Cathy Bukowski has served as vice president of revenue cycle at Boston-based Tufts Medical Center since March 2017.
Prior to joining Tufts, she was vice president of revenue cycle at Springfield, Ill.-based Hospital Sisters Health System, where she played a key role in developing the 14-hospital organization's revenue cycle strategy.
She also previously worked as vice president of revenue cycle for Milwaukee-based Ministry Health Care.
Given her experience, she is familiar with the challenges hospital revenue cycle leaders face today. Ms. Bukowski recently answered questions from Becker's Hospital Review about these challenges and her goals in 2018.
Note: Responses have been lightly edited for clarity.
Question: What's your favorite part about being a revenue cycle leader of a healthcare system?
Cathy Bukowski: Being a leader in the revenue cycle provides a fantastic opportunity for my team of registrars, financial counselors, medical records staff, patient accountants and customer care representatives to engage with our patients and meet their needs from a nonclinical perspective. Our challenge in the revenue cycle is to continually improve our patient experience while responding to and anticipating the constantly changing regulatory and payer environments.
Q: What is the biggest challenge you're facing as revenue cycle leader?
CB: Revenue cycle leaders are finance leaders and have a fiduciary obligation to our organization and to our patients to keep quality high and costs low. Some of the biggest challenges we face are reduced reimbursements and increased administrative burden from both the governmental and private sectors. Changes to authorization, coding or billing requirements require retooling IT systems and/or changes to operational processes increasing the risk for payment delays or denials.
Q: What is one of your goals this year?
CB: Our basic goal never changes: increase reimbursement to make sure we are getting paid for the exceptional medical care that we provide and reduce administrative costs. In 2018 we will have an intense focus on denial root causes taking more preventative steps than reactive ones. Our main focus will be on standardizing and improving the pre-access, financial clearance and admitting functions to both reduce denials and improve the patient experience.
Q: What is one thing you'd do to improve the revenue cycle process?
CB: The healthcare industry has spent decades and billions of dollars developing technology, specifically the EHR. However, comprehensive, standard, interoperable, effective and efficient revenue cycle systems remain elusive. Continuous improvement on developing an improved revenue cycle IT infrastructure will improve efficiency and control costs.
Q: Are there any revenue cycle initiatives Tufts specifically is looking at?
CB: As a member of [Burlington, Mass.-based] Wellforce, [the parent to Tufts, Lowell (Mass.) General Hospital, Medford, Mass.-based Hallmark Health System and New England Quality Care Alliance], our members will be working together on a number of revenue cycle initiatives looking toward best practice opportunities in vendor alignment and improved billing and collection practices while we explore revenue cycle IT standardization prospects. There are no specifics yet, although this will be the year of exploring the project plans and making sure that we keep the appropriate patient initiatives in line as we move forward in making IT selections and coming together as a system.
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