The Hospital Finance Podcast

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Jun 2026

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If you’re concerned about revenue at your hospital, then The Hospital Finance podcast is your go-to source for information and insights that can help you protect and enhance the revenue your hospital has earned. From regulatory changes to revenue cycle optimization, readmissions to bundled payments, you’ll get important perspectives, news and strategies from leading experts in healthcare finance. For show notes and additional resources from Besler Holdings, visit https://www.besler.holdings/podcasts.

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June 12, 2026Episode 5498 min

Medicare Cost Report Appeals and Reopenings—Commonly Appealed Issues–A Deep Dive Webinar

← Back to All Podcasts Medicare Cost Report Appeals and Reopenings—Commonly Appealed Issues–A Deep Dive Webinar In this episode, Kristin DeGroat, Besler Holdings’ Chief Legal Officer, provides us with a glimpse into Webinar, Medicare Cost Report Appeals and Reopenings: Commonly Appealed Issues: A Deep Dive, presented live on Wednesday, June 17, at 1 PM ET. Highlights of this episode include: What is this webinar about? Who will be joining Kristin on the webinar Key takeaways What this series about Who can benefit from this webinar Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat, Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ next webinar in its Medicare Cost Report Appeals & Reopenings Series, Medicare Cost Report Appeals and Reopenings: Commonly Appealed Issues: A Deep Dive, live on Wednesday, June 17, at 1 PM Eastern Time. Welcome back and thank you for joining us, Kristin. Kristin DeGroat: Thank you for having me again. I appreciate it. Kelly: All right. Well, let’s go ahead and jump in. So would you please tell us a little bit about this webinar? Kristin: Well, as you mentioned, it is the second webinar in the series on cost report appeals and reopenings. And we’re really going to focus on the appeals side and the commonly appealed issues before the Provider Reimbursement Review Board. So hopefully, we kind of gave a little bit of a glimpse into what we were going to talk about in the other webinar. So hopefully, everyone coming will be ready to take that deep dive. Kelly: Awesome. Yeah. Sounds like it’s going to be a great webinar. And you have some guests joining you on this webinar. Can you tell us a little bit about the people that will be joining you? Kristin: I do. I have Leslie Goldsmith and Page Smith from Bass, Berry & Sims joining me. And we have done some webinars in the past together. We complement each other really well. Both Page and Leslie have an extensive background in appeals, both at the Provider Reimbursement Review Board level, the administrative level, and the court level. So, they are ready to help me kind of dive into the issues. And where they have more expertise in the area, they’ll be able to lend you their thoughts as to the status of those issues and kind of where we approach it from a legal standpoint and more of a cost reporting standpoint. So, I think together, it’s going to be a great webinar. Kelly: I agree. I’m really looking forward to hearing you all kind of come together and complementing one another. Please share what you think some of the key takeaways will be from this webinar. Kristin: Greatest thing will be not only an insight into what exactly the issue is that’s been appealed and determining, “Well, is this something that would apply to me, to my hospital? Are there others out there with the same issue?” and then also where it is today. Where is the issue? Are we still waiting on a decision at the Provider Reimbursement Review Board, or are we waiting on a hearing decision? And where we are in court, are these issues there? Are we expanding the ideas behind these appeals? All those insights that a provider who may not have an outside consultant or an outside lawyer that’s privy to the ongoings– I think it’s going to be a great webinar to dive into that. Kelly: Right. I totally agree. Can you tell us a little bit more about this webinar series? The first one that we had, last month. We’re going to have another one in July. Can you just tell us a little bit about why the series came about? Kristin: The series is really focusing on the cost report and more an appeals focus, although a lot of the issues that we appeal can also be reopening issues. And kind of the goal is once we appeal it, if we get a favorable decision, it tends to lead to the issue being more of a reopening issue and getting providers that reimbursement a little bit quicker than the appeals process tends to take. But we’re looking at it high level. We started with, “Well, what is the board? And why do we appeal? And what are the processes behind filing those appeals? And how they differ from reopenings.” But then we’re now going to move into really the meat: not only the why, but here’s what we appeal. And the status of that leading to providers having a better understanding of what might be available to them out there that are– maybe there’s other groups, they’re not comfortable doing it on their own and they want to join a group. Well, then they can see, “Okay, well, where do I fall in that? Is there opportunities for me to join that?” I think that’s really the biggest thing. And then we’re going to end kind of on a best practices from all parts and parcels, not only from the board itself, but maybe how to file the issue. Maybe there’s ways to tailor it a little bit better. So, the best practices, I think, is a great way to end the webinar. And I’m hoping that all of them together, that the people attending will be able to avail themselves of all three together, because I just think it’s a great series to help figure out, again, what do I appeal and where am I at in this process? Kelly: Right. No, I think it’s going to be a great webinar series. Looking forward to this one and the next one. And you mentioned the people who are going to be watching this. What is the target audience for this webinar series? Kristin: So, it really is what I call on the front lines. Those people preparing the cost reports, attending the audits, and whether it be a desk review, and then there’s a final review, final review meeting, that’s probably the front line. But we also have to have those who make the decisions, who decide, “Okay, my reimbursement manager has told me, this is an issue I need to tackle, something I need to handle. Why?” So those decision makers, the CFOs, maybe even the corporate reimbursement directors, maybe even up to the CEO, whoever’s making those decisions and really needing to understand why we have the process. And then, of course, the what. So, I think at all aspects. And then maybe if there’s documentation required – which, quite frankly, there is – maybe getting the patient financial or accounting, or whoever does the data, who would handle the data requests and the data needed to pursue these appeals. So, I think it really spreads across the organization. And so, I think those people attending really would have the best full, complete picture of the process. Kelly: Right. No, that makes a lot of sense. Well, thank you so much for joining us, Kristin, and for giving us this glimpse into Besler Holdings’ free webinar, Medicare Cost Report Appeals and Reopenings: Commonly Appealed Issues–A Deep Dive. Join us live on Wednesday, June 17, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Kristin. <p class="has-text-color has-link-color wp-elements-a3b3e8ae07b810fc41396b2e7eb98d5f" style=...

