Transcript
Philip Stefani (00:00) hey morning, Kyle. Hey.
Kyle Brinkworth (00:02) Good morning. How are you?
Philip Stefani (00:06) Excellent. So, I know we just got 15 minutes. We can move through the pricing updates pretty quickly. Any changes since we last spoke though, any updates or anything? Nope? Okay, cool. So let me jump into this. Okay? So real quick. I just want to align on the scope because I know there was a hiccup on this last time. So I just want to make sure we’re capturing the right pieces. So took your email and laid it out like this. So we’ve got a 1,000 rbts in Indiana, 300 in Florida, 50 in Oklahoma.
Philip Stefani (00:42) So 1,350 total, the enrollment application volume is 6,350. Is this aligned with what you’re saying?
Kyle Brinkworth (00:50) Correct. Okay, perfect.
Philip Stefani (00:52) So, yeah, this is what we went back to finance with to update in the pricing. So obviously the volume is significantly higher. So we were able to come down a bit on the unit cost for the payr enrollment application. And then there’s a medallion core subscription charged per rbt which is a subscription for the platform as well as the implementation and onboarding fee. So I’ll pause here.
Kyle Brinkworth (01:23) Yeah. I think for this specific piece, I mean, it’s just, it’s significantly more expensive than our cost to run it today. So that’s just a question for us, right? Because we’ve got really two folks that are running this. So it costs us 110 grand basically to do the whole thing. So I don’t think that it would not obvious to me that it makes sense really in any way… capacity. I guess on that front, yep. No.
Philip Stefani (01:54) That’s pretty much what I expected on that piece especially because we kind of did the comparison last time. So yeah, we might even be kind of over estimating what the cost is for those two ftes. So yeah, obviously significant premium to do this with medallion. I guess outside of the workflow pieces that we looked at where you’re kind of like automating this application process for the rbts is the main other lever for this than just like cost savings.
Kyle Brinkworth (02:23) For the most part. Okay? Like I don’t even frankly, I mean, again, if it was a small premium, I would say that, hey, we can get on board just with some of the automation benefits, right? But at this material of a premium, it’s a tough one.
Philip Stefani (02:38) Yeah, that’s helpful. Okay. So kind of expecting, that would be the case. I also just wanted to show you what we were able to do with the updated all billing provider scope. So this takes into account the… 1,200 existing we’re calling them bcbas here, but I know there’s a couple other provider types lumped into that. And then 250 new bcbas coming on per year. So we’ve got the 2,500 bcba enrollments plus the 6,000 and change rbt enrollments, and then the caqh management for the billing providers. So about 100 K more than just doing this for rbt’s the reason for that is at the, you know, the expanded scope for payer enrollment. We can get even more aggressive on the unit costs there. So just in terms of like if we’re looking at this just in terms of you’re growing the in house team that handles the billing providers versus doing all of this with medallion, expecting that team to grow kind of by one fte, maybe one fte and some change per year. The comparison to, you know, dropping down to just one fte to kind of handle medallion for all of this volume, there is significant savings in this scenario, which is why I wanted to put this in front of you as well. And frankly.
Kyle Brinkworth (03:52) In your obviously, you guys have done this enough times. You’re seeing, I mean this the real fte scaling side of it, right? I mean, you’re seeing this level of, you know, efficiency or from a case study perspective and saying look the average whether it’s in our example, we’ve got eight fte, you’re really seeing the movement from eight to one essentially.
Philip Stefani (04:20) Yeah, exactly. And you know, we’re I would say in the beginning of the evaluation here, if we were, you know, to be fortunate to continue the conversation, we’d obviously put you in touch with organizations who are seeing success, who have done the headcount reduction so you can hear it from them.
Philip Stefani (04:33) But yeah, this is exactly what we’re seeing in the field. We’ve even gone down, you know, larger teams going down to two or one ftes. So I’m confident that we could kind of talk through that piece. And I think if we were to do a full evaluation, we would definitely want to spend some time specifically on like the, hey, this is what the team is doing today. These are the exact pieces that would be automated with medallion. I just kind of wanted for the purposes of this call conceptually to see like, hey, is this interesting to you? Because we kind of think like if we do this for the whole scope there’s you know, significant kind of economic value here. Yeah. So I guess what are your thoughts on that?
Kyle Brinkworth (05:10) Yeah, I think it’s a core competency for us from a discussion perspective. I think there’s some nuance, I think look, I think if we had in a perfect world and recognize that like your pricing reflects trying to move to this one versus if you only did the rvts in, I would say a normal course of business.
Kyle Brinkworth (05:29) I would imagine your pricing is much lower but recognize like the pricing is geared at trying to get the whole thing versus just the rvts look. I think we can be honest like you’re basically telling us that you don’t just want to do the rvts and you’ve priced it in that side, which is fine. Again, I’m not asking you to do something that’s like not natural for you guys to do. So. I think the,
Philip Stefani (05:51) this.
