Transcript

Front desk bin, we clocked flow cards in the tray. Claims in the rope cold slide up clean and tight. Catch that claim before it takes flight. Verify refile moving through 1. Little Miss, can't slowly kill. We don't guess, we don't drill. Got the Ledger moving, still jacked. Keep the game if it bounces back. Work that cycle through the night. And when I was going through Med school, I knew absolutely nothing about revenue cycle. And then I got into the real world and I realized very quickly that revenue cycle is the lifeblood of any provider, practice, or health system. My name is giving you, and I'm really excited to be here with Abhinav Shashank, cofounder and CEO of Innovaccer, and Jim Bonomo, founder and CEO of Caduceus Health. Welcome. We're super excited to announce The Innovator is acquiring Caduceus Health today. Abhinav, you and innovator have been building the infrastructure and the foundation of health for healthcare systems for last 10 years. Why invest in revenue cycle right now? I think when we started off the company, we've talked about this a lot like our general thesis was the fact that. Information being fragmented across systems is such an important problem to solve, like everything downstream only happens better if you know the context of the patient. And once you have the unified view of the patient, you can start basically delivering better care outcomes, better quality outcomes, better affordability outcomes, and a lot of the things that we've all aspired for in healthcare forever. As we started like in England doing that, one of the things that we realized is that the administrative burden to do things downstream is just so, so hard. And so because of that, like I think like what we realized is that you can set up the best infrastructure like I think in the world, but it does not mean much unless you basically created like the administrative simplification that is required for you to deliver better care. And when we met Jim for the first time, like I think like that is what we realized that. Like he and his team had been working on this incredible processes that eliminate some of that friction of how do you manage things from a payer perspective, how do you basically get the doctor's paid on time. And that was just such a clicking point for us to really think about that. If we can get the two companies together, that could be such a massive unlock for all of the customers that we are trying to serve for betterment of healthcare person. Jim, you started the company in 1997. You've seen, I'm sure, wave after wave of technology advancements every time robably companies reporting a new automation, a new way to improve revenue cycle. But hospitals and health systems are still drowning in denials and it doesn't seem to be getting any better. What do you think makes interface are different? Yeah. Now when I, when I met Abhinav, I mean when we've been through this before, like us, like we started at 30 years ago. So we've seen the glorified typewriters punching out 1500s and hopefully you got the modifier rate, you got to retype the whole form. I mean, we've been around for a long time and there our biggest challenge has always been all the datos and data has been in silos, right. And when I started talking to Abinav right away, I got what really clicked was the unified data set, right? So we can start surgically. Pulling data from whether we need it from registration, authorization, anywhere in the IE that we need to pull that missing piece of data, it's going to be available through the interface layer we've spent 30 years trying to perfect with the data that we had accessible. That full process of getting a clean out, clean the first time and that's really where it's come. But when I started looking into innovative Sir and what they had produced, I said we can, we can start running in this atmosphere tomorrow at a much higher competency rate. We're doing the really hard work. We're doing that last 20% that nobody really can get done. You can't get that done offshore. That is there's a really high technical person and what innovator brings is it's going to allow us to move and do that a lot quicker and a lot better and a lot faster. You know that you're absolutely right. Everybody's talking about you can't hire your way out of this problem. And so many health systems have also tried to go out and find, you know, point solutions, right. I mean, aher can only do so much. So you could try to find somebody who might solve one part of your prior author. You know, maybe you can do spring some AI encoding and Abhinav, why hasn't that worked and and what can we do differently? You could effectively like, I think like start thinking about reimagining what your entire revenue cycle process looks like, whether that's value based care, whether that's fee for service and really think about like the right financial outcome that you can generate as a provider while delivering the care that you want. What are the two things that we all want like we want like a frictionless experience for the provider and we want effectively for them to get paid for what they basically delivered, right. And if, if that's. Basically, the two goals that the health system, CFOs or CIOs are effectively trying to solve for. Then you can for the first time, really reimagine that entire thing. If there's a a fundamental shift in healthcare delivery