Krysten Blanchette Builds Better Healthcare Systems

Getting your Trinity Audio player ready...

Years ago, Krysten Blanchette was a seventeen-year-old intern who fell in love with the hospital where she worked, its staff, and the incredible care the organization provided to its patients. She gained experience at other healthcare organizations, then found her way back to what is now Care New England. Beginning in a supervisory government insurance role, she received multiple promotions, rising to her current position as vice president of revenue cycle.

Blanchette’s passion for her work is clear. But her role keeps getting harder in a healthcare system in flux and under immense strain. The challenges she sees are not unique to Care New England, but symptoms of systemic issues.

“Our mantra on my team and more broadly is that we’re here for our patients,” Blanchette explains. “I am not trying to cast blame, but that is not always the same feeling you get from insurance companies. There is a constant battle for common ground that keeps getting harder because bottom lines keep getting tougher to hit. But hospitals are the ones that hurt when insurance companies won’t pay because we’re going to provide the care.”

Blanchette doesn’t shy away from challenges, but the reality she has to deal with is dire. To better serve her organization and ensure Care New England can operate as efficiently as possible for its clinicians, its staff, and its patients, Blanchette is deep in the weeds of an Epic implementation that will create massive change at the health system.

“We have about a dozen systems on the revenue cycle side, and that causes a significant number of breakdowns fairly routinely,” the VP explains. “I never thought I’d be in a role that feels like it’s half IT, but that’s really what my role has become. This team is very excited about the Epic implementation because there are so many processes we’re not going to have to work through anymore. That fifteen-page process on how to get a claim out? We can throw it away.”

The Epic system will go live in October 2025, with testing already underway. Blanchette says the Epic implementation will make communications processes much more streamlined.

Alongside these preparations, Blanchette has taken investment in case management and utilization review as denials issues arose after these processes moved from revenue cycle to clinical teams. She says the revenue cycle team is ready to do more to support patients and physicians like. For example, physician advisors are conducting more proactive peer-to-peer reviews to ensure that their voices are heard upon inpatient denials. The collaborations here are driving success.

But broader challenges remain. The VP says the past six months have been the most difficult she’s seen in her career when it comes to interactions with payers. Pushback from insurance companies is at an all-time high as Care New England continues to communicate the value of the care being provided and the necessity of reimbursement for that care.

“There is a constant battle for common ground with insurance companies that keeps getting harder because bottom lines keep getting tougher to hit. But hospitals are the ones that hurt when insurance companies won’t pay because we’re going to provide the care.”

Krysten Blanchette

Blanchette also finds the rising number of uninsured patients especially alarming. Unemployment is up in Rhode Island. During the COVID-19 pandemic, Medicaid patients weren’t required to renew their coverage, but that exception has ended.

“Over the next year, I’m going to be trying to find a way to better support our self-pay community, because while we’re fighting with insurance companies, you have this whole other volume of patients who need help,” Blanchette says.

The predicament is a massive step backward to a time when too many people didn’t have health coverage. More people got insurance with the passage of the Affordable Healthcare Act, but not enough and now we’re backsliding. Patients who don’t have insurance won’t see primary care providers who help ward off preventable illnesses and chronic conditions before they turn into something much worse. Those patients wind up in the ER with bills they cannot pay. It’s not supposed to work this way for anyone.

Blanchette can’t fix the system by herself. But the VP, whose husband jokes with her that she’d rather be studying spreadsheets than coming home early, is fully invested in trying to improve patient outcomes. The health system where she once interned is now one she helps lead, and it’s immediately evident that Blanchette is all in for Care New England.

---