Sage Intacct Advantage 2020 - How COVID-19 is changing the future of healthcare at Vera Whole Health

Derek du Preez Profile picture for user ddpreez October 22, 2020
The director of accounting at Vera Whole Health talks through the lessons learned from the COVID-19 pandemic and what it means for the future of work.


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Vera Whole Health prides itself as being a unique healthcare provider, within the context of the US healthcare system. For example, its mission statement outlines how healthcare as it exists today can't provide people with "whole health", as the focus is always on the absence of disease or infirmity. Instead Vera thinks about ‘health' as all aspects of physical, mental and social well-being. 

It's pricing model is also fairly unique for a US healthcare provider, where it charges employers based on a per month, per member fee, which aims to remove complexity and reduce ridiculous incentives found in other private policies. With a number of clinic centres across America, Vera states on its website that it is at the "vanguard of the healthcare revolution". 

This background makes it even more compelling that Vera is now discussing how the COVID-19 pandemic has shed a light on a broken healthcare system in the US and that healthcare once again needs to change. 

Brian Goldrick, director of accounting at Vera Whole Health, was speaking at Sage Intacct Advantage 2020 this week, where he discussed how the company is the onset of the pandemic has led to Vera digitising more of its processes, permanently shift to remote working, adopt telehealth initiatives, and think about a more automated future. 

In terms of the initial fallout from the novel Coronavirus on Vera's operations, Goldrick said: 

It's pretty obvious from dealing with this pandemic that healthcare is in need of a change. COVID-19 brought that to the forefront. There's cancelling of elective procedures, it's really having a huge impact on providers, our senior living has been hit really hard by this pandemic too. Patient volumes have returned, but it's an uncertain economy, it's shifting up and down. 

There's a lot going on with healthcare in general and how it is provided. Vera has been lucky in that we have a different model, because we have the revenue per member, per month guaranteed regardless of the number of visits that we have. So we were able to ride out this storm, so to speak, compared to other providers. But people are without jobs, which means that they're without healthcare, so you really have seen the decline in people. 

An acceleration of digital services 

Goldrick explained that during the height of the pandemic and during quarantine, Vera shifted all of its headquarters to remote working. Since doing this, the organisation has decided to adopt this model for the future, even once the quarantine restrictions are lifted. Goldrick said that it was a discussion that was happening internally already, but the pandemic has just accelerated the change. 

This shift, as well as the adoption of new digital technologies to carry out patient care, including telehealth, has meant that Vera has had to look at its processes, its backend and its paper-based systems. It is now thinking about how it can digitise and automate as much of this as possible.

In fact, the pandemic has highlighted to Vera just how much it has relied on paper up until now. Goldrick said: 

Things became obvious when we went into quarantine and we weren't supposed to go into the office - such as, how do you sign cheques? How do you get invoices paid when they're mailed in to you? That created a lot of headaches from a process standpoint. We were able to work with our bank and do an Excel spreadsheet and XML upload for them, they cut all our cheques, they have my signature on file there. 

We are also working with a lot of our vendors to make sure that everything comes through email or through our procurement system. So we really don't have as much as an impact now, compared when we went into quarantine. It's really been about establishing those processes. Now that we have them, we've made the decision as an organisation that our headquarters will be fully remote, beyond the quarantine. 

In addition to this, Vera has now also moved a significant proportion of its vendors over to ACH (automated clearing house) payments, which has saved on cost and time. Goldrick added: 

[This] cuts down on the number of cheques. Prior to quarantine we were printing all of the cheques in the office, I was signing all of the cheques manually. There wasn't a lot of value added to that process. Well, when we switched over to everything being electronic, the process went a lot smoother. When we started switching a lot of our vendors over to ACH payment it made payment a lot easier, a lot less costly. 

I think the cost to do a cheque was around 22 cents, but the cost in ACH is 15 cents. It just makes sense to save money where you can, especially when in quarantine and not being able to go into the office. The ability to upload our cheques made it a whole lot more seamless. It got rid of all of that manual printing and combining all of the support. That was the first thing we got rid of and it has been a huge cost saving, as well as time saving for my team. 

Vera is now looking to sublet its existing office space for the remainder of its lease, which also raises the question, according to Goldricks: What do you do with all the paper? He added: 

That's something that we are trying to figure out now. What is it that we need to keep? What is it that we need to get rid of? And moving forward, do we really need to be maintaining all of these paper copies? Let's just scan them in and get rid of them. 

The future needs change

As noted above, Vera and Goldrick's team are thinking about the future of healthcare post-pandemic, where they are certain that further change is needed. He said: 

This pandemic has put at the forefront that we need to change this model. How do we do that? What's the secret sauce? I think that's what everybody is trying to figure out right now. But it's in the process. Consumers are not happy with how this model is being provided to them currently and they're not happy with the services being provided. It took a pandemic to realise this, unfortunately, but healthcare needs to change. 

And one area of particular interest to Goldrick is the use of data to identify patient need across populations, as well as the use of automation and AI to better the healthcare provider's processes. He said: 

We get data from our customers and we take a look and analyse, what is it that is failing the population that we are going to be serving? And that's what we will focus our care teams around. In addition to that, AI is huge. That's something that I'm looking to include in our budget in 2021, just to help automate and make our processes a little bit faster. There's no reason that we can't have people analysing and reviewing the AI functionalities that are out there. Whether that be AP automation, or expense reporting, journal entry review. AI is the future. 

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