2023 Crowe Healthcare Virtual Symposium event summary

Learn how connecting with other parts of the healthcare ecosystem can power healthcare revenue cycle performance.

Nearly 700 revenue cycle leaders from the nation’s leading healthcare organizations attended the 2023 Crowe Healthcare Virtual Symposium, held May 9-10. Some 241 healthcare organizations were represented at the third annual event, which focuses on healthcare revenue cycle performance.

The theme of this year’s symposium was “the power of connection.” The theme threaded through seven keynote and breakout sessions over two days. Each session illustrated how establishing a meaningful and lasting connection with other parts of the healthcare ecosystem can only help to improve an organization’s revenue cycle performance.

Colleen Hall, managing principal of healthcare consulting at Crowe, served as the host for the two-day event – welcoming attendees, introducing speakers, interviewing experts, moderating roundtable and panel discussions, summarizing key takeaways, and presenting the 2022 revenue cycle performance awards.

Hall also thanked the first-ever sponsors of the Virtual Symposium:

Collaborative Data Inc. (platinum)
UASI (platinum)
Healthcare Coding & Consulting Services (gold)
Knowtion Health (silver)
Harmony Healthcare (silver)

This event summary features the best of the symposium, including keynote and breakout session summaries, numbers to remember, insights to absorb, and links to on-demand recordings of the sessions. Please enjoy the event summary, and don’t forget to save the date for next year’s Crowe Healthcare Virtual Symposium, to be held March 13, 2024.

1. Connect with change: Healthcare transformation and the power of connection

In this opening keynote to the 2023 Crowe Healthcare Virtual Symposium, Gail Zahtz, managing partner of Zahtz Partners LLC, a New York-based integrated healthcare collaboration company, set the tone and pace for entire two-day event. She walked attendees through the history – much of it failed – of Medicare value-based care (VBC) models. Zahtz detailed new VBC models coming down the pike, new statutory and regulatory requirements, and industry trends that will dramatically change the workflows and the technologies used by hospital and health system revenue cycle departments. Among the new models, requirements, and trends are the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) program; price transparency rules; the No Surprises Act; direct contracting by employers; consumer retail giants disrupting the healthcare market; health systems “without walls”; and more.

A number to remember

The number of Medicare value-based care programs out of 40 that didn’t meet the triple aim of improving the patient experience, lowering the costs of care, and improving population health

Source: Zahtz, citing a Center for Medicare & Medicaid Innovation self-evaluation report

Insight

Gail Zahtz “Most people, even with the title of vice president or president of value-based contracting, don’t actually know what value-based care is.”

– Gail Zahtz, Managing Partner, Zahtz Partners LLC

CPE_HCVS_Connect with Change - Healthcare Transformation and the Power of Connection

Source: Zahtz Partners LLC

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Watch on-demand recording

2. Connect with your peers: Revenue cycle executive panel

To be successful, the revenue cycle department in your hospital or health system can’t be an island; it should extend out and connect with other departments, clinicians, staff, patients, payors, and community groups. That was the big takeaway from this candid panel discussion featuring session facilitator Colleen Hall and four leading revenue cycle executives: Sandy Lood, vice president of revenue cycle at Cottage Health; Adrienne Moore, vice president of revenue cycle at Banner Health; Troy Spring, vice president of enterprise revenue cycle at Intermountain Health; and Lynn Waters, executive director – single billing office at Baptist Health Jacksonville. They suggested reaching out to payors and sharing objective denials data to speed claims payment.

A number to remember

5.8%

Initial inpatient level-of-care claim denial rate for Medicare Advantage plans from January through November 2022 compared with 3.7% for all other payor categories

Source: Crowe KPI Benchmarking Report: Who’s Picking Up the Check?

Insight

Lynn Waters “You have to have the data. When you show them [payors] the data, they are more receptive to having those conversations about a slowdown in payments, [diagnosis-related group] downgrades, those sort of issues.”

