4 RCM questions with University Health CFO Aaron Eichorn

Aaron Eichorn serves as the CFO of University Health System, a nonprofit system based in Shreveport, La.

Mr. Eichorn oversees revenue cycle management operations at the $600 million UHS, which is the clinical partner and hospital for the LSU Health Shreveport School of Medicine. The system includes the LSU Health Sciences Center campus in Shreveport, a 457-bed academic medical center in Shreveport and University Health Conway in Monroe, La.

He also serves as a director with New York City-based Alvarez & Marsal Healthcare Industry Group. Previously, he was CFO and vice president of finance for Pittsburgh-based Allegheny Health Network's more than 650-member multispecialty physician group in Pennsylvania.

Mr. Eichorn recently answered questions from Becker's Hospital Review about his greatest challenges as a revenue cycle leader and how he would improve the revenue cycle process.

Note: Responses have been lightly edited for length and clarity. 

Question: What's your favorite part about being a revenue cycle leader of a healthcare system?

Aaron Eichorn: My favorite part is generating collections and ensuring we maximize our payer mix and our rates and reduce our denials. This work directly drives the initiatives the organization can launch. If we want to build a new medical office building or a new ambulatory surgery center or expand or buy new equipment, my contribution is so important. The second half of my job is the day-to-day operations, the blocking and the tackling. To pay our bills and keep the lights on, I've got to do a better job in an era of declining reimbursement and greater challenges.

Q: What is the biggest challenge you're facing as a revenue cycle leader? 

AE: Both of the hospitals we manage are in Louisiana, which just underwent Medicaid expansion. So we've had hundreds of thousands of people that were previously uninsured now on Medicaid. It's the challenge of enrolling them, it's the challenge of getting pre-authorizations, avoiding denials and managing the utilization of those patients. All these people suddenly have access to care, and we've got to make sure we can get them in and treat them effectively and get paid.

Q: What is one of your goals this year?

AE: Imagine someone sold milk in a grocery shop and you told them, "Five percent of the milk bottles you sell you're not going to get paid for." A grocer would look at you like you're nuts. If you provided somebody with a bottle of milk, of course you should get paid. Yet in healthcare we struggle with the denial rate. So one of my goals is we want to have a 20 percent improvement in our denial rate this year, despite Medicaid expansion. Even though the workload on my team has almost doubled this year, we want to improve our denial rate.

Q: What is one thing you'd do to improve the revenue cycle process?

AE: One thing is to make more information and the administrative work available online. For example, with pre-authorizations, we still have phone calls to make, we still have an inordinate amount of paperwork to fill out. We're not taking advantage like the private sector does of using the internet. For example, you come in for care at a doctor's office and you have a certain amount of your deductible or coinsurance you haven't met yet. We should be able to check online and get the right answer in seconds, not guessing how much money you owe. We should be able to find out online in a second whether you're pre-approved rather than doctors doing peer-to-peer reviews that take up an inordinate amount of physician time. There's got to be a way to leverage the internet to improve the cycle. If it were up to me, if there was a way to do that, I'd do it. I just don't know the payers are motivated to build that infrastructure.


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