In 2016, leaders at Winston-Salem, N.C.-based Novant Health became increasingly aware of the need for revenue cycle improvement.
The health system had a 23 percent turnover rate in the patient access department. Leaders also came to realize that many employees didn't understand the concepts of the overall revenue cycle and desired more professional development opportunities.
"There were questions from seasoned employees in these refresher [training] classes that you think they should definitely know the answer to," said Julie Jaksic, manager of revenue cycle education programs at Novant. "But when you look at how siloed the revenue cycle is, there's no way to take the time out of your day [as an employee] to go to a different department and learn about what the other department does so you know your piece a little bit better."
Revenue Cycle University
These issues prompted Novant to work with healthcare vendor nThrive to create a comprehensive academic-style program.
The Revenue Cycle University education program — which is voluntary — focuses on educating staff about the purpose and importance of their revenue cycle roles, in addition to continual job training, said Debbie Flieger, manager of client concierge at nThrive. Ms. Flieger is a certified professional coder and certified outpatient coder.
There are two 16-week semesters annually under the program, with students meeting synchronously six times per semester to get to know their revenue cycle colleagues in other departments.
Outside of those six meetings, done via Zoom web conferencing, the program requires about four hours of academic work each week, on top of normal job responsibilities. Students go online each week to get assignments from nThrive modules and other educational materials.
Participants are offered two courses — revenue cycle foundations and revenue cycle finance — and can take one or both, based on leader approval. Revenue cycle finance is more advanced, while revenue cycle foundations shows the basics of how each revenue cycle department interacts with the others.
"We partnered with their leadership to make sure they have time away in a quiet space where they're not patient-facing and have time to commit to their coursework," Ms. Jaksic explained.
At Novant, 160 employees have participated in the program, including nearly 70 employees during the semester ending this month.
Program feedback
Based on feedback from Novant employees, the program appears to be working well, said Ms. Jaksic. Each semester, there are discussion board postings online, as well as opportunities to reflect at the end of each unit. Students use those forums to provide feedback and their takeaways from the courses.
"Every semester people say, 'I can't believe how much I didn't know,'" said Ms. Jaksic, giving as an example how much data patient access generates and how much they're responsible for.
Novant also recognizes employees who successfully complete the program with a certificate and a pin they can put on their work badge. Over the last year, 85 percent of employees who started the program successfully completed and received these items.
Next steps
Novant has consistently brought in guest speakers, including revenue cycle managers and vice presidents, to speak to employees enrolled in the Revenue Cycle University program about how they got started in their career. Next semester, Novant seeks to invite even more guest speakers.
"I think it's eye opening for the students to see the vision of the leaders and to hear from them personally," said Ms. Jaksic.
Overall, she said, other hospital revenue cycle leaders should be aware that employees need continual workforce development and need to know the "why" behind their role and the importance of their work.
"They need to know the 'why' behind their role because if they know the 'why' then they know how important their work is," said Ms. Jaksic. "Workforce development can't be just for the leaders. It needs to be for your team members. It's not always about where to go in the [revenue cycle] system. It's about why the system is set up like it is — those concepts in the system."
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