good. It is so much better than phone trees and some of the other, you know, voice automations that used to exist in the past. It's very conversational. The fact that we can have learning modules so that it understands the typical questions patients are going to ask. It learns over time, I think is remarkable. And it's also consistent and consistently handling calls in a way that we would want our patients to interact with our health system. So I'm really excited about Voice AI. I think you can use it in many spaces, not just to interact with patients, to get them quickly scheduled to get them quickly to a physician's office if they have a question to answer their billing questions, answer benefit questions. It really kind of open up, opens up the art of possibility of what are other ways that we would love to talk to our patients but are maybe constrained by having to have a person answer the phone or to call them back? So this could be 24,7 access to information that our patients need at any time, any place, anywhere to have that conversation and then to elevate to another party if they need to. But I'm really excited about the opportunities that Voice AI is going to bring to our revenue cycle.

[A]

Thank you so much for your time today, Heather. It's been a pleasure speaking with you, and I look forward to talking with you again soon.

[B]

Great. Thanks so much for having me.