Kathy Oubre on Navigating the Aftermath of the Change Healthcare Cyberattack

The Change Healthcare cyberattack was a learning moment in that we need to have backup plans and to be able to pivot to continue to deliver high-quality care to our patients, explains Kathy Oubre, MS, CEO of Pontchartrain Cancer Center and a cochair of the Community Oncology Alliance's (COA's) 2024 Community Oncology Conference.

In addition to being 1 of 6 cochairs, Oubre also was a panelist for 2 timely discussions: "The Post-DIR Hangover: Underwater Reimbursement & Challenges" and "Revenue Cycle Management Success in Community Oncology: Measurement & Dashboards."

Transcript

How does meeting content reflect coverage of the Change Healthcare cyberattack?

The way that COA will interweave the Change Healthcare cyberattack into the COA meeting is really just by bringing that conversation in to all of the sessions that we have for this year's meeting, whether that's being more mindful of the current crisis during our cyberattack session or it really also brings to light the relevance of a very successful strong revenue cycle program within the practices. It's not going to really change what we're going to say. But it's going to perhaps bring a greater emphasis to some of the things that we are going to talk about.

Have providers been adequately compensated by payers given the scale of this disruption?

UnitedHealthcare, as well as CMS, did accelerate payments, or loan programs, to providers that requested it. Is that enough funding? I can't speak for all practices. For my practice, yes, I consider it adequate.

But what can the payers do to help us more? I think the payers need to work with practices to bring us back online faster. What do I mean by that? So just because we're doing better or back online, doesn’t mean that my organization can submit electronic claims with all of my payers. My largest commercial payer requires an EDI [electronic data Interchange] application; we are in process. So I still have 8 of my commercial payers that we are still not fully online with.

It's not necessarily, in my perspective, about another loan program at this point. I think it's more about the payers having workarounds or a strategy to bring practices online faster in a more efficient manner so that we can process claims.

What lessons can community oncology take away from how Ponchartrain has pivoted to adjust its operations?

Immediately right after the Change Healthcare cyberattack we were not able to verify benefits or eligibility in an electronic manner. We had to go old school and phone call our payers to confirm all of those things that allow us to deliver appropriate patient care. I think there are a lot of lessons learned there.

I think we have a lot of new staff that perhaps has never done that before. All they’ve known is that electronic way of doing things. Fortunately, we also have some more seasoned professionals within our organization. But it was a learning moment that we all need to be able to have backup plans, disaster plans. When things within our organization—be it something internally or an outside force—if we go down for a reason, we do need to be able to pivot and move in order to continue to deliver high-quality care to our patients.

So perhaps that was pulling some teams, or some people within our organization, who their sole job every day was to make those phone calls to all of our payers to verify eligibility, co-pay assistance, and appropriate co-pays or coinsurance on our patients, prior authorizations to keep our health care system moving.