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Revenue Cycle: Culture Drives Success
Revenue Cycle Support Services is the backbone of Utah’s financial system – from insurance prior authorizations to processing billions of dollars in claims and payments. Their leadership team, led by administrative director Kathy Delis, has been on a years-long journey to make this work better both for patients and employees. Here, she shares how she brought meaning, purpose, and a sense of community to the team.

frequently define our work in terms of the numbers: 1.5 million claims billed, 1 million patient statements, 276,000 patient billing calls. Our team of 300 is busy!

A few years ago, our CFO (now CEO) Gordon Crabtree challenged us to find more cost-effective ways to do our work so we can bring better value to our patients. We started thinking about working smarter and wondered about our culture. How do we keep 300 people motivated and engaged?

Thinking differently: Get to know yourself

First, we acknowledged that change was necessary. We needed to spread the skills our leaders had–accountability, empowerment, trust and open communication–to our entire staff. To do that, we knew we had to get to know ourselves a bit better. A coach helped us understand our own traits and challenges.

Clear is kind

After some soul searching, I realized I’m a “hinter.” Instead of providing direct guidance, I hint. For example, I would say things to my team like, "We need to do X." What I really meant to say was, "I want you to do X." It led to confusion. No one was really sure who was responsible and sometimes things just didn't get done.

I have to consciously correct myself or think, "Am I being clear?" Now, everyone in my department asks me for clarification if I’m not being clear.

Define what makes you successful

All of our Revenue Cycle Support Services team members came up with their own definition of success by asking one question: At the end of the day, how do you know it's been a good day?

One example from our team came from an employee who takes patient billing phone calls. This is how she defined success: “I reduce financial stress for our patients.” What I love about that is this person’s success is not the number of calls she takes, but about how she is making a difference in the lives of our patients.


Empower the team: Accountability and communication

We wanted to instill a sense of empowerment at all levels of our staff to resolve issues and focus on the patient. Our team decided to implement a strategy for one-call resolution. Every employee was empowered to resolve patient billing questions and concerns the first time the patient calls.

We empowered the team to really make and own their decisions. We trusted them to do the right thing for both the patient and the organization. And patient feedback has been overwhelmingly positive.

We believe accountability is empowering. It’s not punitive or scary. In fact, we experienced a real shift in our culture, demonstrated by reduced turnover, increased employee engagement and better efficiency suggestions from our staff.

We encourage fact-based communication (rather than interpretations) as a cornerstone to successful accountable conversations. Throughout our journey, we’ve owned our successes and our mistakes with transparency. And we’ve celebrated the things that we learned from.

What’s Next?

There's always opportunity to grow and do better. A number of our leaders have participated in the Advanced Leadership program through Hospitals and Clinics’ Organizational Development team. Additionally, our internal training team has expanded our revenue cycle professional development program at all levels. We have a supervisory prep course for our staff interested in leadership roles, as well as a supervisor academy to help to grow our current supervisors.

At every team level and staff level, we provide professional development with ongoing focus on accountability and believing that you can make a difference.


Annotated transcript from Kathy Delis' speech at the Oct. 31, 2018, Leader Development Institute in Salt Lake City, Utah.


Kathy Delis

Administrative Director, Revenue Cycle Support Services, University of Utah Health

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