As a part of my series about the “Five Things You Need To Be A Highly Effective Leader During Turbulent Times,” I had the pleasure of interviewing Diana Allen, PhD, president and CEO of The SSI Group, and a longtime healthcare revenue cycle leader. She is also a healthcare finance professor at Southern New Hampshire University, where she teaches courses on leadership and management, healthcare finance, ethics and law, project management, and Lean Six Sigma process improvement.
Thank you so much for your time! I know that you are a very busy person. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I got my start in healthcare revenue cycle management quite by accident. I began my career as a fundraiser for a social services agency that also provided behavioral health services in the greater Boston area. I discovered the agency could bill for its behavioral health services. When I dug into this work, I started to learn the intricacies of revenue cycle, and I was fascinated.
In healthcare, so much begins with revenue cycle, from scheduling a patient for service to verifying the patient’s benefits; connecting the patient with financial assistance, where needed; processing a claim and ensuring the claim is paid correctly. When hospitals don’t have finely tuned revenue cycle processes and expertise, patients struggle to understand their bills, and their claims may not be processed correctly. They may struggle to pay for their care — a situation that can be avoided when patient financial communications take place early in the patient encounter. We know that fear of medical expenses is prompting patients to delay medically needed care, especially during the pandemic. This is an area where revenue cycle teams have the potential to make a profound difference for consumers.
On the business side, the work that revenue cycle teams do ensures that healthcare organizations are paid for the care they provide, and that supports an organization’s ability to provide vital services for its communities. Among the initiatives I’m most proud of are a charge capture project that generated $9 million in additional revenue over two years for a hospital in Connecticut; a charge capture initiative that drove $2 million in net revenue for a physician practice and reduced days in accounts receivable by 28 days; and the development of more advanced revenue cycle processes for a group of specialty practices that led to a bottom-line improvement of $55 million in annual revenue.
Ultimately, I chose to pursue healthcare leadership to really drive change in healthcare and healthcare revenue cycle. I’ve been passionate about healthcare revenue cycle for more than 25 years, and that passion has inspired me to take on bigger challenges that have crossed my path and to lead efforts to achieve significant improvement. I have a tenacious spirit, and I’m not afraid to take risks — two qualities that have served me well in mastering the complexities of healthcare revenue cycle. As a leader, I’m committed to transparency, creativity, diversity and inclusion. I encourage team members, especially women, to bring their voice to the table.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or “takeaways” you learned from that?
When I was working for a social services agency, back when I was first learning what healthcare revenue cycle was all about, I took on the task of developing our insurance billing strategy for behavioral services — but I did not know how to use a computer. I had not even turned one on in my previous job. I had to teach myself how to use a computer while navigating an incredibly complex insurance billing program. I began to wonder what I had gotten myself into, but I was also determined to see that project through. I spent a lot of long nights making a ton of mistakes as I learned not only how to operate a computer, but also about the complexities of medical billing, especially for specialty care.
Looking back on that experience, I realize how lucky I was, because medical claim submissions back then were a lot less complicated than they are today. At the same time, I never believed I couldn’t do what I set out to do, in spite of the challenges.
None of us is able to achieve success without some help along the way. Is there a particular person who you are grateful toward who helped get you to where you are? Can you share a story?
You know, in healthcare, where women comprise 65% of the healthcare workforce, yet just 30% of C-suite roles in the industry, we talk a lot about the importance of sponsorship and mentorship, but opportunity is even more important. I’m grateful to Cheryl Scully at GE Healthcare, where I received my first position as a revenue cycle account manager, for identifying my potential for leadership and nominating me for GE’s leadership development program. So often when leadership opportunities become available, companies step outside to fill those roles rather than looking internally to identify that talent. I really admire GE’s leadership development program, which is one of the best in the world for developing executive leadership, and I’m grateful to Cheryl for helping to propel my leadership journey. Along the way, I also became trained in Six Sigma Green Belt certification, which has been essential throughout my career.