– Lynn Waters, Executive Director – Single Billing Office, Baptist Health Jacksonville

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Watch on-demand recording

3. Connect with success: High-performing revenue cycle tips and tricks

Running an effective revenue cycle department is a skillful mix of art and science. This session, featuring Colleen Hall interviewing three revenue cycle leaders, reinforced that lesson. From sophisticated analytics to personal letter writing, the leaders shared their secrets. Nancy Koors, CEO of UASI, which sponsored this year’s Virtual Symposium, touted technology that can collect hierarchical condition category data to assign risk adjustment factor scores for patients. Dr. Stephen Crouch, medical director for integrated care at Advocate Health Care, recommended writing individualized appeal letters to payors. And Debra Jaeger, senior vice president of revenue integrity at Lehigh Valley Health Network, suggested educating new doctors on clinical documentation before they develop bad habits.

A number to remember

$2,000

The potential revenue difference per year per patient between assigning a hierarchical condition category (HCC) code of 19 (diabetes without complications) or an HCC code of 18 (diabetes with chronic complications) to a patient

Source: Koors, citing UASI data

A number to remember

3.2%

Percentage of medical necessity inpatient claim denials by commercial payors through the first quarter of 2023

Source: Crowe KPI Benchmarking Report: Time for a Commercial Break

Insight

Debra Jaeger “We do monitor trends in claim denials. Sometimes it will be a payor. Sometimes it will be a single physician. Sometimes it may actually be by a coder, or a scheduler, or authorization team member. We look at the trends to pinpoint where our educational opportunities need to be.”

– Debra Jaeger, Senior Vice President of Revenue Integrity, Lehigh Valley Health Network

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Watch on-demand recording

4. Connect with the future: The journey to recovery – an economic view

This thought-provoking keynote that closed day one addressed the question of whether today’s healthcare system is elastic (able to return to normal after COVID-19 stretched it to its limits) or plastic (shattered forever by the pandemic with no going back). The session’s two prognosticators – Matt Dobias, vice president of congressional affairs for America’s Physician Groups, and Andrew Sudimack, an economist – healthcare and insurance, U.S. federal government – said it will be both. On the elastic side are rising healthcare costs, higher prices for care, and industry consolidation. On the plastic side are workforce shortages, digital health, and new market entrants. Perhaps the biggest lasting change will be the move to value-based care payment models, they said.

A number to remember

$12,914

Per capita national health expenditures in the U.S. in 2021

Source: Centers for Medicare & Medicaid Services (CMS)

Insight

Matt Dobias “In terms of the transition to value-based care, I think there needs to be – and we will see – a far quicker shift into two-sided risk arrangements.”

– Matt Dobias, Vice President of Congressional Affairs for America’s Physician Groups

CPE_HCVS_Connect with the Future - The Journey to Recovery - an Economic View

Source: Bureau of Labor Statistics

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Watch on-demand recording

5. Connect with the market: Payor Market Intelligence

As Rod Stewart sang, every picture tells a story. That truism also applies to healthcare revenue cycle key performance indicators (KPIs). Each of the 54 revenue cycle KPIs monitored by Payor Market Intelligence, a new benchmarking tool from Crowe, tells a story. In this day two opening session, Matt Szaflarski, senior manager in healthcare consulting for Crowe, and Aaron Stapp, vice president of revenue cycle at CommonSpirit Health, described how Crowe and one of the leading health systems in the U.S. came together to build Payor Market Intelligence and how the tool empowers hospitals and health systems internally to improve their revenue cycle performance and externally to improve their position with payors. Payor Market Intelligence benchmarks a hospital’s performance against its peer hospitals and a payor’s claims-paying performance against peer payors.

A number to remember

13.7%

Initial denial rate by payors in 2022 of inpatient hospital claims

Source: Client data gathered by Crowe Payor Market Intelligence

Insight

Aaron Stapp “We want to better understand our revenue cycle performance. Is it driven by any internal failures that we need to address? Is it a payor issue that we need to address individually with a payor? Is it a market-driven issue? And if it’s a market-driven issue, can we get our managed-care staff or our advocacy group involved? Payor Market Intelligence takes our understanding of our performance to another level.”

– Aaron Stapp, Vice President of Revenue Cycle, CommonSpirit Health

Watch day two highlights

6: Connect with the payors: What do the payors have to say?

