Transforming Revenue Cycle Management: How Capta Helps Overcome Staffing and Reimbursement Hurdles

In this conversation with Laura Calkins, VP or Revenue Cycle at Presbyterian Healthcare Services, we explore the pressing challenges facing today’s healthcare systems: rising costs, decreasing reimbursements, and staffing difficulties. Discover how a strategic partnership with Capta is transforming these challenges into opportunities. Our guest shares insights on how Capta’s innovative solutions are increasing reimbursements, ensuring proper payments, and reducing collection costs. Learn how automation technology is upskilling staff, allowing them to focus on complex tasks and enhancing job satisfaction. We also discuss the future of healthcare innovation, emphasizing the critical role of partnerships in advancing AI technologies and redefining healthcare delivery.

Are rising healthcare costs and staffing shortages keeping you up at night? You’re not alone. These are some of the most pressing challenges facing healthcare systems today. In a recent episode of our podcast, we explored these issues with insights from a key leader at Presbyterian, who shared their experience partnering with Capta to tackle these hurdles.

Understanding the Healthcare Landscape

In the state of New Mexico, healthcare systems are grappling with increasing costs and decreasing reimbursements. The payer mix is deteriorating, and the commercial market is limited. These challenges are compounded by the difficulty in hiring and retaining qualified staff. At Presbyterian, these issues prompted a strategic partnership with Capta to enhance reimbursement processes and reduce costs.

The Power of Strategic Partnerships

One of the main reasons Presbyterian sought a partnership with Capta was to ensure they were reimbursed for every service provided. This partnership has been instrumental in implementing processes and safety nets to achieve this goal. Additionally, Presbyterian aimed to reduce their cost to collect, which, although already low at 2.5%, still needed improvement to meet state benchmarks.

Innovation and Resource Optimization

Presbyterian has always been committed to innovation, but the partnership with CAPTA has opened new avenues for process improvement. With limited resources, both as a state and an organization, CAPTA has provided the necessary capital and expertise to execute initiatives that were previously out of reach. This collaboration has allowed Presbyterian to upscale their workforce, focusing on complex tasks that require critical thinking, thereby increasing staff engagement and satisfaction.

Embracing New Perspectives

CAPTA is viewed as an extension of Presbyterian’s leadership team, bringing fresh perspectives and expertise from different parts of the industry. This has been invaluable, especially for leaders who have been with Presbyterian for a long time. The partnership has facilitated a broader review of potential opportunities and processes, which is crucial for busy revenue cycle leaders who may not have the time to explore these options independently.

The Role of Technology and AI

Looking ahead, the integration of AI and generative AI is seen as the next evolutionary step in healthcare. However, developing these technologies is costly and resource-intensive. Partnerships like the one with CAPTA are essential for sharing these expenses and risks, enabling healthcare systems to leverage cutting-edge technology without bearing the full financial burden.