Kyle Brinkworth (05:52) conversation in terms of like what this looks like was probably for us, not something that was top of mind this year. Maybe next year. There have been obviously some changes across the board and I think we’re trying to figure out what makes the most sense. You know, frankly the natural portion is look, I’ve got a team of, you know, call it 10 folks today. If I offshore that material portion, then it would just be, I would save 40 percent, right? And get the same piece that said, I think there is some benefit to thinking about, you know, this structure more broadly. I’d love to think it’s possible if you would send this over my head of revcycle, that now is taking over credentialing with rob’s kind of retirement. And frankly, rob stepped into his role, he’s been here for two. He was here for two years and he took over credentialing because that’s what his predecessor was doing. But rob’s not a wasn’t a credentialing Guy. He had a he’s a large payer background Guy and knew enough to be dangerous, but we just didn’t frankly want to upset the apple cart. And then because rob was, you know, exiting the business, which frankly, I’m you know, bummed about, I loved working with rob, but it did give us a benefit of like being able to make this revcycle change, which we know is the best place for credentialing. I think that’s the timing frankly works out in giving you guys like a second look here. So to the extent that you can send this, I’d love to have a conversation with my head of revcycle. She is not, she’s very familiar with credentialing. She is not familiar with medallion on this end. So we might have to like, you know, take a step back just to give her some sense. But as she’s digging in, I think looking at this style of proposal is helpful as it makes sense and we can kind of think through what that would look like. Yeah.
Philip Stefani (07:49) Yeah, I think that makes a ton of sense. I’m happy to send this over for internal review. And then, yeah, just on the rbt versus doing the full scope piece. I’m you know, to be sure like we absolutely if you’re looking at this and you’re like, hey, like we really just want to solve this rbt piece like, you know, we would consider that seriously like medallion is definitely open to doing an rbt only deal I think rather than, you know, pricing around trying to get the total scope of your enrollment volume. What we were kind of thinking about is just like, hey, the two ftes that you have deployed to do the rbt enrollments, like in any world where you outsource the rbt piece, it didn’t sound like you were exiting those ftes, they would just go back to the bcba piece. And so what we were just thinking about was like, okay, so with the rbts there’s actually no like headcount reduction piece there. So the cost savings is purely just on like the cost to do those enrollments. So, yeah, just, we typically kind of see, you know, headcount reduction was where the cost savings come from. So that was kind of the thinking on that. I will say like if you’re open to, you know, continuing the discussion just on rbts, we may be able to sharpen the pencil on that cost. I, you know, transparently I don’t know if we’d be able to get it under what you’re paying today though.
Kyle Brinkworth (09:12) Yeah, yeah, totally get it. Okay. Yeah, to the extent that whatever you’re able to send out of this package over to me, that would be great. I’ll have a conversation my, I think I said this earlier, but my heterocycle’s out for the next few days and I’ll… I will have a conversation with her on Monday during our one on one on this piece, I’ve floated this to her. But again, without saying some of the pricing, it was like look, I don’t want to waste both of our time, you know, having like a massive conversation on it, but I do think it’s important look. I think at the end of the day… credentialing has fundamentally changed. We’re we’re going to get delegation, which is going to help a fair amount, but still medicaid, you know, enrollments are challenging and that’s where we’re definitely going to continue to help. And I think as we look to just really spend a lot of time, I think there’s I think there’s some benefit for us to consider what the art of the possible is.
Philip Stefani (10:10) Absolutely. Yeah. Happy to align with you on that. However that ends up looking. I guess. So you’ll meet with your VP of revcycle next week. Would it be possible to either like get an intro to her, or set up a call with her?
Kyle Brinkworth (10:24) Yeah. Let me, let’s anchor to that next week is where we have two, we have two days off site and I’ve got a board meeting, so it’s a little crazy. And maybe we can look for like early the following week. I think that would probably be.
Philip Stefani (10:44) That’s the week of the 20 seventh, you’re saying?
Kyle Brinkworth (10:48) Yeah, or we could actually do, can we do the 20 fourth? Let me, well, let me do this real quick here.
Philip Stefani (10:56) Yeah. Happy to do the 20 fourth if.
Kyle Brinkworth (10:58) Can we, do you have flexible at like two PM eastern?
Philip Stefani (11:04) Two P. M eastern. Yes, I can send an invite for two PM eastern?
Kyle Brinkworth (11:11) I’ll forward it to her and give her just a quick hey here’s. What’s going on?
Philip Stefani (11:14) Okay, perfect. Great. So, and then in the meantime, I’ll send you this deck that we just looked at. And then, yeah, I think the, you know, what’s great about bringing in revcycle is like, hey, there’s also, you know, potential revenue acceleration here. There’s reduction in kind of days in Ar, and that’s usually the person who has that info for sure. Yeah, cool. Yeah. Well, Kyle, I really appreciate the time. I’ll send you these emails and if any questions come up, happy to be a resource.
Kyle Brinkworth (11:38) Perfect. Awesome. Thanks, Phil. Good to see you. All right. Thank you. Cheers, bye.