Troy Spring is Vice President, Enterprise Revenue Cycle, at Intermountain Health, the health system based in Salt Lake City. Spring oversees revenue cycle at Intermountain, which includes the Peaks Region based in Broomfield, Colorado. Kodiak Solutions recognized Intermountain Health—Peaks Region with its 2023 Revenue Cycle Performance Award, presented at Kodiak’s 2024 Healthcare Virtual Symposium.

Please meet one of the many people behind the performance.

Age

56

Tenure with organization

Nine years

Reports to

Vice President of Revenue Services

Number of direct reports

Four

Number of care sites reporting revenue

Eight hospitals; 150 clinics

Annual revenue cycle budget

$90 million

Number of revenue cycle FTEs

1,200

Work modality

Hybrid

Patient accounting system

Epic

Number of revenue cycle vendors

Nine

Fully outsources revenue cycle or in-house revenue cycle team

In-house

Department reporting structure (links to Finance, managed care, other)

Finance

Biggest external revenue cycle challenge

Payor behaviors, increased denials, and longer time to pay. The Change Healthcare breach also has been a significant disruptor to operations and cash flow.

Solution to external challenge

Working closely with payor contracting and legal teams, where appropriate, to put pressure on payors to address bad behaviors.

Biggest internal revenue cycle challenge

Implementing the right technology that will make the biggest impact. Let’s not implement AI (artificial intelligence) for AI’s sake. Implement what’s going to make the biggest positive impact for our patients.

Solution to internal challenge

Evaluating the best solutions or building our own technology.

Describe your organization’s relationship with payors in one word

Challenging. To say the least. Historically we valued having good relationships with our payors and, while that is still our aim, denials and claim underpayments make this a real challenge.

Favorite revenue cycle KPI

Cash versus goal. Everything we do in the revenue cycle should ultimately result in cash.

Least favorite revenue cycle KPI

I love KPIs, and I don't know that I have a least favorite. All KPIs work together to determine where we have opportunities.

How automated is your revenue cycle?

We are an Epic shop, so we use Epic native automation functionality. We are also building our own in-house automation as well to support Epic. But we are interested in not just implementing automation for automation's sake but, instead, implementing automation that drives better outcomes and results.

How clinically integrated is your revenue cycle?

We are a very clinically integrated system, which is key to driving excellent performance.

If you could change one thing about the Healthcare revenue cycle, it would be...

In a perfect world, we could work more collaboratively with our payors and reduce waste. We spend/waste a lot of resources getting services authorized (and most are approved) and denials overturned (most of which get paid) both on the payor and provider sides.