towards, you know, a truly transformative way that we actually practice medicine and get paid for medicine, I think that's going to be an absolute game changer. And even still, you know, there's no, it's not gonna be a just take it off the shelf that it'll work for everyone. I mean, there's a deep, deep. Ability to really understand what's going on with the customer and ensure that our solutions work. And Jim, I think Caduceus Health has done that so well. You have a really genuinely unique way of starting with a diagnostics whenever you start with any partnership. He tell us a little bit more about that. Yeah. I mean like over the years, you know, we as I said, we've been doing this a while and one of the processes that we found out early on is something that we created called LEAP. So it's called Leading Edge. Acceleration program. And what we've really done is produce, put all of our efforts in that first 60 days of Acclaims life cycle and again when I started talking to innovator. So the earlier we can get good data, obviously the better outcome we have in that 60 day window. And so we start literally as soon as that patient is dialed into the system, as soon as work. Having any kind of contact with that piece and preregistration, that's really when the clean process starts and that's when we want to start thinking about getting paid. So anything we can start adding to that as the patient goes through the process of seeing a physician, we want to build on that and that's what we've done. So we've created what we call LEAP and we're so really hyper focused on delivering a cash result within that zero to 60 window. And what it's allowed us to do is spend less time on actually a denial. Because what we're trying to do is make sure that it's passed every single rule that it could possibly pass. So we know it's going to get paid when it shows up at the insurance company us to judicate the claim. Jim, can you talk to us a little bit more about some of the customer outcomes you've been able to deliver with this model? Absolutely. So when I when I talk about our KPIs and our experience and our results, it's really all based around something we call LEAP leading edge acceleration process. And what we like to do is get that KPI into a 90 to 95% settlement ratio in a zero to 60 window. So we're we're hyper focused on driving. Ask for our clients and if you're really good at that, I mean if you can get a client into a 9095% ratio, what that really means is you're only letting about 4% trail out in pure denials, right? So you've got to get the picture perfect in the beginning, but what it translate to is a very healthy window in your 60 day cast site. It's the reason we've had clients like Englewood that have been with us since 2015. There's a group. And here's a group. They started out with about 40 to 50 physicians back in 2015 when they came to us. And today they generate about $240 million in cash and the practice has grown to about 900 physicians. And they've been a client for us for a long time because of those results. And one of the early things that, you know brought them to us and what we were able to do with our leap was actually increase their same store sales by about 15%. And they'll tell you that. I don't need to tell you that, but that's been a very big success story. And we we built a lot of our models and done a lot of our testing with them. They've been a great client, a long term client and they just resigned for five years. So we're feeling pretty good about them. I want to close by bringing it back to a patient care because I think, you know, we talk about all this about administrating healthcare, but I think everybody in Healthcare is here to make sure that patients get the care they deserve. What do you think, you know, trend this transformative approach is going to mean for our patients? I think like my general view is that you can't. Think of like patient care without like thinking about the administration of care like in meaningful ways, right? And if you basically solve the administrative like part of the problem, I think the care delivery automatically follow up from like so. So that's my view. Like 10 years in healthcare teaches you one thing that if you can't bring all of the components together and you create another silo, nothing gets solved. Again, it's driving costs down. I mean, how do we simplify this? I mean, I love the example in what interface has done, you know, just something simple like. Authorization, how something used to take 45 minutes now takes 45 seconds. I don't know if I have that stat right. That same mentality has not been brought to RCM yet, right? And so that's where you start driving costs down. That's where we're taking the really complex case, figuring out how to gentrify it, starting to do that in a much smaller time scope and being able to provide that service at a lower cost because the costs are driving the small practices out of business, so. I really think that we can do that together, and that's why we're joining forces here to try to drive the numbers down and make it make healthcare more simple. Well, I think on that note, we can all agree that if healthcare was more focused on the provider and on the patient, we would have a better world. So thank you so much for joining from me for coffee and let's go get it. Yeah, No, it's been great. Very exciting day. Yep. Thank you so much.