'Meet the patient where they are': Cone Health revenue cycle VP talks goals, payer side experience

Taking on the role of vice president of revenue cycle at Cone Health has felt at times like "drinking from a fire hose," Jason Nelms told Becker's, but added "that's not a bad thing."

"It's been a good transition for me," he said. "I've been pleased with how things are going."  

Mr. Nelms was appointed to the role at the Greensboro, N.C.-based health system in November, joining from Charlotte, N.C.-based Atrium Health, where he served as assistant vice president of patient financial services.  

The people at Cone have helped ease the transition, Mr. Nelms said. 

"It's clear that they created a wonderful culture for their teammates," he said. "It's been an extremely welcoming environment. It's clear that Cone has a tremendous amount of talent in the organization and they're open to new ideas and new ways of doing business."

He also brings experience on the payer side to the role, having served as a director of payer contracting at Cigna from 2006 to 2011. 

Mr. Nelms recently spoke with Becker's about his goals for 2023 as well as how his experience at Cigna helps him as a revenue cycle leader.   

Q: What are your goals for 2023?

Jason Nelms: Like many other organizations, we are looking for ways to roll out technology to make our teams more efficient. We want to leverage our team's skills to work more complex cases while leaning on technology like RPA/machine learning/AI to handle the more repetitive functions of the revenue cycle.

Another primary goal we have is to improve the overall patient experience as it relates to their digital engagement with Cone Health. We want to improve the patient's experience from beginning to end, allowing them to interact with our organization in their desired manner.  Increasing the patient's ability to interact through texting and mobile apps will be increasingly important as we move forward. It is going to be important that we meet the patient where they are and in a manner that suits their needs.

Q: What are the biggest challenges facing revenue cycle leaders right now?

JN: Staffing resources and human capital. In today's economic environment, it is becoming increasingly difficult to make a compelling case to fill open positions that are not critical. Most shops are running in a very lean fashion, and it becomes difficult to maintain the appropriate number of resources when teammates are out on extended leave or submit resignations. 

Maintaining appropriate regulatory compliance in an ever-changing environment. Healthcare is a heavily regulated industry, and it is imperative we maintain compliance with all the rules and regulations promulgated by both the governing bodies and even the payers. If we don't, there tends to be a material negative impact on our ability to collect the revenue we generate.

How does your experience on the payer side help as a revenue cycle leader?

JN: While it's been more than 10 years since I was on the payer side and things have changed over the years, I think the most important thing I took from that experience was to have a better understanding of the pressures the payers experience. At the end of the day, all of us have goals to accomplish and it certainly helps to better understand the goals of the other party, especially when our goals appear to be counter to the other's. 

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