The major takeaway from this day two breakout is providers and payors aren’t far apart on hot healthcare challenges of the day. Panelists discussed what it will take to eliminate their differences. This roundtable chat, moderated by Colleen Hall, featured Philip Boyce, senior vice president and chief revenue officer at Baptist Health Jacksonville, and Krishna Ramachandran, senior vice president of health transformation and provider adoption at Blue Shield of California. Ramachandran said payors welcome new market entrants that make care more convenient, accessible, and affordable for members. Boyce welcomed the competition but expressed concern over making care and data more fragmented. They also agreed on the importance of improving prior authorization, especially by Medicare Advantage plans.

A number to remember

56%

Percentage of surveyed physicians who said prior authorization “always” or “often” delays patient access to necessary medical care

Source: “2022 AMA Prior Authorization (PA) Physician Survey,” American Medical Association, March 13, 2023

Insight

Krishna Ramachandran “There are many opportunities for win-wins on both sides [providers and payors]. We don’t have to sit across from each other at the table. We can sit at a round table and work collaboratively on making healthcare better for all.”

– Krishna Ramachandran, Senior Vice President of Health Transformation and Provider Adoption at Blue Shield of California

Watch day two highlights

7: Connect with the regulations: Value-based care – yea or nay?

Benjamin Franklin said the only certainties in life are death and taxes. If Franklin attended this closing keynote, he might add two more certainties: Value-based care is here to stay, and doing what’s best for patients is always profitable. Those were two big takeaways from this session led by Colleen Hall and featuring Dr. Pranjal Shah and Dr. Alvia Siddiqi. Shah and Siddiqi are vice president of population health and chief medical officer, respectively, at Advocate Aurora Health. The pair shared a long to-do list for hospitals that don’t want to be outliers that lose money on VBC. The list includes excelling at annual wellness visits and transitional care management visits, chronic care management, and care coordination.

A number to remember

100%

CMS goal for percentage of beneficiaries with traditional Medicare coverage participating in accountable care relationships with providers by 2030

Source: CMS

Insight

Shah Pranjal “Value-based care payment programs create a lot of predictability in your revenue cycle.”

– Dr. Pranjal Shah, Vice President, Population Health, Advocate Aurora Health

Watch day two highlights

8: Revenue cycle performance awards

This year’s Virtual Symposium concluded on a high note by recognizing hospitals and health systems with top-performing revenue cycle departments. Crowe determined award winners objectively using revenue cycle KPIs generated by RCA, which is used by more than 1,800 hospitals and 200,000 physicians across the country. The recipients of the Crowe 2022 Top Revenue Cycle Performance and Most Improved Revenue Cycle awards were:

Cottage Health, Santa Barbara, California (two-time recipient)
Intermountain Health Peaks Region, Broomfield, Colorado (three-time recipient)
Banner Health, Phoenix (three-time recipient)
Community Healthcare System, Munster, Indiana (first-time recipient)
Lehigh Valley Health Network, Allentown, Pennsylvania (most improved recipient)

“No matter what is thrown at these leaders, whether it’s regulation changes, payor challenges, inflation, rising costs, or labor shortages, they continue to perform and perform at the top of their games,” said Colleen Hall, who presented the honorees with their awards during this closing segment of the virtual symposium.

Watch the awards video

See the award winners

Closing

The theme of this year’s 2023 Crowe Healthcare Virtual Symposium – the power of connection – is far more than a catchy slogan. It’s a tactic. It’s a strategy. It’s a direction. It’s a business imperative. It’s all to improve revenue cycle performance as the $4.3 trillion U.S. healthcare industry creates its post-pandemic version of itself.

Old care delivery models are gone. Old technologies are gone. Old relationships among and between payors, patients, and providers are gone. Replacing them is not something the healthcare industry and certainly healthcare revenue cycle leaders have experienced before. And making these replacements will challenge the healthcare revenue cycle like never before.

But there is a solution, and that’s building new connections with change, peers, success, the future, the market, payors, regulations, and value-based care. The 2023 Crowe Healthcare Virtual Symposium gave attendees a game plan on how to do that and ultimately thrive in tomorrow’s healthcare system.

Thank you

Thank you for attending the 2023 Crowe Healthcare Virtual Symposium. We hope you found it informative, educational, entertaining, and peppered with new ideas that you can take back to your own organization to improve your revenue cycle performance. We welcome your feedback about this year’s event and your ideas on how to make the 2024 Healthcare Virtual Symposium even better. Please email us at [email protected].

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