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Jeff Lin
Host of Payment Matters
Payment Matters is a monthly radio show focusing on real issues happening in healthcare payments. Jeff chats with industry experts and thought leaders to bring fresh perspectives on how providers, payers and consumers are all tackling the evolving healthcare payments market. Join the conversation on Twitter with #PaymentMatters.

On this episode of Payment Matters, host Jeff Lin interviews Matt Seefeld, EVP at MedEvolve and founder of myLifeLink. Jeff and Matt talk about the importance of intelligent data and reporting to help healthcare revenue cycle teams understand the effectiveness of their processes and staff. Listen to the episode or read the full transcript below.

Jeff Lin: Welcome to Payment Matters. I’m your host, Jeff Lin. Thanks for tuning in. On this show, we talk about the ever-changing landscape of healthcare payments and the impacts on healthcare payers, providers and consumers. You can follow the conversation on Twitter at #paymentmatters and follow me @JeffBLin.

My guest for today’s episode is Matt Seefeld, EVP at MedEvolve and founder of myLifeLink. Matt Seefeld brings 20 years of management consulting experience in the healthcare industry. He has extensive expertise in the assessment, design and implementation of process improvement programs and technology development across the entire revenue cycle. Thank you for coming and joining us today, Matt.

Matt Seefeld: Thanks for having me, Jeff. It’s cool. I appreciate it.

Jeff: Can you tell us a little bit about yourself and your background and experience?

Matt: Yeah, absolutely. I always make the joke that I graduated college, got started in healthcare revenue cycle and 21 years later I’m still here. So, it’s been an interesting career for me. I’ve done a lot in the advisory consulting side, which is where I began my career. Early on, I started to understand the importance of automation and real-time transparency into revenue cycle shortfalls, which I then carried out throughout the last 15 years. I built my own analytics work automation company Interpoint which was eventually sold to Streamline Health in 2011 and I’m here at MedEvolve.

I’ve been responsible for restructuring the business by focusing on technology that is going to drive reduction in labor costs and improve net revenue, all of which matters when it comes to payments and margin.

I do love this industry. I get really frustrated in the industry, but I think that’s why I love it. I continue to have the opportunity to push the needle on technology and automation and try to tell that story of effectiveness in seconds, not months and months, which fits this day and age. There are too many other pitfalls in healthcare, and you can’t be writing off any penny that you could have collected.

Jeff: Can you tell us a little bit about your role at MedEvolve? What exactly does MedEvolve do?

Matt: MedEvolve is a privately owned company founded by a couple of orthopedic surgeons. It has been around for over 20 years. It started out as a practice management company selling to very small independent physician groups and surgical specialties. Early on it had a lot of physicians ask to offload their billing, so they created an RCM insurance company and that’s how they went for many years.

When I came on board about five years ago, I saw that we were in a commodity space and we had a lot of competition with a lot more marketing, budget and money than we do, and we didn’t have an EMR.

So, instead of trying to compete in that space, we really had to pivot the business, which is where I came in. I took over the revenue cycle. I turned it around mainly by building workflow, automation technology and analytics technology that could get our net collection rate up to where it needed to be for our clients, and then also making sure that our labor force was productive and effective. So being able to reduce that labor expense in the margin came back relatively quickly. I’ve built a data science team, so I oversee all of our data science analytics. I call them my smart guys and girls, and then I’ve got all of our sales and business development marketing in addition to the revenue cycle. I enjoy what I do and it’s nice working for a smaller business where we can make our own decisions and we’re not being dictated by venture capital or private everything.

Jeff: So, when you talk about healthcare revenue cycle, what kind of issues do you see? What are the challenges? I’d love to understand what’s changed also over the last 10-15 years from your perspective.

Matt: It’s ironic and funny at the same time that the same problems I started to learn about early in my career as a consultant are the same problems that we see today. When people ask me what’s the biggest challenge in revenue cycle, I say it’s access to intelligence and really, it’s access to effective intelligence, or what I call “The IQ.” When you ask a revenue cycle leader, “where are you leaving money on the table?” they don’t know the answer and they have to go try to find it and that can take a lot of reports. It can take a lot of pivot tables. It can take a lot of time and you can’t move like that anymore, right? Your story of revenue cycle performance needs to be delivered to you in an automated way. I see you spend your time actually designing action plans and implementing change and getting results.

Same thing with employees, Jeff. I asked, “how many employees do you have lined up? 50? OK, are they effective” And they’re like, “wait what do you mean?” I said, “well, they may be productive, but are they effective? Like are they actually getting the financial outcome you expect for the money you’re paying them?”

