By Shannon White, CRCR President Ensemble Health Partners
March 2020 is a month we’ll never forget—as people, as professionals, as leaders and as a nation. Across four tumultuous and nerve-wracking weeks, Ensemble Health Partners, like many U.S. companies, had to rethink its service delivery logistics in light of a spiraling pandemic. As a key partner to healthcare organizations on the front lines of the COVID-19 crisis, our company had to act quickly and decisively to ensure business continuity for organizations that count on us to maintain strong and efficient revenue cycle operations so they can focus on patient care. At the same time, we needed to act compassionately, addressing the concerns of our staff and meeting their needs for health, safety and security.
Navigating Ensemble’s COVID-19 response has been both challenging and enlightening. Over the course of the month, I along with the rest of Ensemble’s executive and senior leaders, have had to weigh significant business decisions while remaining empathetic to our customers and employees. Although Ensemble has strong disaster and business continuity plans, our leadership team has had to plan without really knowing what the future will hold. We’ve had to address issues, knowing those issues could change rapidly. And we’ve had to meet people where they are, with many fearing for their own health and safety as well as that of their children, parents and other loved ones. Although the pandemic continues to evolve, I think it is valuable to pause and take stock of the first month’s response, celebrating what went well while acknowledging the uncertainty that remains. I could not be prouder of the fact that our team didn’t waiver one iota in the consistent delivery of exceptional results for our clients during the turmoil.
Making the shift to work from home
When it became clear that Ensemble needed to transition the majority of its 4,200 associates to work from home, a critical first step was to determine how we made sure essential services weren’t interrupted during the migration. Ensemble has multiple locations throughout the United States and an already existing Work Form Home strategy, so quickly activating redundancy while completing the remaining migration to home was essential. Ensemble’s workforce is an onshore model which was very much to our benefit as we did not have the performance issues or disruption in services that occurred in other countries, like India. As a leadership team, we had to rapidly evaluate the situation and decide what we were going to do to effectively service our customers not only tomorrow but for the foreseeable future. We recognized the importance of being good partners for our clients, ensuring continuous cash flow so they could focus on providing critical care to patients.
Once we established the vision, we prioritized tasks to enable that vision. To start, we asked what functions were mission-critical for our clients. By focusing on this fundamental question, we were able to generate a priority list by functional area, so we could get the most essential functions up and running quickly. Next, we worked to migrate high-risk associates to ensure they remained safe and healthy. These included associates over the age of 60 and those who had underlying conditions that could exacerbate a COVID-19 infection.
One obstacle that added a level of complexity was that we couldn’t just migrate one location at a time. Ensemble associates are spread across multiple states, and each state has approached its shelter-inplace response differently. To make sure we could deliver essential services consistently, we migrated service lines across locations at the same time, proceeding down the priority list.
As of this writing, 98% of our associates who are not client facing have been transitioned home. The remaining ones are located onsite in hospitals and service centers, performing key tasks, such as patient registration. These associates are volunteers who stepped up to fill the roles. Since most of our staff is cross trained in multiple areas, we were able to shift personnel as needed. None of these volunteers are considered high-risk for contracting the virus, but they are still putting themselves in harm’s way.
In addition to launching a new work model, we also have been helping healthcare organizations address some of their unexpected needs. For example, several customers have asked us to handle business office overflow to keep cash flow moving. Others have requested that we staff the phones and cancel elective appointments. We are serving as an extra pair of hands for our clients and acting as extensions of their teams, helping them accomplish tasks that need doing—even if those are out of our contracted job scope.
It takes a team
he decisions Ensemble made in March, as well as the ones we are continuing to make, have been driven by our executive and senior leadership teams. We meet as a group twice a day: once early in the morning and once in the evening. And then many of us are in meetings and ad hoc discussions throughout the day. During these interactions, everyone’s perspectives and opinions are valued and considered. We have the sharpest minds in their subject areas coming together to discuss the right path forward. Whether its operations, IT, human resources, or communications, our leaders have conferred and collaborated to make this transformation happen. We’ve accomplished as much as we have because everyone has a seat at the table and is committed to our mission and vision.
Acting quickly, refining later
Under normal circumstances, we may have had days or weeks to pull the kind of plan together that was needed to maintain consistent and accurate operations while moving to a new work model. However, in this case, we had mere hours before we had to start taking action. Our conference calls had a war room feel, where executive and senior leaders worked together to quickly understand the scope and nuances of the situation and put a solid plan in place that had enough flexibility that we could easily re-aim if we had to. We embraced the idea that re-aiming was okay, and we were all prepared to re-balance and refocus as issues came up or gaps emerged. This way of thinking is part of the fabric of our culture. One of our primary principles is that we put people first, last and always. Our response to the pandemic has been, and continues to be, an excellent demonstration of our entire leadership team staying attuned to that principle and getting things done in a manner that keeps the needs of our people and our clients as a top priority.
Remaining calm, empathetic and data-driven
One of the things that has made this crisis so difficult is that we’re not just facing an operational upheaval in a vacuum. We are also worried about our health and the safety of our loved ones. Economic uncertainties are also present. And this perfect storm of concerns can have emotions running high. In this context, it is important for leaders to remain calm. Our associates look to us for leadership and direction and are keyed into how we approach the crisis professionally and personally. They look to us to be servant leaders, remaining composed, compassionate and outwardly focused to build community and support while enabling strong performance. They also expect us to bring our entire self to the work each day. Sometimes this includes expressing deep emotions, and I firmly believe that is an OK thing to do. Leaders need to understand and embrace who they are and willingly apply all their gifts to the tasks at hand.
I have also found it critical to manage through data and facts rather than feelings and hunches. While this may sound like the antithesis of being empathetic, I firmly believe that empathy and data-driven decision-making go hand-in-hand. Using unambiguous information to make decisions, and communicating using clear and direct terms, can be reassuring for everyone and can minimize the spread of fear. While it may be tempting to give in to the unknown and chaos, it is essential to focus on a measured response that gives clarity and direction.
Active listening is also paramount, and you can’t assume you always know the right answer. I am fortunate to have smart, dedicated subject matter experts around me, and they are in the best position to understand and strategize around their areas of expertise. By listening to each other’s perspectives and relying on our various strengths, we increase the likelihood of a successful response.
A heartfelt thank you
The COVID-19 crisis has been an extraordinary and unprecedented event, and there is no rule book to follow. However, in all of this, one thing has become abundantly clear: The Ensemble family is an amazing, adaptable and committed group of people. Our associates have taken this situation in stride and remain passionate about serving our clients. They are committed to doing what’s necessary to work from home and remain productive, accurate and customer-centric. It has been humbling to watch how many of our associates agreed without hesitation to remain in centralized areas or on the front lines to serve our clients, potentially putting themselves at risk. I’m honored to lead within such a compassionate and mission-driven company. Although it will be interesting to see what the future brings, I feel confident that with our servant leaders and dedicated associates, Ensemble Health will successfully weather this crisis and emerge stronger for it. Ensemble is a company comprised of the industry’s best revenue cycle operators who are all champions in their own way. Throughout this crisis and beyond, they are personally and professionally fighting for what is right, surviving the unimaginable and fully believing in the importance of the greater good.