ST. GEORGE — The process of moving some Intermountain Healthcare employees to a new employer, a Chicago-based company, is in full swing, a move the health care giant hopes will save $70 million over three years. However, these changes have posed concerns for many employees regarding the way it was handled and the background of the company to which they’re being transferred.
Intermountain Healthcare workers who handle patient claims and payments officially had a new employer as of Sunday morning. The move to outsource billing and collections for Utah’s largest employer and health care provider to R1 RCM, a revenue cycle management company, was first announced in January.
Initial estimates placed the number of employees being transferred at 2,300 throughout Intermountain’s chain, 141 of whom were working at Dixie Regional Medical Center, according to an email sent to St. George News from DRMC communications director Terri Draper.
Becki Bronson, communications and public relations manager for Cedar City Hospital, told St. George News an additional 42 employees would be affected as well.
Draper went on to say that no Dixie Regional employees were laid off, and “all were offered the opportunity to transition to R1 at the same rate of pay.”
Draper said 96 percent of employees accepted the job offer, adding that more than half of the jobs will remain local, while a portion of the positions will transfer to an R1 center in Salt Lake City.
Some of these employees plan to relocate, she said. Others are working on transitioning to other local positions within Intermountain and some are “applying for work beyond Intermountain.”
The relationship between Intermountain and R1 began six years ago when Intermountain started working with R1 to improve its patient tracking and billing systems. Many hospitals across the nation are opting into outsourcing the growing costs associated with labor, and using a solid revenue-cycle management platform is becoming increasingly important. The growth is expected to exceed $91 billion by 2022.
Intermountain COO Robert Allen said in the January statement on the transition that employees working in nonclinical roles – such as registration clerks, billing specialists and scheduling staff – would keep their current rate of pay and “most will continuing working at their current job sites” as they were moved to R1 RCM, a company that works with about 300 hospitals nationwide.
Both Intermountain and R1 said the employees’ new retirement benefits will be comparable and competitive.
“These savings are not coming on the backs of the employees,” Allen said in January. “They come from gaining efficiencies because of economies of scale and a proprietary software … that really focuses on improving the flow. This software tracks more carefully the payments that insurance companies make to make sure they pay enough.”
Additionally, the agreement between the two companies promises additional jobs to Utah, as R1 plans to establish operations west of Chicago and is hoping to open an office in West Valley City, where many of its patient billing employees already work.
Allen relayed the news of the transfer to approximately 250 managers of the Intermountain workers who would be affected, giving those employees nearly three months to adapt to the upcoming changes.
But is it good for the health of the company culture?
For some employees impacted by the shift, the changes were greeted with frustration. And in some cases there was fear, to the extent that despite multiple attempts by St. George News to garner statements on the record – even under conditions of anonymity – only one statement was given from an employee who had worked for Intermountain for decades and is now an R1 employee.
“It’s certainly not the Intermountain I grew up with any longer,” the employee said.
However, workers aren’t keeping silent everywhere. Some have gone to employer rating sites, like Indeed, which allow comments to be posted anonymously. This site, and other similar sites, can offer an opportunity for them to rate their employer, as well as provide an outlet to work through various challenges faced during the transition by posting comments.
Many of the employee reviews since the Jan. 23 announcement about the transition have been less than complimentary, with subsequent low ratings.
One employee didn’t wait long, publishing their two-star review – entitled “Intermountain was once a good employer, no more” – on the same day.
“Current CEO and upper management has decided that short term financial gain is more important than long term stability,” the employee wrote.
Another comment from March 15 entitled “Being outsourced to R1” had this to say about the changes:
Through the last couple of months since the announcement of moving to R1, we as employees feel like Intermountain does not have our best interest in mind. Sad to see a great leader of the community focus on money.
The person gave Intermountain Healthcare a 1-star rating.
Besides the lowest reviews, many two- and three-star reviews echoed the sentiments of the Jan. 23 comment that Intermountain had been a good company to work for but that recent outsourcing and organizational changes had left them feeling insecure.
Of the 71 reviews since the announcement, almost half were three-star or less, with almost two-thirds citing outsourcing as the primary reason for their rating.
A three-star review from Jan. 25 wrote “We dont (sic) know if we are going to have jobs next month. Before the change, it has been very laid back and fun …”
One employee who had reportedly been with IHC for more than 10 years wrote a review entitled “Changing” on Saturday, just one day before the official transfer.
“Everything is being outsourced to control costs,” the comments read. “Employee morale is at an all time low. Incredible and talented leaders and staff are losing their jobs as the organization flattens its structure. Many employees don’t feel safe or valued. Not a good environment to step into right now.”
R1 RCMs past and Intermountain’s future
Adding fuel to concerns, R1 RCM has spent the last several years in lengthy court battles and has been accused of losing patient data, deceptively boosting hospital revenues and using intimidation tactics to garner payments from patients.
In 2012, R1, operating as Accretive Health, settled a lawsuit for $2.5 million with Minnesota’s attorney general alleging violation of privacy, debt collection and consumer protection laws. According to a statement released by Minnesota Attorney General Lori Swanson, the case brought into focus the industry’s expanding efforts to collect cash from patients and allegations of pushing patients to pay bills as they sought medical care, even in the ER.
Swanson issued a scathing report in 2012 detailing alleged aggressive collection practices in hospitals and later calling them illegal. Accretive’s then-CEO dismissed the allegations as “either baseless or exaggerated.”
In October 2017, a judge ordered R1 to pay $1.3 million to a separate class-action lawsuit in Michigan accusing the company of violating the Fair Debt Collection Practices Act.
On an Intermountain Healthcare webpage entitled Intermountain’s Expanded Partnership with R1: Five Things to Know, the organization addresses these legal issues and includes the following statement from Allen:
While these issues were known to Intermountain, our experience in working with R1 has been very positive.
Allen continued to note that since Intermountain began working with R1, their leadership had changed and the company had continually strengthened its processes to ensure compassionate patient interactions and regulatory compliance.
“They’re as committed to our mission of helping people live the healthiest lives possible as we are, or we wouldn’t be doing this.”
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Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.
Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.