Jenni Alvey has served as CFO of Indianapolis-based IU Health since February 2016.
Ms. Alvey joined the 14-hosptial system in 2011, holding various finance and revenue cycle-related roles during the four years before becoming CFO. Prior to IU Health, she was public finance director of the State of Indiana and chief executive of the Indiana Finance Authority. Ms. Alvey also was an attorney at Indianapolis-based Ice Miller and worked as a certified public accountant.
Ms. Alvey recently answered questions from Becker's Hospital Review about her greatest challenges as a revenue cycle leader and how she would improve the revenue cycle process.
Note: Responses have been lightly edited for clarity.
Question: What's your favorite part about being a revenue cycle leader for a healthcare system?
Jenni Alvey: My favorite part is how you can see all aspects of the patient experience from beginning to end … which also connects to both the financial health of the patient as well as the financial health of the organization.
What's fascinating to me is the revenue cycle starts with the first patient call. If we [parse] through their information well, and we ask the right questions about their ability to afford our services, we can ensure they have a great experience financially, either at the beginning or the end of the visit. With things like Medicaid expansion, we're able to get people covered before they get into our system or while they are standing at the door. We're not having to have those discussions afterward when they get some huge bill that causes them a lot of heartache. Being able to identify ways for people to be covered and getting that financial burden off of them is really rewarding as a financial leader. It's not about sending people to collections. Our goal is no one goes to collections, because we're able to work out a plan for anyone no matter what they can afford.
Q: What is the biggest challenge you're facing as a revenue cycle leader?
JA: The biggest challenge is as healthcare reimbursement is changing, the rules around getting people and services authorized, ensuring things are medically necessary and ensuring you've done everything you need to for the payer to actually pay for that visit is becoming more difficult. This adds costs to healthcare and puts the patient in the middle. Ensuring we've adjusted the way we do business to be able to ensure our prices are in line and appropriate and affordable — that is also more difficult as we have high-deductible health plans.
In addition, a challenge is knowing when to really shift the department to be more value-based focused than fee-for-service-focused, and how to balance the two.
Q: What is one of your goals this year?
JA: One of our goals this year is to align with our best payer partners to try to remove unnecessary barriers at the time the patient is visiting us, and instead take that same [time] we'd spend trying to get authorized and use that to better educate our physicians on things that might not be geared toward population health. To redeploy the resources that we use today — arguing with the payers — into actually aligning our incentives to together get better population health for our patients.
Q: What is one thing you'd do to improve the revenue cycle process?
JA: I would reduce the amount of steps a clinician has to take to get paid. And ensure as long as they're taking good care of the patients and documenting appropriately, we always get paid. I don't think [the process] is any value add to the patient, to the clinician, to our system and even to our payer. I would love to be able to figure out how to stop the age-old, "These are the payer requirements in a healthcare system to get paid." That isn't easy. You would have to get rid of those checkpoints in the process.