Healthcare

Q1. Could you start by giving us a brief overview of your professional background, particularly focusing on your expertise in the industry?

I am the Director of patient access and revenue at George Washington hospital, particularly focused on registration, financial clearance, authorization, HIM and call centre operations.

Q2. Which healthcare systems are leading in revenue cycle transformation—and what measurable outcomes (e.g., days in AR, collection rates) demonstrate success?

• Cerner Oracle
• EPIC
• Optum health
• Change health 

Q3. Which RCM processes have shown the highest ROI from automation—e.g., prior authorization, patient eligibility verification, automated appeals?

• Prior authorization
• Eligibility verification 

Q4. Which startups or mid-market platforms are gaining traction in patient engagement and access automation, and what valuation multiples are being seen in recent funding rounds or M&A?

• R1
• Ensemble
• Experian 

Q5. How are data protection investments shifting between in-house IT security teams and third-party managed security service providers (MSSPs)?

Due to changing cyberthreats, financial limitations, and a lack of skilled personnel, data protection investments are significantly moving from internal IT security teams to outside managed security service providers (MSSPs).

Cost Efficiency: Outsourcing security operations to MSSPs can be more cost-effective than maintaining a full in-house team, especially for 24/7 monitoring, threat intelligence, and incident response.

Q6. What payer-specific guidelines (Medicare, Medicaid, private payers) are shaping reimbursement policies for remote consultations, and how are RCM systems adapting to them?

Payer types—Medicare, Medicaid, and private payers—have very different reimbursement policies for remote consultations (telehealth/telemedicine), which influences how RCM systems need to change. 

Both commercial payer contracts and state Medicaid differ from one another.

Q7. If you were an investor looking at companies within the space, what critical question would you pose to their senior management?

• Security of data
• EMR
• Pain points in RCM