Phoenix-based Valleywise Health is proud of its history as a safety-net hospital, serving its unique community since 1877. In June, Valleywise Medical Center moved more than 200 patients from its legacy facility into a modern new facility – and the organization aims to keep growing.
Claire Agnew, executive vice president and CFO of Valleywise Health, recorded an interview with the Becker's Healthcare Podcast during the CEO+CFO Roundtable in mid-November about navigating the challenges and evolving opportunities in healthcare.
AI and payer disruption
Valleywise leadership is very focused on incorporating artificial intelligence into clinical and operational aspects of the system. The technology is another big investment for a safety net hospital, and Ms. Agnew wants to make sure the AI is built on good data.
"If it's not working from good data, you're going to get bad results, and that in healthcare can be devastating," she said. "Part of the way we look at it in terms of instituting AI is through trusted partners. Epic is an example. One of the things we're working on right now is ambient listening in our clinics. It can support physician documentation, taking notes during the visit based on the discussion held inside of the room. It still will require that the provider spend time to review the documentation and make sure it's accurate before it's submitted and becomes actionable."
The goal is to reduce the time physicians are typing notes and increase their connection with patients. On the revenue cycle side, the hospital is using automation to keep pace with claims submissions and payer policy changes. Payers are now using AI to review claims and identify denials; hospitals are looking for revenue cycle AI and automation partners to appropriately respond.
"I'm seeing there's going to be a continued expansion on revenue cycle automation because as much as we in revenue cycle are investing in automation and AI, so are the payers, and they will put a lot more money into it," said Ms. Agnew. "You're going to have to up your AI game. You're going to have to get into automation on the revenue cycle side because you are going to be dealing with this on the other side. They will become even more [precise] in terms of their accuracy. They don't take breaks on weekends, and it'll continue on."
Cybersecurity
One of the biggest disruptions for hospitals this year has been cyberattacks, both on third-party vendors and hospitals themselves. Many organizations are increasing cybersecurity budgets and spending more of their executive team meetings zeroing in on the right investments.
"As a safety net hospital, we don't have a lot of funds for capital. So when we are deciding what's going to be used for capital versus clinical investments or infrastructure investments, the most important thing is our leadership being able to come together and have a framework for thoughtful conversations," said Ms. Agnew. "Cybersecurity is an investment in cost-avoidance…That cost is not just financial cost, although that's important to me as CFO, but also with our brand, with our trust with our employees and our providers, and our trust in the community."
Patients coming to the hospital want to ensure their information and data is protected, and operations aren't disrupted because of a ransomware attack. That's why an investment in cybersecurity is so critical. Hospitals can either build their own programs or partner with others to manage cybersecurity.
"Oftentimes, we're looking at companies that specialize in [cybersecurity] and they have that as a service," said Ms. Agnew. "That's probably the better option for us, but we do a review."
Forging third-party vendor partnerships is also a risk. Hospitals must be prepared if a cyberattack disrupts their vendors or exposes patient information. Ms. Agnew said Valleywise has been impacted by multiple vendor breaches in recent years, including the attack against Kronos, which supports payroll management. Kronos' systems went down in 2021 during the holidays and made it challenging for Valleywise to pay employees, most of which are hourly.
"It's about disaster recovery and what you are able to do so you can continue to put money into their pockets, and so that you can continue to provide the services that are needed," said Ms. Agnew. "We do drills with disaster preparedness and emergency management. Unfortunately, we've also had enough incidents that we've done these sorts of practices live enough times over the last several years that I'm feeling, unfortunately, really good with setting together incident command and having everybody involved in coming up with the processes."
The cyberattack against Change Healthcare earlier this year also affected the hospital, even though it didn't use Change; payers contracting with them did.
"We were impacted because we can submit claims to [the payers], but they can't process payments to us," said Ms. Agnew. She said healthcare companies are now diversifying their vendors more to mitigate the impact of future cybersecurity incidents.