How St. Luke's is addressing revenue cycle challenges

Robert Mueller serves as vice president of revenue cycle at Boise, Idaho-based St. Luke's Health System.

An experienced healthcare executive, his background has been in revenue cycle management, payer contracting and net revenue reimbursement.

Before joining St. Luke's, Mr. Mueller was senior vice president of revenue cycle at Milwaukee-based Aurora Healthcare, which has since merged with Downers Grove, Ill.-based Advocate Health Care.

Here, he shares his proudest moment as a revenue cycle leader, discusses revenue cycle challenges and offers advice for other hospital revenue cycle leaders.

Editor's note: Responses were lightly edited for length and clarity.

Question: What is your proudest moment as a revenue cycle leader?

Robert Mueller: When I think of the essence of the revenue cycle, we're charged with collecting everything in terms of reimbursement. My responsibility at St. Luke's is to collect $2.5 billion a year. It's a pretty significant responsibility, and I enjoy that. I enjoy the challenge of training up leaders and dealing with the complexity of revenue cycle, whether the ongoing challenge of new regulations and/or payer rules or implement new systems or facilities.

Q: What is the greatest revenue cycle challenge you face?

RM: I think right now we're focused on price transparency for patients, affordability for the uninsured and transitioning to value-based healthcare and what impact that's going to have on the revenue cycle. Educating physicians regarding appropriate documentation’s impact on their quality scores as well as its impact on system reimbursement.

Q: How is the organization working to address that challenge?

RM: We've had several years of improving our patient financial satisfaction scores — robust policies, procedures, patient payment portals, etc. — and that gives us the framework to continue to go forward. We'll be rolling out a patient price estimation tool in the near future on a self-service basis. We already have phone lines patients can call, but want to continue to expand our patient options.

Q: What is one thing you would change about the revenue cycle process today?

RM: I think the amount of the regulations are crazy, both by CMS and the commercial payers. There's a ton of administrative work to get paid for the services you do. I think I'd like to get all that to go away, but it's this complexity that creates the opportunities for professionals in this field.

Q: If you could offer other hospital revenue cycle leaders a piece of advice, what would it be?

RM: Focusing on developing revenue cycle leaders in your organization. You're only as good as what your leadership can do. I think that's what helped me be successful — training up leaders. I also think it's important to stay connected with operational leaders so that they understand the complexity of the revenue cycle, and you can work with them when changes occur and have to be implemented.


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