LUCKY US GREAT PARTNERSHIPS IN RCM
Tom McCormick
VP of Patient Accounting
Tony DiLuca Principal and Owner
MARCH2025
“Big Kahuna”
Jena R. Eggert
Founder&CEORCR|HUB
TOP O’ THE MOR
In this edition, I had the absolute pleasure of spending an hour with “The Big Kahuna” and Tony DiLuca two gentlemen from different sides of the aisle, one a provider and the other a business partner. I’d usually throw in a pun something about luck (since it is March) but the truth is, it was an honor to spend time with them and hear their insights.
One of the key takeaways from our discussion? Never give up. Get involved with the client. Think patient-first. No matter which side of the aisle you're on, success comes from persistence, connection, and always keeping the patient at the center of every decision. A little luck, a lot of hard work, and plenty of blessings can make all the difference.
As we continue our journey through 2025, I am amazed daily at the innovation our business partners are bringing to the table Our next showcase will focus on prior authorization—the advancements, the investments, and how getting it right is going to benefit everyone
RNIN’!
At the heart of it all, innovation drives progress but human connection is what truly makes it happen. Business partners create the solutions, but to bring them into healthcare systems, it takes trust, relationships, and a real understanding of need At the HUB, we connect It’s our CommUnity that builds the relationships, fosters trust, and ultimately gets contracts signed creating partnerships that last entire careers.
And speaking of connections, on a personal note, we recently lost a great soul Eric Currie Looking back at his texts to Keith and me, he was always so positive about his treatment, such a fighter, and even in the midst of his battle, he never forgot to say, "I hope you guys have a great week," or "Thank you for reaching out, I hope you’re doing well." His infectious smile and kind spirit will be deeply missed I don’t know why life reminds us in these ways, but loss always makes us pause and puts everything into perspective. Our thoughts and prayers are with his entire family and our CommUnity.
And since everyone’s a little Irish around St. Paddy’s Day, I’ll leave you with this:
"May the road rise up to meet you, may the wind be always at your back. May the sun shine warm upon your face, and the rains fall soft upon your fields. And until we meet again, may God hold you in the palm of His hand."
Sláinte
Jena Eggert Editor-in-Chief, RCM Connections
TABLE OF CONTENTS
INTERVIEW
Tom McCormick and Tony DiLuca talk about successful partnerships
WHO IS PATHS
An insight into the RCM Business Partner
METRICS THAT MATTER, PERIOD OR QUESTION MARK
SME Article by Jennifer M. Worthy
LEARN MORE
Interested in knowing more about RCR|HUB?
TJena: Welcome to another edition of RCM Connections Magazine! I’m thrilled to have Tom and Tony here today As always, I’ll let the gentlemen introduce themselves
Tom McCormick: My name is Tom McCormick, and I’m the Vice President of Patient Accounting at the University of Pennsylvania Health System Though unofficially, I’m often referred to as the Big Kahuna we call our revenue cycle space Kahunaville- Where Cash is King. In fact, more people at Penn probably call me Big Kahuna than VP of Patient Accounting!
I’ve been here for nearly 40 years, starting as the Director of Patient Accounting, then Associate Vice President, and now Vice President. I always say that as I grew, so did the health system both literally and figuratively
Jena Eggert: See, I could never have done that title justice! Tony, I’ll hand it over to you.
Tony DiLuca: I’m Tony DiLuca, Principal and Owner of PATHS, LLC, a full-service Revenue Cycle Management company operating in Pennsylvania, New Jersey, and Delaware.
We also work outside the region, but I’m proud to be part of this business, having started back in 1982.
Over the years, I’ve seen massive changes in RCM, and I’ve seen how resilient we are as an industry It’s not always easy, but we’ve adapted, grown, and found ways to improve care while managing the complexities of healthcare finance. I truly appreciate being here today and having this conversation with Tom
The Provider & Business Partner Relationship
Jena: Let’s start by discussing your partnership. Tom, can you talk about your business relationship with Tony and how you handle partnerships at Penn?
Tom "Big Kahuna" McCormick: Sure Tony and I actually had an interesting start. Our first interaction was through Mars, a company he used to lead before it was sold. Back then, I didn’t work directly with Tony, and frankly, our experience wasn’t great
So, when Tony started a new company and my CFO introduced us, I had some reservations about working with him again. But we decided to give his new company a small piece of our business, starting with physician-related work and he did a fantastic job.
From there, the relationship grew. We built trust. At Penn, we outsource quite a bit of our revenue cycle management, and Tony’s company has become a major part of our strategy. PATHS helps us with Medicaid eligibility, small balance account management, and RCM support for both inpatient and outpatient services.