June 10, 2026Episode 54735 min

The Financial Burden of Pressure Injuries

In this episode, Dr. William Padula, Health Economist and Professor at the University of Southern California, and Martin Burns, CEO at Bruin Biometrics discuss the financial burden of pressure injuries.

June 3, 2026Episode 54810 min

Understanding the Escalating Costs of Musculoskeletal Care

← Back to All Podcasts Understanding the Escalating Costs of Musculoskeletal Care In this episode, Scott Linthorst, Senior Vice President of Value-Based Care for TailorCare, discusses understanding the escalating costs of musculoskeletal care. Highlights of this episode include: Why musculoskeletal care is such a major financial challenge in healthcare Where costs escalate in MSK episodes What role early navigation plays in controlling costs What role data or predictive analytics play Predictive analytics results What metrics hospital/health plan leaders should track Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Scott Linthorst. Scott is the Senior Vice President of Value-Based Care for TailorCare, a leading provider of specialty value-based care solutions focused on improving patient outcomes for joint, back, and muscle conditions. Scott leads the organization’s efforts to optimize outcomes under value-based care arrangements. He oversees the actuary, medical economics, and analytics teams to drive a data-informed strategy that improves clinical, financial, and operational performance. Scott has a diverse background in finance, patient engagement, and healthcare services. In his previous role at Babylon, he led the Value-Based Care Finance Function, managing over $1 billion in deals from contracting to forecasting and ongoing performance management. Prior to that, he spent eight years at CVS Aetna and also served as the CFO of an internal startup that empowered physician-led organizations to assume medical cost risk and led FP&A teams focusing on digital health, member engagement, and virtual care initiatives. Scott also has a decade of experience as a management consultant, enhancing his strategic and analytical capabilities. He earned a Bachelor of Science in Engineering from Columbia University. In this episode, we’re discussing understanding the escalating costs of musculoskeletal care. Welcome, and thank you for joining us, Scott. Scott Linthorst: Hey, Kelly, great to be here with you. Kelly: Well, let’s go ahead and jump in. So why is musculoskeletal care such a major financial challenge in healthcare? Scott: Well, I think there are a couple things. I mean, first, musculoskeletal conditions affect about half of all adults. And in the United States, it’s about $420 billion in annual spend, the single largest specialty, more than cardiology, cancer, kidney, and it’s really closely aligned with a lot of other comorbidities, cardiovascular health, metabolic health, behavioral health. I think one of the big challenges is that it’s a mix of both chronic, think degenerative arthritis and hip or knee, and episodic costs, think acute injuries from falls or lifting something too heavy. And for patients, often the biggest challenge is just knowing where to start. Patients begin their journeys in a variety of different places. It might be their PCP, it might be with a physical therapist, it might be with other downstream specialists. And so, it’s just really fragmented and hard to figure out where the costs start and where they escalate.Kelly: Yeah, no, that makes sense. The chronic and episodic costs that you talked about, that makes sense with this particular care that we’re discussing. So where do you typically see costs escalate in MSK episodes? Scott: Well, the anecdote I often hear from orthopedic specialists is that patients will suffer a functional decline in silence, think you’ll put your salt shaker on the counter instead of up on a shelf. But when they get to pain, that’s what really begins to motivate action. What we