Nobody can answer that question because PM systems and patient accounting systems don’t capture all the structured data necessary to tell that story, which is where automation comes in. What we’ve developed to augment the billing system and access to intelligence continues to be the number one thing that I think healthcare is suffering with on the revenue cycle side. And it’s really around effectiveness of the overall revenue cycle, which areas are in good standing, and which aren’t, and employees. We’re going to talk later about some of the staffing challenges, but now at this day and age you have to have this effective intelligence quotient. The last thing I want to see is a private practice having to sell to private equity or a hospital because they feel like there’s no hope of maintaining independence.

Jeff: So, you talk about this intelligence and the workflow side of that and I’ve heard some other providers say that’s too onerous that’s too burdensome in terms of actually trying to measure this, and you know, asking the question that you highlighted like, “Is your team effective?” How do you reconcile the burdens of data collection and analysis versus the ROI and the value that’s created?

Matt: Great question. Every provider who is listening has the right to their data. I don’t care if you’re a health system, an Academic Medical Center, an IDN or a small orthopedic group in Missouri; you have the right to the structured data for the systems that you pay for, right? Obviously, patient accounting/practice management would be a big one. I make sure clients understand that building a data warehouse is no longer a nice-to-have. Every provider group out there needs to have a centralized data warehouse which you could log in workflow automation analytics technologies to start telling that story of effectiveness, right? It’s just data. It’s structured data.

The problem is that 20 years ago everyone was talking about big data. Then, everyone was talking about business intelligence. Access to key performance does not mean you have intelligence. You may have data and reporting, but you don’t have Intel. Intel is when in less than two minutes or a cup of coffee I can tell you how effective your revenue cycle is and how effective your people are and what to do about it. That’s intelligence, and frankly, at MedEvolve, l I’m trying to push that to three seconds. I want a mobile text to tell me that. I don’t even want to get out of bed, and I want to know this. That’s the level that we’re trying to push here at MedEvolve for our clients, but also our revenue cycle services, right Making sure that we are as lean and as effective as possible when we take on receivables or any revenue cycle function for any of our clients. So, data warehousing, tapping into that data, not being held hostage by your PM are all things that have to be addressed. But you need intelligence on top of it, and most companies in our space aren’t even thinking about this.

Actually, none, in my opinion, are thinking about effective intelligence. They’re still focused on reporting that then takes 25 clicks to export to excel and after a bunch of pivot tables, I still may not know.

Jeff: This is a big change right in the healthcare industry, you’re right. A lot of revenue cycle reporting was Excel pivot tables and who knows what other kinds of formats are out there. You talk about effective intelligence. How do you translate that real-time intelligence that you’re getting out of the data into action? I think a lot of that’s determined by the people also, right? How do you ensure people are reacting and addressing and focusing on that to deliver change to their businesses?

Matt: Yeah again, another great question. If you have intelligence, but you’re not giving it back to the individual that’s driving the work in real time, you’re not getting to where you need to be. In my world, everyone who touches revenue cycle knows what their EIQ is, right? They understand they’re effective, and they’re actually recognized and rewarded for being effective at their job, and the ones that aren’t effective either self-select out or they rise up. We get them trained and we give them the other skills that they need. So, it’s really making sure that you bring that information back to the people that are running the revenue cycle: the staff person, the charge entry code, the front office, pre registrar, pre shirts, patient liability collections, etc. All of those people are doing a function, but they need to know if they’re effective and if they are effective, you need to retain them and you need to reward them. The last thing you want in this day and age where it’s hard to find people, is to lose your effective folks. Bringing that information back to each individual staff person and building incentive programs is really important in the revenue cycle. These are not crazy concepts. I’ve been thinking about these concepts for 20 years. It’s just that grabbing the structured data necessary was a lot more difficult 20 years ago than it is today. We have a lot more access to data which can drive this intelligence and more importantly, the effectiveness algorithm.

Jeff: If you’re just tuning in, you’re listening to Payment Matters. I’m joined by Matt Seefeld of MedEvolve, and we’re discussing revenue cycle efficiency and health care.

I wanted to highlight one of the things that you alluded to before; staffing challenges are tough in healthcare and across the entire industry. How should you address that? What are the things to focus on to ensure retention of key employees?

Matt: Every industry out there is suffering, right? And you know you have people that are changing jobs. They’ve found new ways of living. You also have people who are going to be jumping from job to job and demanding more money. I was just in Michigan this week meeting with a potential large group with 35% error rates right now, so now you have you think about the operational challenges of having to recruit, hire, train, and then they leave. Then you have to recruit or train, right? The key is making sure that you understand who your effective people are today and do what you have to do to retain them, right?

You know that’s the key to work, can you imagine if a bunch of your effective folks decide to walk out the door and you don’t know that they were your most effective folks? I mean that would be a dangerous game to play because now your net revenue surplus, right?

What about hybrid or full-time work at home scenarios, right? Can you offer that? If you can’t offer that, you’re going to struggle with recruiting and retention.

