Laurie Hurwitz, executive director of revenue cycle at La Crosse, Wis.-based Gundersen Health System, has managed the system's revenue cycle management operations for the past three and a half years.
In her role, Ms. Hurwitz oversees preservice, registration, coding, billing, insurance and payment for the six-hospital system. Prior to Gundersen, Ms. Hurwitz served as director of physician practice finance and decision support at Petoskey-based McLaren-Northern Michigan for more than two years.
Ms. Hurwitz recently answered questions from Becker's Hospital Review about her greatest challenges as a revenue cycle leader and how she would improve the revenue cycle process.
Note: Responses have been lightly edited for clarity.
Question: What's your favorite part about being a revenue cycle leader for a healthcare system?
Laurie Hurwitz: I get really excited about improving the patient financial experience. That's really important if you're talking about someone who has a life-threatening illness. They need to be focused on getting well, not focused on what they are going to do about their bill. For others, they're paying a lot more than they're used to. To some degree, we touch them first, we touch them last, and we can have an enormous impact on their feelings about care here. It's about trying to take the focus off all the forms we need to get signed and the authorizations and focusing on the patient experience. If we do that well, the rest follows.
Question: What is the biggest challenge you're facing as a revenue cycle leader?
LH: Change is hard. As we approach our work differently, we need to have a different skill set. It's challenging to help existing staff acquire a new skill set, it's challenging to get others in the organization to understand things need to change … trying to manage all of that is an enormous undertaking. We've always needed people who are detail-oriented, efficient and effective. But what I need now is staff with all of that and really good people skills, who in spite of the hectic, frenzied pace, still manage to make a connection with the patient. A little compassion goes a long way.
Q: What is one of your goals this year?
LH: We are undertaking a big project to physically centralize registration at our main hospital and main clinics. We have nearly 50 registration hubs in our hospital and our two main clinics. It's impossible when you have that many sites to standardize the process and ensure the patient has a consistent experience. In addition, when patients come from far away, they may have multiple appointments and may need to register for every single one of them. From a patient perspective, that doesn't make sense. They're already registered, [and] they don't know why anyone has to ask them for the same information. We're looking to provide the patient with a consistent experience.
Q: What is one thing you'd do to improve the revenue cycle process?
LH: Providing the staff with an excellent experience. I don't believe most people have any idea how difficult their jobs can be. It's not easy to call somebody who hasn't been able to pay their bill and have a conversation with them about whether they need financial assistance or they need help setting up a payment arrangement. It's not easy when someone calls in and they're furious about their bill and they start yelling. It's not easy being the registration person who is trying to collect all that information when the nurse is standing there and wants the patient right now. It's not easy when you're coder and having providers second guess your work.
If I could make that — and I try — better for them, I would do that. As part of the registration redesign, we will make sure it's staffed appropriately so staff can make eye contact with the patient and feel good about what they do. In our customer service department, we've given staff thank-you cards and told them, think about a patient conversation that started tough but ended well, and write the patient a thank-you note. Thank them for letting you help them today. This reinforces for the patient that you care, and it reminds you about a positive interaction.