see in the data is there’s little consistency across different patients’ care journeys. There’s imaging. There are specialist visits. And especially when those come before conservative care treatment options are attempted, they predispose patients towards surgery at a much higher rate than if you start with some of those conservative care options. And if there isn’t some form of clinical triage that starts at the beginning, some guidance to those patients, they often end up on the most intensive care pathways as opposed to those that might work best for them. Kelly: No, that makes a lot of sense. Thanks for explaining that for us, Scott. So, what role does early navigation play in controlling costs? Scott: I think there’s several things that influence cost. I think the first is just educating patients about their conditions, spending time with them, really understanding not just what is the diagnosis, but what are the functional constraints? What is the impact? And then talking to them about what are their goals, what do you want to accomplish? Are you trying to walk your grandchild down the aisle? Do you want to get back to your gardening habit? What is the thing that you want to be empowered to do? And then really exploring what are the different treatment options and modalities, and what has worked for patients similar to you? Going through that kind of shared decision-making process and navigating patients to the best providers downstream can really help control costs. When patients go through that type of navigation, they’re more likely to start with physical therapy or exercise programs, and those may help them avoid those more invasive procedures downstream. Kelly: Yeah, no, I love what you said about shared decision-making. That totally makes a lot of sense in this particular instance. So, Scott, what role does data or predictive analytics play here? Scott: Because there are such a different variety of places that people will start in their care journeys, try to identify patients early and before they get to some of those escalated care modalities is really important. You can identify, using predictive analytics, those patients that are just more likely to have surgery. And if you can look at those patterns and engage those patients early, sometimes you can engage them even before they get to those places that they were likely to get to downstream. Kelly: I’m always so fascinated by predictive analytics. And I think engaging patients early, that also makes a lot of sense to me. So, what results have you seen from this model? Scott: When we see patients that begin with that kind of structured evaluation that I talked about, when it’s clear to those patients what are the pathways that they could choose, what we frequently see is that patients choose to start on conservative care pathways, conservative treatment options, exercise programs, physical therapy before they would then continue on to more invasive or more escalated options. And I think when they do that, what we typically see is a decent number of those patients stick to those pathways and report really meaningful improvements in pain and in their function. And they also report a lot higher satisfaction. When patients feel informed, they feel supported through the process, they generally just have a more warm, fuzzy ...

May 27, 2026Episode 54516 min

Why AI ROI Becomes Guesswork Once Systems Scale

In this episode, Dave Trier, CEO of ModelOp, discusses why AI ROI becomes guesswork once systems scale.

May 20, 2026Episode 54425 min

Fixing the Systems Professionals Depend On--The Hidden Operational Drivers of Hospital Financial Performance

May 13, 2026Episode 54323 min

The Hidden Cost of Healthcare Distribution--What Hospital CFOs Need to Know

In this episode, Tony Paquin, Co-founder, Chairman, and CEO at iRemedy Healthcare Companies, here to discuss the hidden costs of healthcare distribution, what hospital CFOs need to know.