These are all things that a lot of your listeners are going through right now. But what does this all come back to? The structured data is necessary to determine who’s effective and who’s not in which areas of revenue cycle. Its structured data is put in a way that drives intelligence around effectiveness, right? And I keep going back to that because that’s what it’s all about.

It’s not a subjective emotional discussion anymore. We have to be objective, not emotional. When we talk to our individual representatives and when we look at our revenue cycle areas that need to be improved, we do that through data and we do that through intelligent data.

Jeff: Work from home has been a ever present here, over the last year or so. Do you think there’s a long-term thing that you’ll see in healthcare in terms of work from home? Or do you see this being a transitory thing that will get back to normal and get back into the office?

Matt: I used to fly every week, Jeff, for 18 or 19 years, and then COVID hit, and I didn’t travel for a year. Is it ever going to go back to normal? Well, it’s not, right? I’m never going to go back to travelling like I did because we discovered as a society, we can do more from home. We can do more over Teams or Zoom meetings. The bottom line is, yes, it is here to stay. If you can’t support a work-from-home model, you’re going to be challenged in running a revenue cycle, and maybe outsourcing is what you end up wanting to do. People expect it now. They have a lot of things going on in their lives. They want to be able to have flexibility in their day and their schedules because that’s what we got for 18 months with the first wave of this. I don’t believe it’s going away. I think it’s only going to accelerate, and I think anyone that can’t recruit and retain people in that model is going to be challenged.

I’m sure you’ve experienced it too in your personal life or professional life. You know, I don’t need to get on a plane every week, just because I think I have to be there, right? I really challenge myself and say, do I actually, physically need to go there, or is this something I can handle remotely and then still coach a baseball team or soccer team and spend time with my family, exercise, eat better, and still be extremely effective at what I do?

Jeff: Some of our listeners who are hearing this show may be thinking, “Wow – workflow, automation, intelligence – this sounds great.” My sense for those people who are listening that have none of these tools are thinking, “Where should we start?” Are there some quick wins? Are there some things that they could be doing in order to help improve their business?

Matt: Yeah, absolutely. Look, I’m beating a dead horse here, Jeff. But the answer is evaluating what level of access they have to their structured data that’s being stored in their PMR system or in any other system that drives revenue cycle performance process.

Right out of the gate, it is really important. If you don’t have access, that’s your number one takeaway. You have to get access. I would highly recommend building a data warehouse or hiring companies out there to do it. And then, it’s looking at what workflow automation technology your current system has or doesn’t have. And that’s where the bolt-ons come in, right? There are companies like us that have had to invest millions of dollars and years now building a workflow automation tech that can sit on top of any PM, right? It’s not just mine. If you want mine, that’s great, I’ve got a good one. But these things are out there, and they can plug in the data warehouses and then same with the analytics side. So, where’s your structured data? Do you have access to it? And then you have the automation tools and the analytic intelligence tools that are going to provide these outcomes that I’m talking about. So, I think that that’s key.

The other thing I always need to throw out is it’s not just about technology, right? If you’re not willing to look at your people and your processes today and how they will be realigned to maximize the use of technology, then don’t invest in technology. Just don’t. Save the money because it’s not going to be effective for you. Too many times I see people buying tech because they saw these vendors at MGMA or HIMSS and they were promised a story from a salesperson. Then, they install it, and a year later they’re not using it because they were never consulted internally on how to maximize the use of that technology by changing people and processes to align with the tech. That’s a huge thing. I won’t even talk to a sales prospect unless they’re willing to give me as much data as possible so I can understand where there’s potential return on investment and if they’re open-minded enough to recognize they may have to change the way they do business to align with our tech to get the results.

There are two other things to call out if I were talking about quick wins. One, you’ve got to get control around this whole patient liability piece. The bottom line is if you don’t have ways to collect that patient debt prior to service and estimate the debt, you’re already behind the 8 ball. I can’t tell you how many millions of dollars are coming in every single month that are already owed balances from our client Stop treating people for free. You can’t afford that. If you’re an emergency room, yeah, I get it. You’re an urgent care, it’s a little more difficult at times. But, if you’re an independent physician practice, then you’re leaving money on the table. These are high deductible plans. They know that they owe the money. Be flexible in how you collect it. People may not have the $3000 in January, so payment plans, discounts, things like that are important, but you’ve got to get the patient liability piece down and then overall financial clearance. 52% of our front end or of our first pass analysis come from front office.

So, when we’re talking about effectiveness and measuring people, this is not a back-office name only. This is an entire revenue cycle. So, financial clearance demographics, for instance. If you don’t have a good mobile text and email nowadays, how are you going to communicate, right? Nobody wants to pick up the phone anymore. I want to Venmo you for lunch. I want to order my toilet paper on Amazon. I want it here today, right? I mean, this whole world of immediate gratification and digitization is here today. Why are we not doing this in healthcare? That’s crazy to me and are you getting the data that will allow you to do that? I mean, we see some clients where you look at valid phone numbers and they’re 75% valid. They’re not 10% valid email addresses like come on folks, it’s not that hard.

