Jeff Podraza recalls how difficult and disorienting his early days in healthcare were.
“When I started in this industry, I was amazed by what I didn’t know,” Podraza says. “I had just gotten out of law school, and when you get out of law school you think you’re pretty smart,” he says. “You have to be open to having your brain filled with all kinds of new terminology and concepts.”
Now an executive partner at Specialized Healthcare Partners (SHP), he’s helping to create a tech-driven training, support, and engagement solution for revenue cycle organizations. Based in Delray Beach, Florida, the company supports healthcare organizations undergoing revenue cycle transformations. It supports health systems and large hospitals by resolving their most problematic and complex insurance claims. In addition, SHP also provides assessments and training on maximizing reimbursements on behalf of healthcare providers.
Podraza spent years training professionals and delivering seminars on the legal aspects of healthcare revenue. Over that time, he developed an intimate, nuanced knowledge of how these teams operate and what it takes to improve them. Podraza transitioned to SHP when his former colleagues, Pat and Tracy Lutz, founded SHP, invited him to join the company to help expand their service and to tap into a major asset: the knowledge and ability to train people on complex billing and reimbursement procedures.
“Most Americans don’t appreciate how complex it is, what it takes to send a bill out for what some people think are routine clinical services. It’s anything but routine,” he says.
Today, SHP focuses on its core niche: resolving denied and complex insurance claims on behalf of hospitals. Its specialization is key to their ongoing success, explains Podraza; by keeping its menu extremely short, SHP developed and advanced its practice to a world-class level. At this single project, he says, SHP is unrivaled.
Although its niche is specific, SHP thrives because it helps these institutions while they’re training new staff members who might not know the ins and outs of reimbursement yet. Additionally, it’s expensive and time consuming to fully onboard a new associate, and for the first sixty days, there’s no productive revenue contribution, Podraza says. Indeed, it’s likely negative, as the new team members tie up veterans and supervisors with questions and needs. Since the training process is so resource intensive, any improvements to efficiency or duration pay dividends across the enterprise.
To that end, SHP developed a cloud-based training and team-member support platform that teaches team members how to make decisions while providing the context and resources they need. It’s a flowchart, a living library, and a support tool that orients new associates efficiently and effectively. It started as a tool to bring SHP’s own associates up to speed. The company’s core competency training typically takes 6-8 weeks; the interactive training platform reduces this time by 2-3 weeks.
There’s a typical training experience in any healthcare organization, explains Podraza, but it’s only partially institutionalized. After general training and specific systems training, an associate joins a team and gets to work—but their knowledge is far from complete, and they have to continue training themselves with the resources at hand. Maybe that involves searching through a fat binder of outdated documents; however, often it means asking a neighbor questions.
“What they usually do is start talking to the person who sits next to them. ‘What do I do here? How do we do this?’ he says. “That’s a fairly typical way to train someone, and there’s a much better way to do it: we could take all that material that we’ve developed ourselves and virtualize it. We could do it in such a way that it becomes a complete brain.”
Now, SHP can customize and license the work, as well as provide tools for partnering organizations to add their own procedures and resources. Then those organizations can distribute the material virtually. With more associates working globally or remotely, this helps management control processes for cost and error. It’s an organization’s growing information hub, accessible globally.
In creating the training and team-member support technology, developers needed to make sure it wouldn’t wind up causing team members to spend more time looking for answers, resulting in an overwhelming user experience. The tool itself had to be immediately intuitive, or else it would go unused or waste associates’ time. This balance, recalls Podraza, was surprisingly complex, and it led to unforeseen development costs.
“The biggest challenge was synthesizing something that was user-friendly and deep,” he says. “People shouldn’t spend any time figuring out how to use it. We have our technicians sit down with users for 2–4 minutes to show them how to navigate, and they’re off.”
It’s an exciting development that foreshadows an exciting future of fully automated medical delivery and finance. But that’s still decades away, says Podraza, and building the training platform was complicated enough.
“Great things are happening in terms of applying robotic process automation and machine learning to drive efficiencies in revenue cycle, but there’s still a lot of work to be done that requires skilled team members. The job loss isn’t there yet,” he says. At this point, these tools support and develop—rather than replace—human workers.
Most of all, Podraza is excited about what the tool does for people. The potential for the organizations it helps is great—reduced attrition, shorter training times, and wider margins, among other factors—but really he sees himself helping young professionals, daunted and eager as he once was.
“In this industry it takes about 4–6 months and costs an RCM company, depending on the makeup of its team, between $25,000 and $50,000 to replace an existing employee and get a new team member up to competency. I knew if we could cut that, it’s a real opportunity,” he says. “But there’s also a huge benefit to that employee: by engaging people through this platform, we show team members how to win and also to feel better about what they’re doing.”