Extensive research suggests that “purpose-driven businesses” are more successful in many areas. When your company started, what was its vision, what was its purpose?
Our company, The SSI Group, was founded in 1988 with the mission of providing reliable, easy-to-use healthcare software to empower healthcare providers to efficiently manage their fiscal operations. That purpose is still a core focus of our company today. We design innovative solutions to help our clients excel at the business of healthcare, which protects hospitals’ financial health and ensures they have the resources to provide vital care and service for the communities that depend on them in times of need. These solutions include the use of artificial intelligence to predict when claim payment will be received, down to the hour it will be received — an innovation that no one else in the market offers. It’s a tool that takes the guesswork out of when hospitals will be paid and empowers healthcare leaders to gain greater visibility into their performance and use the information to make critical decisions at a time of economic uncertainty. We’re proud that our purpose-driven mission to help healthcare organizations succeed in the business of care has made a tremendous impact on their ability to provide care in a tumultuous environment.
Thank you for all that. Let’s now turn to the main focus of our discussion. Can you share with our readers a story from your own experience about how you lead your team during uncertain or difficult times?
I think women, in general, are excellent at wading through chaos, and that is especially apparent during the COVID-19 pandemic. One of the keys to leading my team through the uncertainty of the pandemic is to stay focused on business continuity while ensuring that my team members feel supported as they navigate a new work-life paradigm. During the first months of the pandemic in particular, work was taking place in the home while children and spouses were at home, too. I remember how challenging it was to be a working mom in a leadership role when my daughter, who recently graduated from college, was small and how important it was to set priorities around work and home. I kept that experience in mind as I worked to nurture, engage and invigorate the leaders on my team and helped them develop ways to engage their own staff, remotely, to keep the business moving forward.
I found that women leaders in particular had the skill sets and emotional intelligence to do this naturally, whereas there were male leaders — not all, but some — who needed coaching in those aspects. It was incredibly rewarding to see the ways in which my team responded to the crisis and maintained high levels of productivity, even as they sorted through what this new environment would mean for themselves and their families. By staying focused and assuring employees that they weren’t alone in the struggles they faced, we remained a trusted partner for hospitals, health systems and health plans during a period of extreme stress — financial and otherwise.
Did you ever consider giving up? Where did you get the motivation to continue through your challenges? What sustains your drive?
I have never considered giving up because I have folks counting on me — both clients and employees. I know that when we all work together, we can overcome any challenge, no matter how daunting.
What would you say is the most critical role of a leader during challenging times?
The ability to stay clear-headed and drive toward solutions is a critical attribute for leadership. Whether in the middle of a pandemic or while facing any challenge, leaders can lose sight of the imperative to project calm and remain resilient in the urgency of the situation. That can have a disastrous effect on a department or organization because teams react to the energy of their leaders. Likewise, reacting without a clearly thought-out plan can lead to a sense of chaos at a time when teams need direction. The data support this view: During the pandemic, a Gallup poll found that less than half of healthcare workers agreed that their employer had communicated a clear plan of action for COVID-19, and 78% will come out of the pandemic with a negative view of their workplace because they lacked the leadership they needed.
When the future seems so uncertain, what is the best way to boost morale? What can a leader do to inspire, motivate and engage their team?
The best way to boost morale is to find new ways to stay connected to teams, even in a remote work scenario. At The SSI Group, one way that we stay connected is through a walking app that we are each using to track our steps connectively. We call this initiative “Walking Across America.” It’s a great way to motivate each other and hold one another accountable for making investments in our physical health that have dividends for our emotional health and that kickstart our creativity. We’ve also formed a virtual book club and teams for online games that give us space to let our hair down, have fun with one another and get to know each other better. The relationships we build during this experience will strengthen our teams and our work.
What is the best way to communicate difficult news to one’s team and customers?