Jeff: You also founded a company called myLifeLink. I’d love to understand more about what that is and how does myLifeLink intersect with health care?

Matt: Yeah, absolutely. So, I’m in recovery from alcohol. I’ve been sober for over four years. I just celebrated my fourth year. One of the big challenges that I saw in trying to get into recovery and sober was how you can find people out there that are like you beyond your addiction. What happens is addiction in this country and frankly, the world, tries to be a one-size-fits-all, and that’s not the case anymore, right? You look at emotional addiction, behavioral addiction, and physical addiction. We’re a hodgepodge of all those things. But how do I find folks that I can relate to? When I checked out of a rehab four years ago, I asked a simple question. I said, “Is there anyone in San Diego North County who has gone through this program, who’s sober?” The lady said, “well, I don’t know.” Then I said, “well, do you have any idea what hobbies they do? Do you have any idea what type of work they do? Could I surf with these people? Could I talk about being an entrepreneur with these people? Could I start to build a life and learn from somebody who’s recovered?”

And the answer was no. So, I said, “How can I go on to a match.com or an eHarmony or cars.com and match with my ideal thing, but I can’t go onto an app and find people in North County San Diego who like to surf who are fathers who are coaches or entrepreneurs who are in healthcare who have anxiety disorder?”

And that’s where myLifeLink came in. It’s free. It’s an app. It’s in Google and the Apple stores. We have thousands of people all over the world engaging in it every single day. It’s my passion project because it’s saved my life and that’s how I want to be of service to others. If you’re out there, you’re listening and you’re suffering right now from either emotional, physical or maladaptive behavioral addiction or a combination of all three, you’re not alone. Come join us. Check us out. Come join us. You’re going to find a great community.

And of course, if anyone listens to Jeff and they know of folks within their family or their friends or their colleagues refer them up. This world is not going to become less addicted. When obsession becomes normal, that’s addiction. It doesn’t matter if you’re a workaholic or you’re addicted to social media or you’re addicted to anxiety or not feeling good enough or you’re addicted to opiates or alcohol. It’s all the same, right? It takes away our ability to see the possibility of transforming our lives into something extraordinary, something that we’re proud of, and that’s what we’re trying to do here at myLifeLink.

Jeff: You know, people forget the word “healthcare” is all about the care and clearly this is the care part. You have an amazing ability to see both the revenue cycle side of the business, but also the healing and the care part.

If you had a magic wish for healthcare, what would that be?

Matt: Gosh, that’s such a a big question. I would love for the healthcare industry to understand the possibility of how efficient they could become with better intelligence on what their folks are doing and what outcomes are getting. It amazes me how healthcare is still such a transactional business. People who are effective in your organization need to be recognized and rewarded, but you have to understand how you will determine the effectiveness. I think that over 21 years now in this industry, the fact I’ve had to develop four workflow management systems and intelligence solutions is crazy to me. To be honest, right? I would think that these legacy systems would start to figure this thing out, and they don’t. You know, other industry verticals have.

So, I would hope that at the end of the day, if you have a lean, effective workforce and they’re recognized and rewarded by being effective, your margin is going to naturally improve because you’re going to collect what you’re supposed to collect on time, and you’re going to do it with as few people as possible, and that’s what we’re trying to strive for here. I think the pandemic only accelerated the necessity to run healthcare like a true business. Now, these macro events are not going to change, right? Deductibles are only going to get higher for insurance. Companies are only going to pay you less, right? Then you have things that are out of your control, like a virus that may shut your area down for two weeks or four weeks. So, there’s so many macro things going on that are in our control and out of our control. But the stuff that is in our control, in my opinion, is understanding labor effectiveness and how that drives revenue cycle results, and that’s what we’re solving here at MedEvolve, because we have to.

Jeff: Those are the apparent matters we’re tackling today. Thank you to my guest Matt for joining me today. Where can our listeners learn more about you?

Matt: Yeah, well, certainly you can always hit me up on LinkedIn. I do use LinkedIn quite a bit. In terms of MedEvolve, we have great resources on our website at medevolve.com and then mylifelinkapp.com for those of you that may want to learn more about the virtual recovery community app, that would be a great place to go or search the Apple or Google Play stores and come join us.

Jeff: Thank you once again for joining us today, and thank you to all of our listeners for listening in. Remember that they can listen to this episode on weekdays at 4:30 AM, 12:30 PM and 8:30 PM Eastern. You can also listen to this on Apple Podcasts and Google Play Music, or just say, “Alexa, play HealthcareNow Radio.”

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