Now, over 25 years later, our partnership is built on trust, open communication, and shared decision-making. I don’t see outsourcing as just a business transaction it’s an extension of my business office. I know that my team or even myself can call Tony’s team anytime, and they’ll respond like they’re part of Penn.
Jena: That leads perfectly to my next question. Tony, what was it like rebuilding that relationship, and how did it evolve into the strong partnership you have today?
Tony DiLuca: PATHS is one of the few remaining smaller, regional RCM firms. Most of my peers have sold their businesses to large, national companies and I respect their decision For many, it was the right time for their families, employees, and business goals.
But for me, this isn’t just a business I love it I truly love my clients and what we do I also don’t buy into the negativity you sometimes see regarding our healthcare. I believe we have one of the best healthcare systems in the world.
At Penn, our value isn’t just in RCM expertise, but in our hands-on approach I personally attend every meeting and stay involved in all aspects of our work. We compete with large national firms by offering high-level customer support, expertise in Epic, Medicaid, and complex reporting, and a personal commitment to our clients’ success.
Tom can call me 24/7 and he does! We meet with his team multiple times a day. Some meetings, he attends; others, my team works directly with his managers But the point is, we’re always in sync.
And we don’t just provide a service we give back. For example, we help Penn with community outreach initiatives, like assisting uninsured patients in getting coverage. We do these programs at no additional cost, simply because it’s the right thing to do. That’s what makes this partnership unique.
Big Kahuna: I want to highlight something Tony just mentioned because it’s important. As a health system, we engage in community outreach, hosting health fairs and enrollment events to help uninsured patients sign up for medical assistance or the health exchange when the season opens.
Three of our downtown hospitals are located in some of the poorest neighborhoods in the city. Tony’s team has played a huge role in these efforts. They don’t just process claims they actively help individuals obtain coverage, ensuring they have access to care
One moment that really stood out was when Tony and his team volunteered their Sunday afternoon to join us in the community. They sat alongside our financial advocates, working directly with patients, answering questions, and helping them navigate the enrollment process.
And here’s the thing they did this without charging anything extra Tony and his team believe in giving back, and that commitment speaks volumes. It’s not just about business it’s about helping people. That’s the kind of partnership we have, and it’s why I trust them completely.
But for me, this isn’t just a business- I love it. I truly love my clients and what we do
Tom "Big Kahuna" McCormick: This is my favorite question! Nobody grows up thinking, “I want to be the Director of Patient Accounting at the University of Pennsylvania Health System.” It’s just not a job kids dream about!
For me, it was a bit of luck I was a starving college student, working as a radiology file clerk at Temple University Hospital while getting my degree. Temple helped pay for my tuition, and after graduating, I was interviewing for various jobs insurance sales, retail management, even fast food!
One day, the Director of Radiology asked why I was all dressed up. She introduced me to the Chair of Neurology, who needed a Business Manager. I had zero experience, but he took a chance on me
From there, I earned my MBA, moved into hospital finance, and became Temple’s first Director of Patient Accounting a role that didn’t even exist before the 1980s. Eventually, Penn recruited me, and I’ve been here since 1987
Tony DiLuca: A lot like Tom, this wasn’t what I planned to do.
My father immigrated from Italy and became a contractor His dream was for me to become a doctor. I enrolled in Drexel University’s pre-med program, but I knew early on that it wasn’t for me. I hated hospitals just visiting made me nauseous! Luckly, Drexel had a co-op program During my first placement, I became a brewmaster at Schmidt’s Brewery.
For my second co-op at Drexel, I began working at a hospital in Germantown, which was a city hospital located in a different area One of these areas, as Tom just mentioned, had a lot of uninsured patients and many self-pay cases. As a coop, I worked in the emergency room doing registration and in the medical records department, where I assembled records manually I entered the numbers one by one until I eventually advanced to a position in the business office as a co-op in the finance department, which aligned with my major in accounting. I switched majors, and there, I learned about cost reporting and hospital accounting, and I worked on the cost reports
Eventually, it became a full-time job for me. They helped me attend night school. I completed my degree at night while working, and like Tom, I ended up in patient accounting This is how my career began, trying to fulfill my father's wish for me to become a doctor. I stayed within the medical community and worked at a couple of hospitals. I was at Germantown and also worked at another hospital in the Delaware Valley called Main Line Health, which was part of Bryn Mawr Hospital at that time. From there, I received an opportunity to work for a vendor, took it, and have never looked back since.
