Ask a Revenue Cycle Leader is a new series featuring insights from health system and hospital revenue cycle executives nationwide. Becker’s poses questions on the most pressing issues in healthcare finance — from payer relations and automation to workforce and patient experience. We welcome responses from all revenue cycle, finance and reimbursement leaders.
Question: How has your definition of revenue cycle success changed over the past several years?
Samantha Cable. Vice President of Revenue Cycle at Peregrine Healthcare (Houston): Over the past several years, the definition of revenue cycle success has evolved far beyond simply collecting payments and reducing accounts receivable days. Revenue cycle management organizations are now navigating an environment of constant change, where success depends on the ability to rapidly adapt to new technologies, payer requirements, regulatory updates, and ever-changing practice management and EHR platforms. The accelerating adoption of artificial intelligence, automation tools and advanced analytics has created tremendous opportunities for efficiency, but it has also required significant investments in training, workflow redesign and change management.
RCM teams must continuously learn new systems, integrate emerging technologies into existing processes and ensure staff remain proficient while maintaining operational performance. At the same time, they face increasing payer complexity, evolving reimbursement models, staffing challenges and heightened client expectations for transparency and real-time reporting.
Today’s successful RCM organizations are those that can balance innovation with operational excellence, leveraging technology to improve performance while maintaining the expertise, flexibility and human oversight necessary to navigate an increasingly complex healthcare revenue landscape.
Alona Dunlap. Vice President of Commercial AR Operations at Conifer Health Solutions (Dallas): For most of my career, revenue cycle success was defined almost entirely by the numbers — DNFB, AR days, denial rates, cash collected as a percentage of net revenue. If the metrics looked healthy, the revenue cycle is healthy. That was the scorecard, full stop.
That definition has shifted significantly for me over the last few years. The metrics still matter — they always will — but they’re now table stakes rather than the whole story. Success today is much more about how quickly and efficiently you can identify and respond to payer issues and trends before they become systemic problems, and whether you’re building technology, AI and automation into your workflows so your team can do more with the resources you have, not more resources.
Beyond that, I’ve come to see success as the ability to create real alignment across three things that used to be managed in silos: the patient’s satisfaction and experience, payer accountability and the strength of your relationships with top payers in market and the efficiency of your backend processes through technology and automation. When those three are working in concert — instead of each being optimized independently — that’s when you get a revenue cycle that’s not just healthy on paper, but sustainable and resilient over time.
Blake Evans. System Vice President of Revenue Cycle at Rush University System for Health (Chicago): My view of revenue cycle success has evolved beyond traditional financial measures such as cash collections, AR, and denials. While strong financial performance remains essential, success today also means providing a more transparent and seamless patient financial experience. It includes investing in our people and equipping them to thrive as technology, automation and AI continue to transform the industry. Ultimately, I define success by the value we deliver, not simply the volume of work we complete.
Murry Ford. Vice President of Revenue Cycle at Kettering (Ohio) Health: While a strong net collections ratio still matters, how the collection happens and what it costs to get there are important markers of success.
For example, improving the percentage of claims resolved with zero human touches or without rework reflects rigor around eliminating waste and effective use of automation. An additional success measure is patient engagement with the revenue cycle: satisfaction data and adoption of frictionless self-service tools for scheduling, check-in and pre-service payments, supported by accurate price estimates and flexible payment arrangements.
Strengthening these measures helps reduce cost-to-collect at a time of financial headwinds across the industry.
Joel Gentry, Vice President of Revenue Cycle at OU Health (Oklahoma City): Over the past several years, my definition of revenue cycle success has evolved from a departmental focus to an enterprise focus. Traditional measures such as cash collections, denial rates and accounts receivable performance remain important, but they’re increasingly the result of strong organizational alignment rather than the sole measure of success.
In an academic health system, revenue cycle performance reflects shared accountability across clinical, operational and financial leadership throughout the patient journey. Success no longer begins or ends within the revenue cycle department. It depends on how effectively we align processes, data, and decision-making across the organization to support both patients and caregivers.
Success is also no longer defined solely by what happens after care is delivered. It’s defined by how effectively we remove friction for patients, support caregivers with reliable processes, and ensure appropriate reimbursement for the care we provide. The shift from reacting to issues after they occur to preventing them before they impact the patient experience or financial performance has become increasingly important.
Ultimately, revenue cycle’s role extends well beyond financial operations. Our responsibility is to help ensure the organization’s financial strength so it can continue advancing its tripartite mission of education, research and clinical care. The best revenue cycle organizations are no longer measured only by how well they respond to problems, but by how effectively they prevent them.
James Hartman. Director of Revenue Cycle at Thorek Memorial Hospital (Chicago): Early in my career, revenue cycle meant patient financial services — a siloed function focused solely on AR metrics. Over time it’s expanded into an organization-wide discipline spanning the full patient journey, from pre-registration and intake through authorization, coding, utilization review, chargemaster, payer contracting, denial management and even bad debt vendor oversight. I think of the revenue cycle leader like a conductor — it’s no longer one section playing alone; it’s coordinating every department in the orchestra toward one outcome. Increasingly that also means bringing in AI and contract management tools to support that coordination across the entire hospital, not just within PFS.
Angel Hovanessian. Vice President of Revenue Cycle, HIM, CDM and CDI at Emanate Health (Covina, Calif.): Over the past several years, my definition of revenue cycle success has expanded beyond simply collecting revenue, with insurance companies becoming more challenging, with increased denials, delays and complexity in reimbursement.
I believe success requires looking at the entire revenue cycle from beginning to end, from patient registration, eligibility, authorization through accurate coding and billing, to claims, denials and final payment. At the same time, hospitals have a responsibility to provide the best possible care to patients. To me, revenue cycle success is finding the right balance between supporting patient care, improving operational efficiency, reducing avoidable revenue loss, and ensuring we collect the reimbursement we are entitled to so the organization remains financially sustainable.
Paul LePage. Vice President of Revenue Cycle at UC Davis Health (Sacramento, Calif.): Earlier in my career, I viewed revenue cycle success primarily through the lens of cash, AR days and denial rates — and while those metrics still matter, they no longer tell the whole story. Today, I believe success is about building an integrated, resilient operation that prevents problems upstream instead of celebrating how well we clean them up downstream. This aligns in partnering with clinical leaders and using technology thoughtfully, developing people, and making the financial journey easier for patients without losing sight of the organization’s financial health. Ultimately, the best revenue cycle is one that delivers strong results consistently, adapts quickly, and does not rely on daily heroics to succeed.
Dee Montee. Vice President of Revenue Cycle at HonorHealth (Scottsdale, Ariz.): Traditional key performance indicators, including DNFB, AR days, denials and cost to collect, will continue to serve as foundational measures of revenue cycle performance. However, a critical component of future improvement efforts is assessing the EMR automation functionality already available within the organization and determining where it has not yet been incorporated into revenue cycle processes. This evaluation can help identify opportunities to improve outcomes, increase efficiency, and enhance return on existing technology investments.
Next question: What’s one leadership lesson you learned the hard way? If you are interested in responding, please send responses to Andrew Cass at acass@beckershealthcare.com.
