OhioHealth's Margaret Schuler on automation in revenue cycle and meeting patients' expectations

With more than 20 years of healthcare revenue cycle management experience, Margaret Schuler knows the challenges leaders in this area face and how industry trends are evolving.

Ms. Schuler has served as system vice president of revenue cycle at Columbus-based OhioHealth since January 2017.

Before taking on that role, she was a vice president of revenue cycle at OhioHealth. She also held positions within the system as executive director of revenue cycle and revenue cycle administrator.

Here, Ms. Schuler shares her greatest challenges as a revenue cycle leader, discusses how she would improve the revenue cycle process and offers her goals for 2019.

Note: Responses have been lightly edited for clarity. 

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

Margaret Schuler: The ability to be creative and engage people, processes, and technology to create a seamless experience for patients, reduce costs and improve net revenue.

Q: What are the biggest challenges you're facing as a revenue cycle leader? 

MS: To ensure that we're meeting the expectations of our patients who are now consumers and customers. Customers and consumers want a simple, affordable and accessible healthcare experience and revenue cycle needs to deliver.

Revenue cycle continues to be challenged with the lack of automation throughout the industry between payers and providers. There are still many manual touches between payers and providers that have yet to be automated or streamlined to reduce costs.

Q: What are your goals this year? 

MS: Two goals we have for this year is easy access for our patients and continuing to reduce the administrative costs in revenue cycle. We are focusing on the centralization of physician office scheduling, pre-registration and authorization processes. Centralization will allow patients to call one phone number to schedule services, pay bills and obtain financial assistance. Technology will be enhanced to allow for the Do It Yourself (DIY) services for scheduling, pre-registration, patient estimates, etc. 

The second goal for the year is to reduce administrative costs in revenue cycle. We use both lean methodology and technology to achieve these results. We're partnering with multiple vendors on robotic process automation and artificial intelligence to create work that is by exception. We use KPI [key performance indicator] boards, Gemba walks and Kiazen events to identify process improvement opportunities and reduce waste.

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

MS: Eliminate denials and bring payers and providers together to agree upon utilization standards, and eliminate the need for administrative denials due to lack of authorization or medical necessity.

Q: How has the revenue cycle changed during your time at OhioHealth?

MS: During my time [here], we've gone onto a single EMR platform for the health system. This standardized infrastructure has enabled us to advance the simplification of the patient billing experience and optimize our revenue cycle processes.

Q: Are there any other current revenue cycle initiatives at OhioHealth?

MS: We've had a focus on work from home. Over the last two years, we've continued to roll out this strategy. Having a standard EMR platform, we're able to monitor the productivity of associates, and we're able to send them home [to work]. This is great for our associates and for OhioHealth. It reduces turnover, reduces overhead costs, it's an associate-satisfier, we can keep jobs in communities, and there's a larger talent pool to find resources. This is a win-win strategy.


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Trump administration pushes for healthcare price transparency: 6 things to know

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