Technology & Automation in RCM
Jena: We’re living in an era where technology is advancing rapidly. In RCM, we talk a lot about automation improving the patient experience. Tom, when you recognize a process that could be automated, how do you evaluate potential partners?
Tom "Big Kahuna" McCormick: Great question! Necessity is the mother of invention.
For example, take Medicaid eligibility it’s an incredibly difficult process. The patients needing assistance often don’t understand how it works. Some fear applying because of misinformation, like worrying that the state will put a lien on their house or that it might affect their immigration status.
Initially, we tried managing it internally, but once a patient leaves the hospital, the likelihood of completing an application drops significantly That’s when we knew we needed a trusted partner.
We started working with Tony’s team at PATHS, giving them cases where the patient had already left They tracked them down, provided guidance, and even accompanied them to county assistance offices when face-to-face applications were required. Their approval rates were outstanding well over 90%.
As Penn grew, we expanded Tony’s role to handle eligibility from start to finish, embedding his team onsite in our emergency rooms.
I was skeptical at first, but they proved me wrong we now cover nearly 40% of our uninsured emergency department patients, a huge win for both patients and the hospital
Jena: Tony, on your end, how do you develop and implement technology solutions for Penn and other clients?
Tony DiLuca: We’re constantly adapting and evolving. At PATHS, we work across many aspects of RCM from Medicaid billing to behavioral health claims, out-ofstate enrollments, and provider credentialing
Technology plays a huge role, but the key is knowing when and where to use it. There are a lot of automation tools out there, but not everything should be automated some processes require a personal touch
For example, with Medicaid eligibility, we’ve tested different automation models, including AI-driven outreach and selfservice portals Some worked well, but others had minimal impact That’s why we balance tech with human expertise, ensuring patients don’t slip through the cracks.
Beyond internal IT teams, we also work with consultants to explore new RCM innovations. We’re constantly asking ourselves:
Can we do this differently? Why did this happen? How can we improve?
If you’re not constantly rethinking your approach, you’ll fall behind.
Advice for Future RCM Leaders
Jena: What advice would you give to someone looking for a career in RCM?
Tom "Big Kahuna" McCormick: Network, network, network. I tell students and interns join professional organizations like HFMA
Attend meetings, meet people, and put yourself out there. Opportunities don’t just happen; they come from connections.
At Penn, we run a summer internship program for college students in finance and healthcare administration. We expose them to real-world RCM operations, give them projects, and even have them present their findings to senior leadership.
Many of these interns go on to work in RCM but it all starts with getting involved.
Health Fair in Philadelphia that Penn and PATHS volunteered at:
Tony DiLuca: I agree 100%. If your company won’t cover conference fees or membership dues, pay for it yourself it’s worth it Get out there, volunteer, attend meetings, become a thought leader, and speak. Invest in yourself.
Jena Eggert: Many top-level RCM executives don’t have travel budgets, so they participate in provider panels and roundtables where associations cover costs. Even at the highest levels, networking is invaluable.
Big Kahuna: Exactly! We also do succession planning internally When we see promising talent, we invest in their growth.
Sometimes, people move on to other opportunities and that’s okay. We recently had a supervisor leave for a competitor because they had a better role available. I couldn’t be happier for her! One day, she might come back to Penn, and when she does, she’ll bring even more experience with her.
Final Thoughts
Tony DiLuca: I love this business The relationships, the people, the impact it’s incredibly rewarding. At the end of the day, we’re not working for Google or Apple we’re working in healthcare, helping patients and families every day.
Big Kahuna: I couldn’t agree more RCM gets a bad rap sometimes, with people thinking we’re only about money and collections. But the truth is, if there’s no margin, there’s no mission.
Keeping hospitals financially strong means keeping the lights on, supporting staff, and ensuring patients get the care they need.
That’s why we do what we do
If your company won’t cover conference fees or membership dues, pay for it yourself— it’s worth it. Get out there, volunteer, attend meetings, become a thought leader, and speak. Invest in yourself.
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With more data capability comes more questions in revenue cycle operations and the interest in revenue cycle data continues to explode, taking exciting new turns into conversations many of us are fairly new in navigating. Over the last several years, data capability and stake holder interest has left revenue cycle leaders questioning their tried and true measures of performance as clinicians, operations and finance counterparts take a much needed place in making sense of them all. Along the way, and I have witnessed this many times over now, revenue cycle KPIs have somehow morphed from performance indicators, early warnings of problems and even what defined good quality into new territory of a cut to the chase cash story. Oh, if revenue cycle operations were only that simple!
