MaineHealth's revenue pro Robert Rubinowitz suggests a way to achieve price transparency & 2 more thoughts

In this special Speaker Series, Becker's Healthcare caught up with Robert Rubinowitz, director of revenue cycle management business integration at MaineHealth.

Mr. Rubinowitz will speak on a panel during the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference titled "Revenue Cycle Solutions and Trends," at 3:00 p.m. Friday, Sept. 21. Learn more about the event and register to attend in Chicago.

Question: What do you see as the most vulnerable part of a hospital's business?

Robert Rubinowitz: Payment policies implemented by commercial payers that fall outside of the base contracts. These policies can have a tremendous impact on reimbursement, patient volume and operations. Most of the time these policies are published in newsletters and on very short notice of implementation.

Q: What is the biggest barrier to price transparency in the healthcare industry?

RR: Accessing and understanding appropriate data. How services, supplies and medications are documented, coded and charged will dictate the complexity of the data. Once that level of understanding is identified and mastered, you need to take the patient into consideration. There are so many variables that can [influence] the same procedure: demographics, chronic conditions, severity of illness, etc. The final step is then applying the cost that you just calculated against patient benefits and their deductible balance to determine an accurate out-of-pocket estimate.

Q: How has your organization improved the revenue cycle process in the past year? Or, if your organization hasn't improved its revenue cycle process, how would you go about it?

RR: We have implemented a lean process, going through 26 kaizen events over the past three years. Additionally, we have created a revenue cycle management business intelligence team and have built over 25 analytics apps. In one example, we reduced denial amounts in labor and delivery by 67 percent by changing the charge methodology all while maintaining revenue neutrality.

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