Samuel Moore – Vice-President and Chief
Financial Officer, Midland Memorial Hospital
Passionate about healthcare finance and promoting smoother workflows, Samuel has been a part of several innovative healthcare programs. He is currently working with Midland Memorial Hospital, a not-for-profit hospital located in West Texas. In this interview, Samuel talks to me about the various aspects of this field that possess a challenge as well as keep him motivated.
Starting Out In Healthcare Finance
Samuel began his career in healthcare finance over 10 years ago as an accountant. The chief financial officer at the time was his mentor relationship and played a key role in helping him achieve his current position.
An aspect that Samuel finds most interesting about healthcare finance is the variability in their daily work wherein no two days are alike. There may be similar meetings on the calendars but there are always things that come up that need to be worked through with clinicians and non-clinicians.
Current Business Structure And Organization
Currently, Samuel is leading a team of over 100 people in both hospital and ambulatory business offices, which also includes the team for revenue cycle management. Regarding revenue cycle management activities such as coding, Samuel mentions that the majority of staff work remotely with some outsourced support to supplement services.
They utilize vendors for such services as bad debts collections and denial management. Some of the third parties help Samuel’s organization ensure that appeals get written timely and accurately for clinical denials to be reimbursed for the work that they are doing. Denial management is a big piece in every hospital, there are a lot of dollars there. Additionally, in revenue cycle and accounts receivable the hospital uses about five to six vendors that will help collect bad debts and serve in a variety of roles.
Talking about innovative processes that Midland Memorial Hospital utilized to streamline the revenue cycle management process, Samuel states that the billers and the collectors work in the same room together which provides the team the unique ability to talk about a specific patient account. It also helps people help each other on the team dealing with similar problems. Many times issues are resolved quickly with this setup.
By utilizing technology, team leads have the ability to chat with each other without leaving their desk which leads to timely communication –the most important thing.
Standout Moments As A Business Leader In Healthcare
Samuel mentions that they started as a clinical documentation improvement program at his first hospital as CFO. They would come together and meet with the physicians, nurses, case management members, and come up with a program that was going to work for that facility. They also found good clinical documentation specialists who helped make the program successful which was rewarding because they got all the stakeholders together.
Another standout moment for Samuel has been revamping the business office and challenging people to do things that are outside of their comfort zone, with his team’s help. Setting goals and milestones for his team to achieve, supporting them but watching them grow and ultimately be successful in things they perceived that they wouldn’t be able to do is a huge source of pride.
From an organizational standpoint, Samuel takes pride in their ability to work hard and streamline workflows, specifically in the business office. From automating manual processes without intervention or speeding up the cash process, the organization has been able to succeed and achieve several milestones which have been quite rewarding.
‘We spent quite a bit of time looking at processes, seeing where we could streamline those things, and then again set goals for people to be sure that they understood what success would look like along the way.’
Overcoming Challenges In Healthcare Finance
Currently, staffing is a challenge, not only in the clinical areas but things like coding which is a critical piece of revenue cycle management. As this is a remote position nowadays, coders can work from the comfort of their home and a lot of companies are hiring them.
Samuel states that the company has lost all of their inpatient coders which has been quite challenging. Some of the cash began to dry up because they were not able to move those claims through the process timely enough.
‘We have been fortunate to partner with some third-party vendors to get us through this point but when you go from 1 million dollars of bills on hold for coding to 10.5 million dollars of bills on hold for coding, everyone gets a little bit nervous.’
Amidst high competition, Samuel stresses on the importance of making staff feel valued as a key factor in retaining them. Additionally, the organization ensures that they pay competitive rates and actively communicate with the team. Finally, a key piece is helping employees who need more of a challenge grow by increasing their area of focus.
‘We all have those people in our organizations who are high achievers and if we don’t work actively to challenge those people they will leave and go somewhere else where they think they are going to be challenged.’
Impact Of COVID On The Hospital’s Finances
The biggest challenge most facilities faced was PPE and everything from masks to gowns required creative solutions. Hundreds of days by trying to normalize PPE kits for every department. The next big challenge was of capacity. There were not enough beds and vents in the hospital and not enough nurses to care for patients.
Business Plans For Improving The Revenue Cycle Management Department
One aspect is to bring in all of the leaders from each area of the revenue cycle together. Where that starts is the main registration followed by clinical documentation improvement, case management, coding, billing – bringing all the leaders together for a healthy conversation about where the opportunities are and how best to approach them.
Top Philosophies And Core Values In Business
The most important philosophy for Samuel is to be visible and present for the staff, not just for the executive team. He advises spending time in those departments that are going to ultimately make you look good as a revenue cycle leader in the organization.
Another philosophy is to support the people who are down in the trenches doing that work, listen to their concerns, take action where possible but most importantly just be supportive.
Advice For Newcomers Looking To Start A Career In Revenue Cycle Management
‘Find a mentor, find someone who has been doing this for a little while, and get them to just unload on you what they have learned.’
Samuel advises asking good questions and being prepared for the mentor meetings by doing the homework and showing up interested and ready to soak up all the information.
Best Practices In Healthcare Finance Implemented Over The Years
‘Be willing to challenge and be willing to listen to new ideas from your staff.’
From a CFO’s point of view, Samuel believes it is critical for a hospital to improve its revenue cycle management operations. Obviously, the patients and their care come first but to be able to do that, revenue is important as it goes to paying supplies, paying wages, and other important things that keep a hospital working.
‘You always have to be on top of your game and be watchful for what is going on. You have to be able to have strong people on your team, you have to be supporting those people, and to do that you have to be present.’
Vision For The Future Of The Industry
The next big hurdle is about bridging those relationships that maybe haven’t been there in the past. This way, if there is an issue upfront, the team already knows how it could affect the bill going out the door.
For companies and professionals looking to stay successful in this domain, Samuel advises spending time on the floors and in the departments. It is a great way to gain the trust and respect of the people in the organization.
‘You cannot expect people to respect you and trust you if they don’t know you.’
Leaders need to be proactive and be consistent with their message. Also, it is important to be transparent with the staff about any challenges. Sometimes people have great ideas but leaders are not asking and hence losing out.
Leadership Lessons Learned Over The Years
‘When you are taking time to talk with people, listen to what they are going through and to their perspective.’
There is a lot that can be learned from listening. Second, ensure a good work-life balance by taking time to recharge and return to work the next day.