The interview below is part of a new series from McGuireWoods that features interviews with C-suite leadership of private equity-backed portfolio companies. To recommend a leader for a future
interview, email Holly Buckley at
Q: What do you believe is the most significant current challenge to
growing your business and what will be necessary to overcome it?
Healthcare and, specifically, healthcare revenue cycle are changing
drastically in the sense that there is a desire for payors and providers to
come together. Eventually, to get cost out of the system and achieve
improvements and efficiencies, this bridge between payors and providers
must be built. But in today's environment, there's a distrust between them.
Our job is to try to help resolve some of that distrust.
This is not necessarily a challenge to growing the business, but more
specifically, market dynamics that are affecting how this industry sector
will eventually evolve. There is still a great deal unknown about how to
eventually bring payors and providers together, especially as distrust and
misalignment in incentives persists.
I participated in a payor-provider summit a few weeks ago. The provider
said to the payor, "Will you let me see the margin that you are making on
this particular contract?" The payor's answer was, of course, "No." The
provider responded by saying, "But you are asking me to go through your
contracts and support price transparency. You want to see what my cost is
through this equation. Why is what's good for you not also good for me?"
As this exchange shows, getting payors and providers to work better today
is going to be a challenge. Our job in the revenue cycle often requires our
removing the barriers placed on providers, who are our customers, such as
authorizations, denials or other such issues. There are a lot of pressures
on providers today, including consolidation, payor behaviors and regulatory
changes, which is a big reason why our business is growing.
Q: What plans do you have to further grow your business and what will
be necessary to achieve this growth?
Our plans are to continue to grow, but at a pace consistent with our
founding ethos. We believe that, essentially, the devil is in the details.
We believe that technology is an enabler, but it is not the largest
differentiator between mediocre and great results. What we focus on is how
do we hire great people to effectuate results for our clients and do this
in a way that produces not only great financial results, but great customer
satisfaction as well.
We are very proud of our customer satisfaction results and want to continue
to grow the business around that ethos. We are adding some very innovative
technological capabilities around artificial intelligence, machine learning
and automation. We don’t do so with an eye toward replacing our people, but
rather to augment what they do and allow them to focus on the higher-value
work. We are looking at growing not into a tech company, but more of a
tech-enabled services company that allows us to be more efficient and make
Q: What do you think is the key to attracting and retaining your
Our culture is extremely important to me. It's the one matter I will never
compromise on. Since I started the company and was the first employee,
through today when we have close to 5,000 team members, we believe that you
need to treat people really well, whether they are mailroom associates or
have executive vice president by their names. Engagement, making people
feel valued, treating them like family, investing in their growth and
giving them a purpose are key parts of what we do.
Giving purpose is tremendously important in our work. We're in the business
of providing services to healthcare organizations. Typically, it's very
easy for nurses, doctors or clinicians to find a purpose in what they do.
It can be harder for billers, collectors or registrars to see how their
work translates into providing better care for patients. They sometimes see
it as purely transactional work. We make a daily effort to connect the dots
for our associates, illustrating the impact that excellent revenue cycle
performance has on clinical outcomes and patient experiences. Since we've
been able to align our $16-an-hour employees with purpose, our turnover is
much lower and engagement scores are outstanding.
People ask me, "What do you attribute your success to? How have you taken
the business from one employee to almost 5,000? How have you achieved your
client results?" I answer that the one thing we attribute this all to is
our culture and people. Retaining our people is my top priority. They are
the differentiator for us.
Q: What do you think is necessary to most effectively capitalize on the
momentum of your recent private equity investment?
One of the reasons we selected Golden Gate Capital (which
in Ensemble in August 2019) was the experience it brought with technology
outside of healthcare. It doesn't have any other healthcare assets; that
was a positive for us. We are trying to revolutionize the way that
healthcare revenue cycle management works and essentially apply many of the
lessons learned and value-adds from other industries. Our partnership with
Golden Gate is designed to add capital around our investments in technology
that will not, as previously stated, replace people, but help them make
better decisions and focus on value-add work versus transactions.
Our partnership is about the long view. Golden Gate has a perpetual fund
versus a set horizon to monetize the investment, so it is not on a three-
or five-year horizon. That was important to us. We did not want to need to
make decisions that negatively affected our customers and/or our associates
and how we are going to grow the business. We can take a five- or 10-year
perspective on how to make investments that will pay dividends for the life
of the investment versus trying to get the business to be the most
profitable within a three-year period.
Golden Gate wanted us to continue to run the business in a customer- and
associate-centric way, believing that if we do those two things and then
make additional investments in technology, the long-term result will be
exponentially greater than a short window of purely trying to work toward a
financial goal. This approach can be successful, but we've seen plenty of
examples where bad decisions are made that affect customers and associates,
simply to "succeed" in that three- or five-year window. We didn't want
that. We really felt that our long-term reputation in the marketplace is
more valuable than a short-term window to create profit.
About Judson Ivy
Judson Ivy founded Ensemble Health Partners in 2014 after spending almost
15 years as a revenue cycle executive in large hospital corporations. His
belief in loving what you do, providing excellent service and caring about
your team are at the core of the Ensemble Health Partners’ philosophy. Ivy
has extensive operational experience in helping providers maximize their
revenue cycle operations, in addition to his ability to drive innovation
within revenue cycle.
As vice president of revenue cycle at Health Management Associates, he was
responsible for regional service center operations, patient access
services, health information management and revenue integrity and
analytics. Ivy held multiple related positions with Community Health
Systems, including director of patient financial services, regional patient
financial services director and vice president of the regional service
center. As vice president at Community Health Systems, he was responsible
for establishing a new regional service center and received multiple
internal awards for his accomplishments.
Ivy is the co-author of "Cataract Surgery for the Revenue Cycle" and a
member of HFMA and ACHE.
To contact Judson Ivy, email email@example.com.