When Becker’s connected with Shelly Soileau, CFO of Opelousas (La.) General Health System in August 2024, one of the main challenges on her mind was patient transportation, an issue that many rural healthcare organizations face. Nearly a year and a half later, that struggle still persists.
“I think it’s very much going to continue to be an issue in rural Louisiana, because our patients either don’t have transportation or don’t have family available to transport them,” Ms. Soileau said during a Becker’s “CFO+Revenue Cycle Podcast” episode.
Ms. Soileau described a recent example wherein Opelousas General attempted to contact a Medicare Advantage plan to arrange transportation for a hospice discharge patient, but the company went silent. With no family or other options, the hospital nearly had to send the patient home by ambulance at a high cost, but luckily, the company got back to them.
She said this scenario has also become common with psychiatric patients.
“We’re getting Uber rides and taxi rides, or we even call the local police department to see if they will help us,” she said. “It’s quite common. We are talking with the state. I know there are Medicaid transportation companies, and we utilize them as much as possible. We’re looking for other companies that we could use at a reasonable rate to help us with the situation.”
On the financial side, Ms. Soileau said shifting payer behavior is another pressing issue. Unlike larger health systems with more volume and payer leverage, Opelousas General doesn’t have the room to absorb specific shifts.
She said a small change in denials, managed care policy or overall reimbursement rules can quickly affect margins at the 171-bed hospital. The challenge will increase when UnitedHealthcare exits Louisiana’s Medicaid managed care program March 31, 2026, forcing patients to select new coverage and creating uncertainty around whether those transitions would result in uncompensated care. Lastly, Ms. Soileau said she and her team are keeping an eye on workforce costs, including recruiting and retaining local talent where possible.
To combat ongoing challenges, Ms. Soileau has been investing in people and data. She recently hired a new revenue cycle director and expanded the team’s analytics capabilities to track denial trends in real time.
“Our team is always in the data,” she said. “It’s important; data tells the story. It doesn’t tell the whole story, but it always gives you a picture of what’s happening in your organization. Our team is always looking at service lines. What are their margins looking like? And, where can we squeeze out a little bit more there without harming patient care or cutting anything important to the patient, but that would help us increase overall profitability?”
Ms. Soileau also runs her finance team with this mindset: calm urgency, with intentional, data-based decision making.
“If the CFO is nervous or showing anxiety, it penetrates down,” she said. “[The mindset] allows teams to know that I’m here for them. I’m going to give them the truth. I will always give them the facts, and I will name the facts, and then we will outline our next steps on how to address things and improve our finances.”
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