'We are operating a forever organization': UC Irvine's investment strategy amid inflation

Randolph Siwabessy serves as CFO of UC Irvine Health. 

Mr. Siwabessy will be on panel "The Future of Revenue Cycle - the Patients as Payers and Engaged Consumers" and "Data Transparency and Interoperability: What Early Adopters Learned and What's Ahead" at Becker's 7th Annual Health IT + Revenue Cycle, which will take place in Chicago from Oct. 4-7.

To learn more about the conference and Mr. Siwabessy's session, click here.

Question: What are you most excited about right now and what makes you nervous?

Mr. Siwabessy: The most exciting aspect about being in my role is the opportunity to work with colleagues who are passionate about serving our community and growing the enterprise. Having joined a year ago, I’ve witnessed firsthand our co-workers' compassion, versatility and perseverance in the handling of the pandemic and the various challenges that came along with it. In addition, to connect the various initiatives across our clinical enterprise, we are currently working on an integrated strategic financial plan that will help us focus on areas of the highest impact from the perspective of quality, experience, access and value for our patients. 

We are also building a new medical center in Irvine. Two ambulatory sites will open in 2023 and the new acute care facility will open in late 2025. We are very eager to serve our community and support our tripartite mission of discover, teach and heal. Along with this excitement comes the need to grow our revenue and manage our costs. Given the highly inflationary environment and the increased regulatory requirements such as pricing transparency and No Surprises Act, we will need to be more strategic about which initiatives and capital investments we pursue. I am confident that we have the right leaders and co-workers to make sure our health system thrives.

Q: How is your role evolving?

RS: I have been in this role for more than a year now, coming from another Southern California academic health system. I’m very lucky to be able to partner closely with our CEO and the dynamic and execution-focused team of leaders that he has assembled. Within finance, our team has primary responsibility over areas ranging from government reimbursement, accounting and financial planning analysis to revenue cycle, patient access, clinical documentation integrity and managed care contracting. Given this broad portfolio, we are able to partner with colleagues across the enterprise to understand opportunities and connect the dots, identify financial opportunities and determine the financial impact of various initiatives. 

Population health is also an area that we are paying close attention to right now. For example, the finance team portfolio includes our expanding ACO. With all this in mind, I see that my primary responsibility is to serve as a business partner to our operators and strategists so that we can enable prudent stewardship of our resources. I expect that my role will continue to evolve in support of my colleagues.

Q: How are you thinking about growth and investments for the next year or two?

RS: Given the inflationary environment, we need to be very strategic about how we invest. First of all, we need to take a long view of our organization. Our CEO often reminds me that we are operating a forever organization. With this in mind, we want to make sure that we invest our resources on areas that will enable not only those with us today, but also those leaders who will follow us in the future — all within the context of improving care, access, quality and value for our patients. 

Secondly, we need to focus on maintaining our existing assets so that we can avoid expensive repairs or even unnecessary replacement. Taking this preventive approach should help us manage cost and deliver greater value. 

Lastly, although lower than the state and national averages, we are seeing an uptick in employee turnover, so we must pay close attention to building an environment that will encourage our co-workers to stay and invite new co-workers to join us. Retention is the new recruitment strategy. More satisfied and engaged co-workers will lead to happier and healthier patients. This will have some up-front costs; but we believe the benefits to care and retention will pay off in the long run.

Q: Where are the best opportunities to integrate tech into finance operations and the revenue cycle?

RS: Finance and revenue cycle operations must be more and more strategic to add value to our organization. To do this, we must recognize the interconnectedness of finance functions with strategy and operations. Meaningful data analytics will allow us to plan and make decisions more efficiently. Partnership with IT is paramount.

In addition, on the revenue cycle front, we are seeing that certain payers are more difficult to navigate than others. To address this, our leaders are working on leveraging AI technology to anticipate and prevent denials, improve our authorization process, and optimizing work queue. 

Lastly, UCI Health recently created a venture fund as a way to vet potential opportunities in the healthcare technology space. I look forward to integrating innovative ideas that could generate value to the organization.

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