May 6, 2026Episode 5325 min

Medicare Cost Report Appeals and Reopenings--What You Need to Know Webinar

← Back to All Podcasts Medicare Cost Report Appeals and Reopenings–What You Need to Know Webinar In this episode, Kristin DeGroat, Besler Holdings’ Chief Legal Officer, provides us with a glimpse into Webinar, Medicare Cost Report Appeals and Reopenings: What You Need to Know, presented live on Wednesday, May 13, at 1 PM ET. Highlights of this episode include: What is this webinar about? Who would benefit most from this webinar and why? Key takeaways Best practices Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat, Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ first webinar, Medicare Cost Report Appeals and Reopenings: What You Need to Know, live on Wednesday, May 13, at 1 PM Eastern Time. This is our first in our Medicare Cost Report Appeals and Reopenings Series. Welcome back and thank you for joining us, Kristin. Kristin DeGroat: Well, thank you for having me back. Kelly: Well, let’s go ahead and jump in today. So can you tell us what’s this webinar about? Kristin: So, we’re going to talk about the Provider Reimbursement Review Board, at least a background of that. And then we’re really going to focus on what you need to do to preserve your appeal rights as well as your reopening rights, which are different and are handled differently. And we’ll get into a little bit of the differences and provide some best practices. Kelly: Awesome. Sounds like it’s going to be a great webinar. So, who would benefit most from this webinar and why? Kristin: So, most people immediately think, “Oh, this is just for reimbursement people.” But actually, people in patient financial services, even executives that maybe don’t deal with the cost report and appeals and reopenings and really don’t get into the depth. But there are data elements that we need, which usually come from patient financial services. There are cost report elements needed. And again, you need the buy-in at the top so that they understand what it takes and maybe the costs associated with filing appeals and/or reopenings. Kelly: Well, that makes a lot of sense. So, what will be some of the key takeaways from the webinar? Kristin: So, the key takeaway, I think, really will be, “I can have an appeal that preserves my rights, and I can have a reopening at the same time.” Most people don’t realize that. And so, I think that’s beneficial where it’s an issue that can be settled. So, the problem we’ve got with the board, right, in filing appeals is that they often take a number of years. And so, the reopening may be the faster route, not always, but maybe the faster route to getting the dollars. Kelly: That makes sense. And yeah, I didn’t know that you could do an appeal and a reopening at the same time, so I’m sure others don’t know that as well. So, what best practices do you have for those going through an appeal or reopening? Kristin: So don’t take any chances. Don’t just assume you’re going to be able to appeal or reopen. You need to understand the specifics of those rules and how they apply to your cost report. Protest, protest, protest, protest, that is the key. And again, file your reopenings, even if you have an appeal. Kelly: Those are some great best practices. Thanks for sharing those with us. So why is having an external partner important for this very complex and often long process? Kristin: The change in rules between the cost report rules, the reopening rules, the board’s rules. There are many pitfalls. And if you don’t understand how they fit together, you could lose your right to appeal or reopen. So, you’ve got to understand how that comes together. And having an external partner that focuses on the rules, the changes, ensuring that everything is filed properly, that you have the right tools to ensure that your appeal rights are protected. Kelly: No, that makes a lot of sense. Sounds like finding the right partner is important for this process. Well, thank you– Kristin: Definitely. Kelly: Yeah, so thank you so much for joining us, Kristin, and for giving us this glimpse into Besler Holdings’ free webinar, Medicare Cost Report Appeals and Reopenings: What You Need to Know. Join us live on Wednesday, May 13th, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Kristen. Kristin: You’re welcome. Looking forward to seeing everyone Wednesday. Kelly: Sounds great. And thank you all for joining us for this episode of the Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com. Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links AboutTeam PodcastsWebinars Solutions <p class="has-white-color has-text-color has-link-color wp-elements-0f3c5c26c46748c47...

