Predicting the future can be tough or easy, depending on whom you ask. If you ask Sylvia Browne, a well-known psychic and medium, it’s something that she says she does on a daily basis. Her predictions don’t always come true but isn’t that par for the game? I attended the “Revenue Cycle 2025: Strategies for Innovation” panel discussion that featured Kevin Roberts, CFO at Geisinger, Christopher Giuliano, VP of Finance for CVS Health and Gerilynn Sevenikar, VP of Revenue Cycle from Sharp. Moderating the panel was Alison Shipley, Principal from The Chartis Group. While they aren’t psychics, they had some very interesting perspectives and shared insights to what they are currently doing to navigate this changing industry.
The panel was asked what impact value-based care is having on the industry. Gerilynn shared that there are conflicting initiatives between payers and providers, and we needed to find a way to remove that friction. She detailed a pilot program where Sharp entered a partnership on presumptive authorizations with a payer. With this program, Sharp allows the payer access to the patient medical records during the patients stay with the understanding if they plan to deny the stay, they need to contact Sharp. The pilot has made a huge impact over the first 90 days. So much so, they have rolled out to two additional payers.
It is undisputed that on the largest impacts to the industry is the consumerism of healthcare. The panelists agreed the it is more than posting the charge master. Kevin shared that experience is valued more than actual value. Providers need to have higher integration and more tailored to patients and how they prefer to access information and communicate.
On the question on how do you reduce costs while keeping innovation high – Kevin used the phrase “extreme automation.” He shared that the industry has a provider-centric view not a consumer-centric view and needs to create a much higher-level set of expectations on our technology and payers. Gerrilynn talked about how she is bringing gamification to her teams. Employees create their own avatars and can see their progress against their co-workers. The organization has found that everyone in the gamified workflow has experienced a substantial increase.
Regardless of where we end up in 2025, it’s good to know that we have organizations already working to find their way in this changing landscape of healthcare.