Ahead of the marcus evans National Healthcare CFO Summit 2022, read here an interview with Rick Reid where he discusses what strategies healthcare CFOs can implement to improve the financial situation of their facilities.

1. Interview with: Rick Reid, Chief
Executive Officer, The Rybar Group
“Healthcare CFOs need to make a
strategic decision about how they are
filing their Medicare cost report, as it
affects how their hospital is reim-
bursed,” advises Rick Reid, Chief
Executive Officer, The Rybar Group
“Not all healthcare CFOs understand the
financial impact the cost report can
have and often do not make sure that
the data submitted is correct and
appropriate,” he adds.
The Rybar Group is a service provider at
the marcus evans National
Healthcare CFO Summit 2022.
What lessons did hospital leaders
learn from the pandemic? What
financial issues did they struggle
with and how did they address
them?
The biggest lesson they learned during
the pandemic was that healthcare is not
protected against outside influences.
When the shutdown happened, the
bottom fell out of healthcare from a
volume perspective. That had never
happened before, and nobody thought it
could. They learned they really had to
be ready for a disaster. Not having
enough cash on hand did not cut it in an
emergency like that.
What strategies did some
healthcare CFOs implement that
helped close gaps in revenue or
cash flow?
Some went into a significant cost-
cutting mode, which was difficult as
volumes had gone to zero, while they
still had fixed costs to maintain such as
staffing and supply. Facilities with
strong balance sheets were able to
maintain and pay staff throughout the
pandemic, while those with no cash
reserves had to lay people off.
What are the financial and reim-
bursement triggers that can bring
additional revenue to a facility?
Many of the triggers are on the
Medicare side, making sure that they
take advantage of regulations and
employing the options that have the
biggest benefit to their facility. We also
find a significant number of facilities
that have earned additional revenue but
not claimed it on their cost reports.
They have to make sure their charge-
master is up to date with current codes,
that they have a pricing strategy for
setting prices, and that the way they
price their services is to their best
advantage. Critical Access Hospitals
have an advantage, where they can
charge less and actually get paid more
from Medicare and less from patients.
They must however consider the
commercial impact of that before
reducing prices.
It is really important for healthcare
CFOs to consider how they are making
some of these decisions and how they
are filing their Medicare cost report,
because that is the tool the government
uses to come up with cost-to-charge
ratios, and how hospitals are reim-
bursed. They must submit the correct
data for all the different items that are
being requested for those audits. That is
a very important strategy. Not all
healthcare CFOs make sure the data
submitted is correct and appropriate.
Many just focus on filling out the forms,
and assume it is good to submit to the
state or the outside audit firm. They
need to make a strategic decision about
how that data gets submitted, as it
affects their payment pools.
Another strategy to make sure that they
are getting paid correctly is to under-
stand how their payment rates are
calculated, which comes back to the
Medicare cost report. That is really the
source that Medicare and most states
use to determine rates. Even if they do
not have an impact this year, they will
have an impact two or three years down
the road.
What is the best way of identifying
these opportunities for revenue
generation? Where do they start?
They should start the process by looking
at how their cost reports are currently
filed, if there is an opportunity to refile
previously submitted reports to capture
additional reimbursement. Another way
to start is from the pricing side, to look
at how commercial contracts are paid,
and if there are any that are paid on a
percentage of charges, to consider the
impact of that before doing anything
with the pricing structure. They cannot
just increase charges. If there is no
significant cost increase, Medicare can
actually take some money back.
How can they identify the root
causes of underperformance?
It is important that providers look at the
entire revenue cycle process, from when
the appointment is scheduled until the
bill is paid and there is a zero balance
on the account. Best practices should be
employed and there should not be any
workarounds. When a problem arises,
rather than implementing a practise that
moves them away from those best
practises to fix the problem, they need
to go back to the source, find what
happened and correct the issue.
Workarounds tend to be manual
processes that lead to delays in getting
paid. Nobody in a facility wants to slow
down the payment process, but they will
not know they are doing something
incorrectly until somebody tells them.
Just because a facility has the best
practices and policies in place does not
mean they are practised.
What mindset is required to achieve
this?
I was a hospital CFO for ten years, and I
know that when you just look internally,
you think you are doing the right thing.
A lot of times it helps to bring an expert
in, to have a second set of eyes looking
at your processes and practices. If you
just look at past performance, you will
see you are doing better than before,
but you will not know if you are doing
better than your peers.
What areas do CFOs overlook, that
you consider critical for success?
Keeping current on the regulations.
Healthcare finance is very complicated,
and regulations change frequently. It is
easy to slip into the mindset of, “this is
how we have always done this”.
Hospital CFOs are busy putting out fires.
They do not have time to stay on top of
all the regulations. It helps to have a
trusted advisor keeping them up to date
with reimbursement changes.
Just because a
facility has the
best practices and
policies in place
does not mean
they are practised
Closing Gaps in Revenue and Improving
Cash Flow in Hospitals Today

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About the National Healthcare CFO Summit 2022
The National Healthcare CFO Summit is an invitation-only, premium Summit
bringing senior level healthcare finance executives and innovative suppliers and
service providers together. The Summit’s content is aligned with key healthcare
finance issues and interests, relevant market developments and practical and
progressive ideas and strategies adopted by successful pioneers.
www.nhcfosummit.com
About The Rybar Group
The Rybar Group is a trusted source for healthcare providers seeking to optimize their financial viability. Focusing exclusively in the
healthcare arena, The Rybar Group brings in-depth industry knowledge to help clients create solutions designed to identify
opportunities for revenue generation, isolate root causes for underperformance, accelerate cash in the door and support long-term
margin improvement. Their multi-disciplinary team has a proven track record of delivering leading-edge financial management and
reimbursement services to the most prominent providers in the country.
With more than 300 years of combined experience in the healthcare industry, they feature comprehensive expertise in healthcare
reimbursement, operations, regulatory frameworks, payor relationship management, and mapping the flow of information across
the front, middle, and backend of the revenue cycle. This enables them to consistently identify patterns of underperformance
limiting revenue generation and develop solutions aligned with existing process and business strategy. They are experts at helping
their clients get paid more, on time, and in accordance with contractual parameters.
www.therybargroup.com
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