I believe strongly in conscious communication. It’s a style of communication that emphasizes managing one’s emotions and treating others with respect. During tough conversations, conscious communication centers on communicating information in a transparent, factual way and demonstrating a desire to support the other person in resolving key issues. In highly stressful environments, conscious communicators are known for their ability to deescalate conflict quickly. During the pandemic, a leader who is focused on conscious communication will make sure that sensitive conversations take place face to face — even via Zoom — rather than by email. This limits the potential for an emotional reaction and enables the leader to read the other person’s body language and respond in ways that demonstrate emotional intelligence, a commitment to collaboration, and respect.
How can a leader make plans when the future is so unpredictable?
At The SSI Group, we are finding we have to be more nimble in anticipating and adapting to the needs of our clients, which, at the beginning of the pandemic, seemed to change almost daily. One way we support our healthcare clients is by providing tools and information that help them navigate COVID-19 financial recovery and the complexities of managing a remote revenue cycle workforce. We anticipated their needs early on by offering solutions that helped eliminate paper-based work in the home, such as new ways to process paper-based payment. This kept cash coming in the door and protected sensitive information while maintaining continuity in financial operations. We also ramped up communications on timely topics — such as how to correctly bill for telehealth, which exploded in volume during COVID-19 — to proactively address our clients’ top-of-mind questions. Our subject matter experts have been excited to share their insight on critical topics, and their passion for their work and for meeting the needs of clients comes through in each piece they produce.
Is there a “number one principle” that can help guide a company through the ups and downs of turbulent times?
Do not lose sight of the business’ purpose during challenging times. When your work stays grounded in a mission-driven purpose, the decisions you make as a leader will resonate with your team, your clients and the industry.
Can you share 3 or 4 of the most common mistakes you have seen other businesses make during difficult times? What should one keep in mind to avoid that?
The most common mistakes I have seen companies make during difficult times include:
Losing focus of the company’s core product or services while they look for other market opportunities.
Staying focused on not only the company’s mission, but also the clients that have put their trust in your company and the services that have established your company as a leader in the market is essential to retaining loyalty, building and maintaining trust, and distinguishing your company as a here-to-stay player in a competitive space.
Not developing employees during difficult times.
Just as leaders need to look within their companies for talent when positions open up to ensure they aren’t overlooking emerging talent, they also need to invest in employees’ growth when times are tough. In the shift to a remote workforce during the pandemic, while mentorship and sponsorship opportunities may be limited, there is still potential to strengthen employees’ skills, such as through online learning. Hand-selecting employees who demonstrate potential for leadership to work on projects that may be outside their comfort zone but could provide tremendous opportunity for growth also has dividends for the company and the employee over the long term.
Taking focus off the long-term plan in favor of the short-term solution.
While it’s not clear how long the pandemic will last, leaders must stay focused on their organization’s long-term goals even as they address the company’s immediate needs. Doing so provides a road map for recovery from the top down. It also keeps teams centered on the work that matters most.
Generating new business, increasing your profits, or at least maintaining your financial stability can be challenging during good times, even more so during turbulent times. Can you share some of the strategies you use to keep forging ahead and not lose growth traction during a difficult economy?
One of the secrets to our success during turbulent times is the ability to access and leverage highly timely, actionable data to spot emerging trends. We then use this data to pinpoint and address our clients’ biggest pain points, and we personalize our approach to each client. We also explore partnerships — even with our competitors — that accelerate solutions that protect healthcare organizations’ financial health to put our purpose-driven mission into action.
For example, during COVID-19, The SSI Group partnered with Ensemble Health, another revenue cycle company, on digging into our clients’ claims data during COVID-19 and using it to spot trends that provide a window into hospitals’ financial health — both in the first months of the pandemic and in the months ahead. We discovered that hospitals should expect one to four weeks of flat to slow declines in volume followed by seven to eight weeks of recovery — likely in June or July — after which patient volumes could hold steady over the near term. We also identified several ways that hospitals could accelerate COVID-19 recovery, such as by using data analytics to proactively respond to changes in payer behavior and emphasizing a back-to-basics approach in revenue cycle.
