Becker's Hospital Review

13 CFO / FINANCE 'We don't want people afraid': Inside Cleveland Clinic's revenue cycle AI literacy program By Andrew Cass A I adoption in healthcare has often outpaced the workforce's comfort with it, and revenue cycle departments, where automation touches coding, denials and prior authorization daily, are no exception. The Cleveland Clinic's revenue cycle department has gotten ahead of that discomfort by building its own AI literacy program for its employees, providing an opportunity to both upskill its workers and provide confidence and comfort with the new tools available to them. "We don't want people afraid and fearful," Cleveland Clinic System Vice President of Revenue Cycle Management Tracy Peffley told Becker's. Ms. Peffley sat down with Simona Vidican, the department's director of education and development, in the fourth quarter of 2024 to put together the plans for the program. In its first year, the program was made available to the revenue cycle department's leaders, before expanding to all of the department's caregivers — the term the system uses for all of its employees, regardless of role. "It was important to us to start at the top because our front-line caregivers are going to be looking at our leaders," Ms. Peffley said. Caregivers were already hearing, in the media and elsewhere, that AI could replace their jobs, she said, and leadership needed to be able to speak to that anxiety directly rather than let it go unaddressed. The program began with a needs- assessment survey to gauge revenue cycle leaders' baseline understanding of AI concepts and their comfort with the health system's internal ChatGPT and Copilot tools. Leaders then worked through AI Essentials self-guided training, covering core AI concepts, terminology and a glossary, ahead of an in-person leadership retreat, where workshops walked them through applying ChatGPT and Copilot inside Word, PowerPoint, Outlook and Teams, plus structured peer-sharing of best practices. Next, leaders competed in a two- track gamification competition, with monthly challenges run through a private Teams channel, a leaderboard and points awarded for completing tasks and for sharing best practices and resources with peers. Top performers were formally recognized in December at revenue cycle's town hall. From there, an AI essentials curriculum was built out for 2026 for the department's caregivers, learning from what worked and what didn't in its first year with the leaders. Ms. Peffley said they set an objective requiring 70% of employees to complete at least one course. They surpassed that goal five months into the year. "We were like, OK, that was way too conservative," she said. "Let's do 90% by the end of the year." Attendance has outgrown the division. Monthly sessions, often built around practical, relatable use cases, now draw interest from those outside the revenue cycle entirely. "They're hearing about it and wanting to join, and so we leave it open," she said. The department's work has also caught the attention of Cleveland Clinic's broader leadership. The division is presenting its approach in August at Cleveland Clinic's AI summit. Ms. Peffley said the department has seen increased engagement with AI, with employees leaning in and using its internal ChatGPT and other tools. "It's been nice to see that translate into real work." n said at the time. "We felt that the focus that was necessary during our turnaround necessitated pushing this off just a little bit." at discipline is now translating into growth, he said, with the system moving toward expansion in diagnostics, ambulatory surgery centers and virtual care. But the bar for new investment has shied permanently, according to Mr. Wexler. "We are much more focused and disciplined on the places where we will invest," he said. "We are coming out of a retrenching mode, and even a period of shrinking a bit, and we are now moving into a growth mode… Now, we're more focused on ensuring that the core is supported and that the risk is within reasonableness, given the challenges that healthcare faces in the years ahead." Bracing for what's next Providence executives have been clear that the turnaround is about building a cushion for the financial pressure ahead, particularly from HR 1, which begins phasing in Medicaid eligibility changes and work requirements in 2027. "With the Q2 results, Providence has now achieved more than a year of positive operating margin. While this is an important milestone, the real significance is what it allows us to do next," Providence CFO Greg Hoffman said in the Aug. 13 release. "Healthcare is heading into a period of significant financial pressure, especially with the expected impact of HR 1 in 2027. e progress we are making now will allow us to respond to those headwinds and better prepare Providence to continue serving patients through those challenges." Providence has already been preparing for that shi. Leslie Flake, the system's CFO of system and operations finance, told Becker's in August that HR 1 is forcing the system to plan for materially lower Medicaid funding over time, even though the law's steepest cuts have not yet taken effect. "We are budgeting for increased coverage churn, higher levels of uncompensated care and the gradual impact of reductions to state-directed payment programs," Ms. Flake said. "We face several hard decisions as reimbursement for safety net services will significantly decline." Despite that outlook, Providence continued to invest in its mission-driven work during the first half of 2026, reporting $1.1 billion in community benefit spending and $220 million in net investment gains from financial markets, according to the news release. n

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