In her early career as a business consultant, Leah Klinke once joked that she would never work in a hospital’s billing office. “They just looked like they were always working so hard,” she says. “Constantly running around, working so hard for every penny. It just looked like a really stressful job.”
As chance would have it, Klinke soon found herself knee-deep in billing when she took the position of director of patient financial services at WVU Medicine. In 2016, she was promoted to the assistant vice president of hospital revenue cycle.
Klinke says she loves the work and is doing her part to make the billing environment less hectic by standardizing key processes across WVU Medicine’s eight different billing sites, which are scattered throughout rural West Virginia.
Previously, the locations didn’t operate as a united, streamlined system, Klinke says. “Everybody was doing something different,” she says, noting their use of systems such as McKesson, Allscripts, and Meditech. In August, however, WVU Medicine kicked off an initiative to convert each hospital to Epic, a top-of-the-line software suite that provides a host of benefits in the realm of billing, not to mention numerous other healthcare functions.
Epic has no shortage of benefits for the organization. Klinke says the system allows her to develop strategies and set goals for her team, and it also provides simple solutions. For example, if there was an error in choosing one’s coverage in the previous systems, the error would snowball to such a degree as it traveled throughout the system so that efforts to correct it required a great deal of manual intervention on the back end. Epic has the ability to auto-select coverage based on eligibility, which not only saves time, but allows for fewer errors downstream.
WVU Medicine’s flagship hospital, J.W. Ruby Memorial Hospital, has been using Epic since 2008, and one of Klinke’s first projects when she started in 2012 was bringing the company’s two Eastern Panhandle hospitals onto Epic. In that process, however, the billing functions of those offices were brought to the Morgantown billing office as part of an initiative decided before she began her tenure. As a result, Klinke says they were able to only retain a handful of employees, meaning WVU Medicine lost a great deal of billing expertise and, due to an influx of new employees, needed to “start from scratch from a training perspective.” This is an outcome she hoped to avoid with WVU Medicine’s Epic conversion efforts.
“One of our goals through the transition was not to do what I think a lot of systems have done, which is to close down billing offices in these rural areas of West Virginia and move all the jobs to Morgantown,” she says, citing the common practice of a company corralling all of its billing staff into one large service center.
The problem is that, in doing this, a company is often taking away jobs from communities that desperately need them. “Being in a rural state like West Virginia, where there aren’t a lot of good jobs in these communities, we don’t want to be that large employer that consolidates jobs in areas where there aren’t jobs.”
She continues, “One of our objectives is to figure out how we can optimize operations and deliver a high-quality product while retaining the expertise and the jobs in the local market.”
It helps having a system such as Epic, which makes it easy for the billers at WVU Medicine’s myriad locations to communicate. “With this system, we can’t operate independently. Everything that we do is now interconnected,” Klinke says.
Previously, it was easy for each office to operate in a silo. Now, Klinke says that WVU Medicine leaders who don’t often get the chance to circulate to different sites have a renewed sense of alignment and connection with staffers throughout the state.
“We really understand what’s going on in their system, and we have regular connections with each of the sites to talk through their challenges and everything,” she says. “We’re also building relationships among the leaders by having them use each other as resources. Communication has gotten much better, as has the transparency into what’s happening in each office. All you need to do it just pull up the Epic dashboard to see what’s going on.”
Still, even this staff-centric approach comes with its own unique challenges. Epic will have a major impact on the day-to-day functions of these billing offices, and Klinke notes that this changing of responsibilities among leadership can be “perceived as a narrowing of scope.”
What Klinke and her team are trying to convey is that, although a director’s or manager’s responsibilities might be evolving, the actual scope has broadened considerably.
“Trying to communicate that in a way that employees receive positively is certainly a challenge,” Klinke says.
The key for Klinke is in conveying to staff and executive leadership at each hospital that the Epic rollout and staff retention initiatives she’s pursuing will result in greater efficiencies and better results from billing functions that come with little additional cost. Over time, however, those results are bound to reveal themselves organically, with Epic’s functions working hand in hand with Klinke’s leadership to ensure a smooth transition.
It’s essential that healthcare embrace efficiency and technological innovation, but, as Klinke demonstrates, sustaining the communities at the heart of an organization is just as important.