April 29, 2026Episode 54112 min

Using Tech to Boost Patient Care and Streamline Operations

← Back to All Podcasts Using Tech to Boost Patient Care and Streamline Operations In this episode, Beth Raboin, Founder & CEO of Global Medical Virtual Assistants, discusses using tech to boost patient care and streamline operations. Highlights of this episode include: What is a medical virtual assistant? Where do hospitals typically see the most meaningful cost savings or efficiency gains when using the medical VAs? How GMVA ensures medical virtual assistance remain fully HIPAA-compliant and safeguard patient information while working remotely How the virtual assistant model scale for larger hospital systems or multi-facility organizations compared to smaller practices Where’s the best place to start to ensure long-term ROI? What other hospital departments are a good fit for medical virtual assistance? Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Beth Raboin. Beth is leading GMVA in vision in the day-to-day business operations securing the functionality of the business to drive extensive and sustainable growth. Combining her strong leadership and determination with over 22 years of corporate experience in the private and public sector of surgical device, pharmaceutical, and specialty pharmacy industries, she keeps the company moving forward with high-level strategy while understanding the details of day-to-day execution to ensure steadfast success. Prior to Beth’s corporate and entrepreneur experience, she competed as a full athletic scholarship athlete as a Division 1 gymnast at the University of Florida, where she graduated with a Bachelor of Science in Health Sciences. In this episode, we’re discussing using tech to boost patient care and streamline operations. Welcome, and thank you for joining us, Beth. Beth Raboin: Oh, thank you so much for having me, Kelly. I’m so excited to be here. Kelly: We’re excited to have you. So, let’s go ahead and jump in. So, for listeners who may be newer to the concept, what exactly is a medical virtual assistant? And how do they differ from traditional outsourcing models? Beth: Yeah, oh thank you so much. Starting with a big question there, Kelly. So, first of all, medical virtual assistants are additional staff that you can bring into your hospital or medical practice to help facilitate some of the back office work that needs to happen. So, we do not do clinical care. Medical virtual assistants do all of the clerical and/or administrative patient care that happens behind the scenes. So that’s the differentiator between your typical in-hospital setting versus bringing in a medical virtual assistant. And how we’re different from other models is you’re not outsourcing. You’re not sending and outsourcing all of the work elsewhere. That’s not how it works. We are actually more like an insource. We’re additional staffing that’s brought into your medical practice and/or hospital to do the work that needs to get done within your tools, within your systems, within your workflows. And so, we’re actually integrated as part of the team. Kelly: I love that. It’s so intriguing. From a financial standpoint, where do hospitals typically see the most meaningful cost savings or efficiency gains when using the medical VAs? Beth: Oh, gosh. Well, so we’re a fraction of the cost of what it would be to hire someone here in– within the hospital system within the United States. We are outside of the United States, so we’re mainly in the Philippines where the cost of living is lower. So therefore, the cost structure for our business model is also lower. And where they can utilize our services is just, it’s endless. Where we’re seeing where we’re a huge asset– for example, we just were onboarded this past year with a huge healthcare hospital system on the West Coast. They brought us just in to do patient access to fill in some open appointments, making sure patients are going to show up to their appointments, and then backfilling the appointments within the schedule that those patients were not going to show up to. And they saw an immediate, an immediate, I think it was like $2 or $3 million difference in their bottom line just within two quarters. So that’s just one simple example. We’ve also been brought in heavily within the hospital systems, within revenue cycle management. Collecting dollars is critical for hospital systems, making sure that denied claims are in fact paid. And so the resubmittal of claims, following up on denied claims, making sure that patient balances are paid, all of that. So that also is a really big– a really great place to be able to bring in our staff to help and augment the way things are being done within that hospital. Kelly: Wow, I mean, so some significant savings there. That’s awesome. So how does GMVA ensure medical virtual assistance remain fully HIPAA-compliant and safeguard patient information while working remotely? Beth: Yeah, well, so there’s a few different ways we do that. Number one, we’re hiring professionals, right? We’re hiring people who have a bachelor’s degree, a bachelor’s degree, typically in nursing. They understand healthcare. They understand HIPAA and PHI. And so, they’re put through obviously a HIPAA certification class, so they’re HIPAA-certified, but that’s not enough. That’s just not enough to ensure patient information is– it’s just not enough to make sure patient information is protected, right? So, we put in additional safeguards and everyone works remotely, they’re not working within a call center, they’re working from their home. So, we’ve put additional software security on their computer systems to make sure that they’ve got a closed network that they’re working within. So, they’re logging directly into the client’s EMRs, directly into the client’s tools, and we need to make sure that there’s no nefarious actors or viruses are able to penetrate the system. So, we’ve got a pretty substantial, what we call a blue box on their computer, and they’re working within the safeguards of that system. It’s amazing. It’s been one of the things that we heavily invested in just to ensure that we’re protecting patient information. But beyond that, we’re also protecting the tools of our clients because we all know that viruses and/or nefarious actors are working consistently to try to break into hospital systems, break into hospitality, break into banks, and any possible way that they can try to penetrate a closed off system. So, we do everything within our power to make sure that we’re keeping patient information protected. Kelly: Yeah, I know HIPAA compliance is so important. And for lack of a better term, it’s an epidemic that we’re just kind of hitting. We’re being hit with all these bad actors all the time. So, it’s just a constant issue, isn’t it? Beth: Oh, constantly. So, I mean, we’re all getting them even into our private email addresses, work email addresses, people sending over what you think looks like a real invoice, but it’s not a real invoice. You click on it, before you know, you’re in trouble. So yeah, we’re trying to do the absolute best we can to keep up to date on protecting any and all software that we’re logging into. <p class="has-text-color has-lin...

