Utilization management is part of the lifeblood of the revenue cycle. Case managers and UR staff man the front lines of helping hospitals stay solvent, yet they are often just trying to stay sane doing it because of the administrative jigsaw puzzle they are forced to piece together day after day.
In a recent webinar, Michelle D. Allen, Director of Case Management at Springhill Medical Center, talks about how adopting new technology helped build the case for her team and made Utilization Review relevant within her organization.
When she entered her leadership position at Springhill Medical Center, Michelle knew she couldn’t keep things the same. After all, “if you’re really not getting the outcomes you want, and you feel like you’re working really hard and can’t make that movement, sometimes it’s time to look beyond what you’re already doing.” She says XSOLIS’ technology offered a new, fresh approach to creating an environment where her team could be successful.
In the webinar, she shares that across organizations and across the industry, case management and utilization management has historically been “tucked back in the closet that no one really sees,” sidelined from conversations with the C-suite and with payers.
But no more.
Michelle and her department needed a change and she says partnering with XSOLIS has transformed the role of utilization management at her organization. “To be able to [be on the cutting edge with machine learning and artificial intelligence] and become very relevant within our organization was a big deal, and makes us relevant with our payers as well.”
With the technology Xsolis provides at their back, Michelle said they’re not overlooked — they’re right in the thick of strategic conversations with leadership. It “puts us at the forefront of the revenue cycle, it puts us at the forefront of patient management, and quality.”
Going live with Xsolis has helped shape how she looks at her job and how her team views their discipline. She says, “it has gotten our department involved in way more than what we were doing five years ago.” As she put it, “in healthcare…if you’re not staying on that cutting edge to keep up with technology, it definitely will pass you by.”
Her advice for leaders looking to make case management and utilization review more relevant? “You have to do something to shake it up, make the change and create the opportunity for yourself and for your facility. Look beyond.”