Erica Gregory Builds Smarter Healthcare and Stronger Systems

Getting your Trinity Audio player ready...

“Success is not final. Failure is not fatal. It’s the courage to continue that counts.”

This Winston Churchill quote, one of Erica Gregory’s favorites, offers insight into her business and leadership philosophy. The greatest setbacks in her career, she says, were devastating at the time but led to some of her greatest triumphs.

“The ability to learn from failure has been so important,” says Gregory, senior vice president and general manager of revenue cycle management at Netsmart. “It’s something that I tell my associates and any of the folks that I mentor.”

Her tolerance for failure allows her to take risks. “If you’re not uncomfortable, you’re probably not doing enough,” Gregory says. “Personal growth comes from taking risks and getting out of your comfort zone.”

With nearly twenty years of experience in healthcare, Gregory has found her stride at Netsmart, an industry-leading healthcare technology organization that helps providers deliver value-based care. Gregory is responsible for revenue cycle management services for the full healthcare revenue cycle. She and her team of 660 individuals, 440 of whom are dedicated to client services, support two main communities: health and human services and post-acute care.

“We provide front-to-back revenue cycle services on behalf of those clients,” Gregory says. Additionally, she and her team offer a revenue cycle management technology suite with specific Netsmart proprietary software that automates clients’ financial processes and increases their efficiency.

Netsmart is committed to improving the standard of living for vulnerable populations. On the health and human services side, Netsmart’s technology assists with mental health services, intellectual disabilities programs, family preservation, foster care and more. On the postacute side, it aids providers with home health, hospice, palliative care, senior living and more. The community care that Netsmart patients receive takes place outside the hospital, either before or after their hospital visits.

“A lot of this care focuses on how we can make sure they live active and full lives in the community and not have to be in an acute or inpatient facility,” Gregory says. “It’s an important part of how we reduce costs across our healthcare system and get a much better result.”

For vulnerable populations, continuity of care is vital, but it’s seldom realized. “The lack of governmental incentives and regulations have made it challenging,” Gregory says. “When you lack an overall standardization around technology and an incentive for them to be on widespread technology, that creates problems in communication and coordination of care.”

Netsmart’s software allows providers to deliver more services and meet demand. “We work with organizations to help them adopt technology, to make that technology affordable, and make sure that it is a full continuum of care,” Gregory says.

Like other companies in the healthcare space, Netsmart is taking full advantage of AI, though Gregory prefers the term “augmented intelligence” to “artificial intelligence.” AI models compile data, such as patients’ comorbidities and social determinants of health, from disparate sources. Then the models produce recommendations that assist providers in establishing a comprehensive picture of a patient’s health.

“If you’re not uncomfortable, you’re probably not doing enough.”

Erica Gregory

Augmented intelligence also has the potential to drastically improve workflows in the revenue cycle, such as eligibility verification, prior authorizations, and collections, according to Gregory.

When these workflows are enhanced by automation, organizations are positioned to collect accurate reimbursement and ultimately, continue delivering on their care mission. In addition, the AI models reveal “hidden data trends,” Gregory says.

“Gathering all these different pieces of information across the full continuum of what a patient or client has experienced is important for getting accurate reimbursement in a compliant manner,” Gregory says.

“Augmented intelligence can enable the human in the loop to consume all the relevant pieces of data, as opposed to spending their time gathering the data. That’s going to be a big part in how we increase throughput and how we provide more timely and accurate care to individuals,” she says.

---