April 22, 2026Episode 54017 min

The AI Security Blind Spot That Healthcare Can't Afford to Ignore

← Back to All Podcasts The AI Security Blind Spot That Healthcare Can’t Afford to Ignore In this episode, Tom Furr, CEO and Founder of PatientPay, discusses how the Shift in ACA enrollment is driving more high deductible health plans. Highlights of this episode include: How the reduction in ACA enrollment numbers are affecting out-of-pocket payments How should providers prepare for this change in coverage Long-term projections Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Vrajesh Bhavsar. VJ is an engineer with a Master’s in Computer Science from USC and over 20 years of experience building hardware and software products. VJ built core technologies for iOS and Mac OS, including dynamic tracing, data protection, and secure enclave at Apple. He holds eight patents in distributed systems, data, and security. He is passionate about building technology-first businesses that drive positive human impact at scale. In this episode, we’re discussing the AI security blind spot that healthcare can’t afford to ignore. Welcome, and thank you for joining us, VJ. Vrajesh Bhavsar: Hey, thank you for having me. Kelly: Well, let’s go ahead and jump in. So, AI is being deployed across healthcare at a remarkable pace. From a cybersecurity standpoint, what’s the risk that most hospital leaders still don’t fully appreciate? VJ: That’s a great question. And it’s such an exciting time that we are living in. There are so many new innovations coming to the entire space. And the impact of AI in so many different areas gets really exciting for a lot of industries where this kind of innovation is needed. And, of course, healthcare has so many different areas where AI can be applied, but also there are a lot of risks that come in when you are exposing this kind of critical area of safety and care to this kind of new innovation. And so the big risks that we see in a lot of interactions we are having is how when you have a lot of kind of new innovation getting sprinkled across use cases and areas where you didn’t really understand the full scope and things are operating without a lot of visibility, especially in the deep areas where sensitive data is in question and you have patient information as well as ways that a lot of the third party systems are going to interface with these things. That’s where there are so many risks that it’s not fully understood and appreciated. And the thing that really gets people is that we are used to kind of operating with these innovative systems in kind of traditional systematic ways, that A plus B results in something. But in the world of non-determinism, where there are a lot of new attacks coming in, the level of risk really, really goes to the roof. And the kind of attacks that have come through in terms of prompt injection or zero-click, and a lot of things that have been reported across the industry, and we have done some of the work ourselves. It really throws people back into like, “Oh, wow, I didn’t realize that this can really exfiltrate the data at such scale and such speed.” And the level of protections and defenses that people had through traditional tools are now out of question. Kelly: Yeah, it’s definitely an interesting time in healthcare and AI, and there’s a lot to consider there. You recently discovered a zero-click vulnerability that can silently extract complete patient records without leaving a trace. What does that mean in plain terms, and why is it a signal of a much larger industry problem? VJ: That’s a very interesting question. And I think as an industry, we have been trying to get everyone to kind of understand that, “Hey, don’t respond to random emails, don’t share credentials, don’t go chase random links and all that, right? But what’s happening in the world of AI is that without users taking any of such risky actions, now you can have a massive exposure and that’s what zero click refers to. And what we discovered is that a lot of these AI systems as they are interfacing with so many different data sources and all the records and all that, they can actually go take the credentials and access that you have given them and try to be helpful in ways that can actually result in data exfiltration and leakage at a massive scale. And so, what we are finding is there are the kind of attacks that come through in AI systems that are prompt injection or jailbreak attempts. And those things are getting embedded in documents, in ways that are invisible to the human eye, but those instructions mean a lot to what an AI system or an agent bot is going to do. And that’s where, now, you are bringing– you have so many, so much intelligence baked into these AI stacks that they are trying to be super helpful and trying to kind of take all these instructions that are embedded and the users didn’t do anything wrong, but this is where some of the attacks that are coming through. Some of the ones that we have discovered and the industry has discovered, even Anthropic reported several different types of attacks. And there is a lot of education needed in the industry to really kind of understand the scale and scope of what these intelligent, non-deterministic systems bring in these critical environments. Kelly: Completely agree. There’s definitely a lot of education required for us. VJ, HIPAA was built for predictable human-reviewed workflows. How does autonomous AI fundamentally challenge the compliance model healthcare has spent decades building? VJ: I know. This is where we are really passionate about like there is so much to be done, and I know HIPAA is trying to catch up on a lot of the new innovation. But at the end of the day, there is kind of like an inert way in which HIPAA assumes there are human accountability layers behind all the different decisions that are getting made. And I think that’s the thing that gets thrown out the window when you bring in agentic AI. And in these environments where you are passing responsibility, you’re passing autonomy, you’re passing decision-making capabilities to agents and at a speed of machine speed at which you can access so many different systems all at once and try to be helpful. That’s where there is no mechanism in place to even understand what these systems are trying to do. And beyond understanding, you need to actually govern and bring controls into these environments, right? And I think that’s kind of the core to a lot of the challenges and what we refer to it as runtime visibility and runtime controls. And when these agents are getting born and they are trying to figure out, like, “Okay, what are the instructions given to me?” And I’m going to try to make sense of that. I’m trying to access the systems that are available to me, and sometimes they overreach. And that’s when these breaches happen. That’s when, kind of, unexpected consequences happen. That’s when you end up with a non-compliant system. So, I think there is a lot to be done. I think the industry was still just catching up on what was happening in the world of microservices and all the API ecosystem. And now we have leaped directly into agentic environments. And I think that requires a full depth understanding of what all things are happening to stay compliant. <p...

