Deborah Vancleave Takes Risks to Make Impressions

As a healthcare industry veteran, Deborah Vancleave knows that the best patient experiences come with keeping up with the pace of change

When Deborah Vancleave moved to Missouri in 2016 to become vice president of revenue cycle at Mosaic Life Care, her first task was to create a healthy patient financial experience at the healthcare system. 

deborah vancleave
Photo by McBee Photography

The lifelong Californian had already worked in healthcare for more than three decades, with roles ranging from director of patient financial services at health systems to owning a healthcare medical management and billing company. Given her breadth of experience, she knew she would be able to add value at Mosaic.

When she arrived in St. Joseph, Missouri, Vancleave knew she had to hit the ground running at Mosaic. So she made an early judgment call to replace two software systems that had proven to be ineffective, she says. The situation required a speed to market approach and Vancleave had to lead her team through a great deal of change while gaining buy-in through communication and inclusion. It wasn’t ideal, but was necessary at the time.

But as a thirty-five-year veteran of the healthcare industry, Vancleave also knows that adaptability is key to survival. She is no stranger to breaking molds when changes need to be made. Early in her career, she quickly worked her way up through various positions in corporate healthcare before running her own business. Now, she channels all that she has learned over the years into her role at Mosaic, where her focus is on optimizing the patient financial experience.

“Deborah’s a visionary,” says Paul Shorrosh, founder and CEO of AccuReg, a front-end revenue cycle software provider. “She understands how critical it is to address issues at the front of the revenue cycle in order to increase net patient revenue, versus the more costly back end approach. AccuReg is proud to help execute her vision.”

Even with all her expertise, Vancleave knows a constantly shifting healthcare industry will always keep her on her toes.

“Your experience is only as good as the last twenty-four months, honestly,” she says. “Because that’s how quickly things change. And that’s how adaptable you need to be. It’s easy to say ‘Oh, thirty-five years of experience,’ but—with the fast pace of change, just when you think you’re an expert, everything changes. What have you done lately? That’s really what is important.” 

Vancleave started off in the industry as a receptionist for a healthcare business in her native Orange County, California. After a matter of months, she found herself wanting more stimulation. She was hired into accounts receivable, and six months later became supervisor of the department. After spending time in various positions in corporate healthcare, she and a business partner decided to purchase a billing service and grew it into a successful medical management company called Advanced Healthcare Solutions, which they ran for more than a decade.

Before joining Mosaic Life Care in 2016, Vancleave worked from Southern California as a senior leader for revenue cycle at Texas-based Conifer Health Solutions. She decided to take the leap to Mosaic because of the talented team there, she says. She also believed the revenue cycle hadn’t received the capital investment that it deserved.

“I think my first objective was really to build a world-class revenue cycle, and the way I knew we should do that is to put the patient financial experience in the center of everything that we do,” she says. Her passion for providing an excellent patient experience stems from the fact that the revenue cycle is often the first and last part of an organization to interact with a patient.

“I think if you give teams what they desire—they desire an environment where they can be successful. They desire autonomy. They desire respect. And I think if you provide those things, you can achieve great outcomes.”

“I think revenue cycle has a unique opportunity to make the best first impression,” Vancleave says.

Additionally, Vancleave sought to measure the patient financial experience. “That’s still a visionary concept for health systems,” said Jayson Yardley, CEO of Avadyne Health, a close partner of Mosaic that helps it to measure, predict, and improve patient financial experience through data. “Under Deborah’s leadership, patient complaints dropped from dozens per week to two per month.”

Part of Mosaic’s growth strategy included the purchase of a new acute care hospital earlier this year. Mosaic’s task was to integrate the new hospital with their electronic medical record platform in the span of about a hundred days. That feat required skill and finesse.

“It was miraculous,” Vancleave says. “We’re still stabilizing, but the team came together, which was pretty remarkable because most of the team had little to no experience in that type of system integration.”

Beyond the immediate and mid-term changes she’s spearheaded or been part of since arriving at Mosaic, Vancleave also has a long-range plan focused on making sure the right people are in the right positions and also keeping up with technological improvements. She created a new department to support technology tools, and employee training to use them. All of that has been crucial in building a strong team that is continually learning, and therefore continually adaptable.

Keeping up with technological advancements is just one part of evolving as a healthcare leader, though. Vancleave believes industry professionals also need to spend less time pigeonholing themselves into one skill set and spend more time expanding their knowledge base. They also need to do a better job of accepting feedback, she says.

“I think all those things make us as nimble as possible,” Vancleave says.

Communication between leadership and employees has been key to strengthening the Mosaic team. Vancleave reflects on her decision early on at the organization to unilaterally make changes to help the organization’s finances. She says sometimes it’s necessary for leaders to unilaterally make the call; however, it is important to explain moves like that to employees.

“You have to communicate the reasons why, you have to communicate the value, and you have to communicate the outcomes expected,” Vancleave explains. “Because I think if you give teams what they desire—they desire a situation where they can be successful. They desire autonomy. They desire respect. And I think if you provide those things, you can achieve great outcomes.”


Avadyne Health, rated No. 1 in patient communications and financial satisfaction solutions by Black Book Research, provides self-pay account resolution and bad debt recovery services to more than 340 hospitals including the largest, multi-hospital, health systems in the US. With patients’ expectations for healthcare services changing, Avadyne Health excels in addressing the increased need for better and less-complex patient financial communication, experiences, solutions, and technology. Our trained and caring professionals are passionate about the patient financial experience and strive to exceed patient expectations during every engagement on behalf of our clients and have for over forty-eight years. For more information, visit avadynehealth.com.