With years of experience in health IT leadership and public policy, Justin Barnes recently joined Atlanta-based iHealth, which offers revenue cycle performance and population health management services as well as care coordination analytics. The health advisory and services company aims to help healthcare providers navigate to value-based care and achieve success under new payment models.
Previously, Mr. Barnes was a senior leader at Greenway Health for 11 years, directing the health IT vendor's marketing, corporate development, strategy, government relations and international affairs.
He left Greenway in 2014 and began serving as an independent corporate, board and policy advisor focused on assisting companies, associations and entrepreneurs with growth and acquisition strategies. Before joining Greenway, Mr. Barnes was co-founder and vice president of the patient-provider communications and engagement company, Healinx, now known as RelayHealth.
Throughout this time, "I worked equally with providers, competitors, peers and industry leaders. We all worked well together, and collaboratively," Mr. Barnes says.
His experience in health IT and as an advisor laid the groundwork for his success in public policy. Mr. Barnes has addressed or testified before Congress as well as the administrations of Presidents George W. Bush and Barack Obama on more than 20 occasions with statements relating to value-based medicine, accountable care, interoperability, EHR meaningful use, consumerism, innovation, patient engagement, quality, HIPAA and the globalization of healthcare, among other topics. He also advised several U.S. Presidential campaigns on healthcare public policy.
He now takes all of his expertise to iHealth as partner and chief growth officer.
Mr. Barnes recently spoke with Becker's Hospital Review about the importance of navigating today's evolving healthcare payment models and what makes iHealth different from other RCM providers.
Note: Interview has been lightly edited for length and clarity.
Question: How was iHealth started?
Justin Barnes: We brought together four revenue cycle management companies and rolled them up under iHealth. There's a lot of experience here. For example, one of the companies is Paradigm Healthcare. Paradigm was started in 1996 with experience in medical billing, coding and practice consulting. So our organization from its origin is more than 20 years old. We're focused on revenue cycle management, practice advisory and credentialing services. It's really everything that has to do with your revenue cycle.
But today providers are re-engineering their revenue cycles for value-based reimbursement. The service expertise we've pulled together helps them successfully navigate this change. Our focus is on best practice revenue cycle performance, care coordination, analytics and population health — the future of healthcare. Here's where my knowledge of all the various payment models is a strategic asset to our company and our customers.
I testified on the Medicare Access and CHIP Reauthorization Act three times and testified for 10 years on the need for fee-for-service reform — to replace the Sustainable Growth Rate formula with a sustainable model. That was something that was very near and dear to my heart in ensuring the stabilization of revenue for physicians and care providers. That breadth and depth of experience I have dealing with fee-for-service, dealing with SGR reform and then helping to create MACRA is the knowledge we're bringing into our new revenue cycle performance platform as well as care coordination, analytics and population health.
Q: What specific need within the industry does iHealth hope to address?
JB: Every doctor, every care provider and every institution is nervous about how fast healthcare payment models and care delivery models are evolving. And there's always some technology vendor lined up to sell them something. But my take is that many providers may not need to buy more software to succeed under value-based care. This is not a technology or innovation problem.
At this juncture of the industry, providers need help learning these new payment models, implementing quality achievement programs, managing their existing technology, and then reporting their data. They need help every step of the way. So this is a services need for them. This is an educational and expertise issue.
There will be 100 companies lined up to sell providers software. But that's not the industry's problem. The industry needs solid, knowledgeable people to understand, implement and manage the new payment and care delivery models. Even large medical groups with 2,000 employees may not have the expertise they need to perform quality reporting or capture the correct information through their entire institution. And it's not just clinical. It's not just financial. It's not just administrative. It's all of it.
Q: What is your workplace culture like?
JB: The No. 1 word that comes to mind is exciting. The team is very excited about solving the problems of their specific customers or our customers in general. That's why we get up every single day — to solve the problems of practices and hospitals across America.
My former Greenway team carried the same mantra. We spent the first 10 years focused very heavily on having the happiest customer base in America or globally as our No. 1 mission. And that's the same mantra we have here at iHealth.
If our customers are happy and successful, that takes care of everything else for our company. We recruit and retain people who have that same passion and mantra.
From a customer perspective, we attract medical practices that want to achieve and thrive. These practices know healthcare is changing, they know it is evolving, they know there's more opportunity out there. But they question what that next step is. They're cautiously optimistic, but they're also saying "I know I can do better. I know I can navigate this successfully. I've been profitable the last 15, 20 or 30 years, and I'm going to be profitable in the future." The way providers operate their business is changing, and our customers are open to that change.
Q: What kind of expansion or growth do you project in the next couple of years?
JB: We know we're going to grow 50 to 100 percent per year at this juncture. I see the rate we're growing right now and the expansion with our service lines. Our products and services will never stop evolving. Technological innovation and what we're able to do with data is also driving exponential growth.
Also, because of the expanding quality reporting programs, initiatives under MACRA and state-based incentive options, our services are on fire. Providers recognize and welcome the need for "hand-holding" through the increasing complexities of reimbursement. They acknowledge that they don't want yet another piece of technology to solve the problem. They need advice and services support.
Finally, since we go at risk for all our advisory engagements, we have to be successful under all of those payment models. So we're expanding very rapidly to keep pace with that.
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