April 15, 2026Episode 53720 min

Personalizing Healthcare: Strategies to Drive Patient Engagement and Financial Impact

In this episode, Casey Williams, SVP of Patient Engagement at RevSpring, discusses personalizing healthcare, strategies to drive patient engagement, and financial impact. Highlights of this episode include: What RevSpring does and the difference it makes for healthcare organizations Biggest challenges healthcare organizations face when trying to protect their finances while also helping patients Personalization and how it impacts patients and providers Practical strategies for meeting patients where they are financially RevSpring’s approach What trends or innovations that will shape healthcare communications and finance Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Casey Williams. Casey leads solution consulting and sales efforts for new direct healthcare customers at RevSpring. He has 20 years of experience in developing customized patient engagement and payment solutions for over 100 healthcare revenue cycle clients. His knowledge of patient engagement strategies, including self-service optimization, has made him an advocate for change for RevSpring clients and the wide healthcare revenue cycle market. In this episode, we’re discussing personalizing healthcare, strategies to drive patient engagement, and financial impact. Welcome, and thank you for joining us, Casey. Casey Williams: Kelly, thanks for having us. We appreciate it. Kelly: Yeah, we’re glad to have you here. So, let’s go ahead and jump in. So, Casey, can you tell us about your background? And how did you end up in your position at RevSpring? Casey: Yeah, it’s a great question, Kelly. I think by default is probably the most honest answer. Coming out of Bowling Green State University, studying interpersonal communication, there was nothing that screamed healthcare finance from that background. But actually, I think kind of started as most people start their jobs or their careers where I had a friend working in a company, a smaller company, at that time called Data Image. And they had just had some transition in their sales environment. And the owner, founder had asked me to join. And that kind of began the path into communication, payments, and engagement overall. And really started at that smaller company involved in the hospitals in and around central Ohio and then expanded into the greater Midwest. But really got a great appreciation for when you’re a small company at that time, you not only position what the value is, but when you do that successfully, then you actually do the setup or the implementation, and then you service it. And then when there’s a billing question, you’re actually the finance arm as well. So, I was very blessed to be able to have such exposure at such a young time in my career to where I got a lot of different experiences within that and have just enjoyed it ever since. And we at RevSpring, which Data Image then sold into what then became RevSpring in 2010– and we’ve continued to acquire value across the market in how we are trying to build our technology stack today. So, by happenstance, I got into it, but I have been fully immersed and fully engaged ever since. Kelly: That’s awesome. It’s great how those things happen. For someone who isn’t– for someone who isn’t familiar, how would you describe what RevSpring does and the difference it makes for healthcare organizations? Casey: Yeah, Kelly, it’s a great question. I think the most simplistic answer to that question and one that I get from my kids all the time is they see me going into hospitals and thought for many years that I was a doctor. And then at one time, we had an office inside a bank, and then they thought I was a banker. So, I practiced this answer a lot over the years. But primarily, we are a patient engagement and communication company with an emphasis on payments. And the sense of this is that when patients need services, we handle everything from the intake to the scheduling to the registration at time of service to estimating the balance that that patient would owe, do our absolute very best in terms of trying to capture payment at that time or a method of payment so that autopay could be performed. Once that individual service, if not collected in full at time of service, goes to be billed from an insurance standpoint and that amount is adjudicated, then there’s a self-pay after insurance balance. We are then engaging within that patient population to let them know that there is a balance to meet them where they are, meaning that if they are unable to pay that balance in full, we have predictive analytics that address how much that patient can afford to pay on a monthly basis. And so, whether that engagement is print, we produce about a billion and a half