Cash is King
Claim payment is the ultimate goal of any revenue cycle operation. Conversely, being able to explain why payment wasn't made is equally important My career has long practiced by the mantra that a revenue cycle leaders role is to get paid quickly, get paid accurately and, when payment wasn't made, what can be done to avoid it in the future No billing operation is going to retain 100% of revenue but there is always a lesson to be learned and tracking what matters gives us the leads we need.
What does matter
Production Standards Matter - Even Starbucks needs to gauge how many cars they can get through the drive through in an hour and you need to know the production ability and expectation of every step of your claim journey Where RCM leaders make mistakes in production measures is to use them for performance reasons. However, simply put, you need to know the most efficient way to progress a claim in its journey, how many claims have to move through that step and assign it a turn around time to meet your claim demand. Teams feel overworked and make errors when they cannot keep up with the demand of the work or systems and processes have overcomplicated a step in the claim journey. The truth is told in regular work observations and setting realistic throughput measures. You will never know what you need if you don't know how much you have
Where You Have Delays Matter - DNFB, charge lag, unbilled, unsigned notes, unfinalized and even late charges - any place a claim is in holding for the next step must be quantified in volume and dollars This is especially important if your billing system ages your A/R on date of service and not date billed.
Where You Collect Cash Matters - Time of service collections, payments from statements or over the phone and collection agency payments tell the story of when you collect patient cash to drive better patient A/R processes and minimize bad debt write off and costly statement expenses
Claim Accuracy Matters - Clean claim rate and payer rejection rate are your first warning of revenue leakage and your claim edits deserve a second look when you see the same reasons repeatedly It is usually the first indicator of credentialing issues as well. It is always better to catch issues before they get into the vicious denial cycle.
How Long To Pay Matters - Days in A/R, aging by financial class and dollars / percentage > 90 days is always going to matter. I could even make an argument in present day that A/R > 60 days aging deserves far more attention and should be the new standard With tightening timely filing windows and a Medicare population now > 50% enrolled in an MA plan, day 90 is just too late.
Informational Denials Matter - Payers will keep requesting records and revenue cycle operations will keep feeling helpless until they start tracking them. Carve them out but do not suppress them from your denial data. Unreasonable informational denial rates are great ammunition in contracting conversations
Fatal Denials & Net Collections Ratio Matters - Don't chase a clearinghouse denial rate, track down what happens in your billing system that led to a write off Tracking a net collections rate is a great indicator of preventable denials and non contractual write offs that can drive true change and RCM improvements.
Cost to Collect - Every revenue cycle leader should set as a personal goal not only to know their cost to collect but use it as a guide to improve it every year. We can't be narrow minded in solutions when healthcare administration costs continue to increase and we must be mindful that healthcare dollars are best spent in patient care functions.
Claim Line Item Denials - A claim was partially paid, great What about the rest of it? Claim line item denials are not underpayments and they are much harder to find. Devising a system that routinely reviews adjustments for non covered charges is critical to minimizing revenue leakage
Payer
Adherence to Contracted RatesFee schedule mishaps don't just happen when rates are updated. It is estimated up to 7% of all revenue is lost each year to underpayments in healthcare (MGMA 01/2024). Investing in a system to identify these is typically a very easy business case to make.
Patient Access Metrics - Insurance verification, financial clearance, authorization rates - measures typically associated as operations metrics - are more important than ever to revenue cycle leaders. If you have heard the phrase "how you start something is how you will end it", well, dirty data in usually means no cash out.
Emerging metrics that matter Conclusion
Revenue cycle management has become a complex claim journey that passes through many hands and places long before payment can even be determined let alone made. It is deserving of tracking and visibility in a straight forward manner that every stakeholder can understand A revenue cycle leaders most important position with data is to tell the claim journey story. It is to visualize the data and speak confidently to every step and why it matters in the collection cycle. Doing so successfully builds trust in our leadership and the teams we are proud to call our own.
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ERIC JOSEPH CURRIE memory of I N L O V I N G
D E C E M B E R 2 3 , 1 9 7 8 –
M A R C H 4 , 2 0 2 5
HE WAS A LIGHT TO EVERYONE HE MET, BRINGING WARMTH, KINDNESS, AND JOY WHEREVER HE WENT. HIS PRESENCE BRIGHTENED OUR LIVES, AND HIS MEMORY WILL CONTINUE TO SHINE IN OUR HEARTS FOREVER.
Our thoughts are with his family, friends, and colleagues during this time.