This partnership is unlike any other that we’ve seen in healthcare revenue cycle, and it provides timely analysis that healthcare revenue cycle leaders can use — now — to enhance their financial performance. At a time of uncertainty, our willingness to partner with our competition to develop insight that could not only help our mutual clients, but also the industry as a whole is demonstrative of our dedication to easing the financial challenges that healthcare organizations face.
Here is the primary question of our discussion. Based on your experience and success, what are the five most important things a business leader should do to lead effectively during uncertain and turbulent times? Please share a story or an example for each.
Five things business leaders should do to lead effectively during uncertain and turbulent times are the following:
Bring your voice to the Zoom call. Express ideas as they come to you, resisting the urge to over-assess whether it is the right solution to the scenario at hand. I’ve found that women in particular wait to offer their feedback until they are asked, but in a remote environment, especially, opportunities to make big contributions are lost when leaders don’t speak up in the moment. Draw from your expertise, and speak with conviction when presenting an idea.
Celebrate your teams. Share successful ideas broadly, giving credit to the people who came up with the ideas or helped execute on strategy. Doing so builds morale during tough times and encourages employees to continue to innovate — critical for client success.
Look for new ways to maintain connections with employees and clients. The employee-centered initiatives that The SSI Group has launched — from walking challenges to book groups to game nights — not only offer a fun reprieve from the heavy lifting of the work we do during a pandemic, but also help teams get to know each other on a personal level. The relationships that are built in a fun atmosphere make teams stronger when all-hands-on-deck scenarios present themselves later. Likewise, finding ways to maintain and tighten connections with clients, such as by anticipating their needs and offering ideas around their most pressing issues — such as how to assure customers that a healthcare facility is safe to visit during a pandemic — engenders good will and further establishes your value as a partner.
Seek opportunities to do routine tasks faster. For example, at The SSI Group, we’ve increased our investment in automation, looking for ways to process claims for efficiently without manual intervention. The results are strong: We have a clean claim rate that is higher than 99% — best in class for the industry.
Show clients what’s under the hood. Now is a great time to meet with clients virtually to demonstrate how your company provides value. Right now, we’re giving clients a visual glimpse into the ways in which we use clients’ claims data to target areas of opportunity in revenue cycle, such as where slowdowns in claim processing are occurring and practical actions clients can take to close those gaps. We also show hospitals how they are performing in relation to their peers during the pandemic, and we offer lessons learned based on decades of experience in our field. The trusted relationships we build now will provide the basis for growth during COVID-19 and beyond.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
In my kitchen, on the door to the pantry, hangs a brightly colored apron with the words “One Size Does Not Fit All” stamped on the front. The apron was given to me by my daughter in jest, as a reference to my tall stature; however, this idiom reflects my leadership philosophy as well. A one-size-fits-all approach to leadership is too limiting. Instead, leaders must be transformational.
The practice of transformational leadership has fascinated me over the years as I have honed my leadership skills in the healthcare administration arena. James McGregor Burns states in his book, Leadership, that the fact that “people can be lifted into their better selves is the secret of transforming leadership.” For me, this quote embodies the essence of transformational leadership. The ability to inspire people to be more resourceful than they know they are capable and to collectively aspire to greatness as a group is part of my “one size does not fit all” philosophy. I am fortunate to have been able to practice transformational leadership in my executive roles over the course of my 25-year career.
Throughout my life, many doors of opportunity have opened, both in my personal life, as well as my career. My vast experiences give me not only the ability to see open doors, but more important, the ability to navigate through them. Over the years, I have trained, mentored, and coached numerous employees, physicians, and medical office staff. Through training, mentoring, and coaching, I have guided employees to understand their abilities and motivate them to stretch in ways they did not know possible. My role as a leader is to motivate those around me to expand their horizons. By stretching their goals to higher levels, my team grows more satisfied with their outcomes in their workplace, and they become more confident employees. I show employees how to see opportunities as well as to seek them.
How can our readers further follow your work?