communications a year from that standpoint, or we engage digitally within that to be able to facilitate payment and those outcomes. And so, I think that’s probably the simplistic answer to that question. And I think why that matters is…is you look at healthcare in terms of the ecosystem in which everything is operating today, there’s a great strain in healthcare. As high-deductible healthcare plans continue to progress, patients continue to pay more for the health insurance, continue to be pushed off from their employers of having to pay more themselves within that. That then puts a strain within healthcare, is that 20, 25% now of the receivables that are within the total revenues of healthcare are now to the patient, meaning self-pay/self-pay after insurance. And so, without our technologies, without our sophistication, without our intelligence, it becomes very tough to engage, as well as getting patients to respond to what they owe. Kelly: Wow, that’s very fascinating. Thanks for sharing that with us, Casey. Yeah. So, what are some of the biggest challenges healthcare organizations face when trying to protect their finances while also helping patients? Casey: Yeah, that’s another great follow-up to that, Kelly. And I think probably the number one answer you would get within a healthcare finance type of roundtable would be insurance denials. And so when you, when you look at the ecosystem and the landscape of healthcare, about 75, 80 percent of all revenue that comes into an IDN/hospital provider is generally on the commercial Medicare and Medicaid side. And then about 20 to 25 percent of that revenue comes in on the patient responsibility. And what that means is, is after their insurance is paid, what is their responsibility? Or if they’re uninsured, what is their responsibility? And so, denials continue to play a large part in that 80% of the revenue stream. But if we’re looking at the 20, 25% of revenue, it is around the patients continue to owe more, but yet the wages have not continued to go up at the same levels in which they’re either paying for their healthcare or their healthcare insurance. And so that creates kind of that massive strain that I was mentioning in terms of how do they collect? How do they give pathways for those individual patients to be able to engage in order to pay their balances? And if that doesn’t happen, we look at rural healthcare as an example, continued consolidation, even closures within that environment, when that doesn’t happen. Kelly: Well, yeah, there are quite a few challenges in healthcare right now, that’s for sure. We hear a lot about personalization these days, but how does it actually impact patients and providers in terms of engagement and financial outcomes? Casey: I oftentimes give bad examples or metaphors. And for those of you that are old enough listening to this, know the old TV show Cheers is that kind of the opening song is, “Everybody wants to know your name.” I think it’s a…I think it’s a really good illustration in the sense of what personalization means to any commercial engagement that we have as a patient, as a human, from a commerce perspective. And the more that the business knows about me and can perfect that engagement, can perfect that pathway, to where I don’t have to continue to repeat myself. Once I’ve answered a question, I don’t have to answer it again, or meeting me where I am, meaning that if I if I don’t have $1,000 in my bank or if I’m like 50% of Americans that do not have $500 in their account to pay for a surprise bill, that you’re not just sticking a $2,500 bill in my face and saying, “Pay me.” So, the personalization really gets down to meeting the patient where they are. To give you a couple of practical examples of that is if I am a patient, let’s even say I’m a millennial to where I do not like to receive paper and all I receive is paper. But if you send me a text, I’m going to pay within 15 seconds as long as I can afford that. That’s a good example of meeting the patient where they are, as well as personalizing that. If you have, let’s say a person like me that is midlife, I think 47 is midlife. Maybe that’s on the older side of the life. I’m not sure. But I actually still like paper. Now maybe that’s because we print and mail a billion and a half communications. But let’s say I’m one of those individual patients that cannot afford $2,500. So am I receiving a communication in printed form to where I can touch, feel, and interact with that, but yet see a pathway to where I can potentially hit a QR code taken into a payment application where it’s giving me the option of 10 payments of $250. That is where the dynamic of patient engagement is massively changing and it has been massively changing ...

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