Michelle Hicks has a lengthy and impressive resume of prolific achievements in the field of addiction, from trainer to program developer to consultant to full-fledged entrepreneur, and everything in between. A longtime New Yorker who earned undergraduate and graduate degrees in Arkansas, Hicks decided to move to Louisville, Kentucky in 2006 to explore an opportunity to change the way addiction treatment was delivered. After spending the bulk of her career working with clients suffering from addiction, she was consistently disillusioned by the corporate care models that failed to truly help patients transition into healthy lifestyles that would allow them to thrive. She believed Louisville had the right landscape and resources to enable her to advance addiction treatment and turn the existing model on its head.
“These corporate-owned programs weren’t servicing the integral parts of the human soul,” says Hicks. “They were too shallow, too surface, too rigid. I knew it could be done differently and I understood what the clients needed.”
Hicks had a vision for a fully integrated care model, but she was met with barrier after barrier. The leaders in her field said the program she envisioned wasn’t sustainable, yet these same leaders would leverage her ideas and her skills to improve their own delivery of care.
“For me it’s always been about saving lives, not about revenue,” Hicks remarks. “I wasn’t going to allow these corporations to use me to create and run their programs. I wanted to run my own program, so I started Louisville Integrated Care.”
At Louisville Integrated Care (LIC), founded in 2019, Hicks has worked tirelessly to develop, adapt and continuously improve a fully integrated approach to treating addiction – and keeping her clients clean. Her innovative model is essentially a “one-stop shop” for all the dimensions of care that an addicted client might require. And the numbers illustrate the effectiveness of her model. In the past year alone, her employee base has grown by 67 percent and her revenues by more than 3000%. Most importantly, upwards of 70 percent of LIC’s clients successfully complete the program, as compared to industry measurements that suggest less than 42 percent of addicts will complete a program.
“I attribute the growth of LIC to our integrated approach. We provide a continuum of assistance by sourcing stable housing, food, mental health services, therapy, medical care, access to groups and meetings, education, transportation to group and other destinations, peer support, and more,” comments Hicks. “Our clients spend time around sober people, they’re being tested to stay clean, and they’re being inspired to stay sober.”
Hicks continues, “Through our program, not only do they achieve sobriety, they also earn a professional certification in addiction care endorsed by the state. In our model, successful clients become our employees, so they can support new clients from a position of empathy and skill. It’s holistic, it’s spiritual, it’s about physical and emotional wellbeing, and accountability.”
Though Hicks’ passion is saving lives, LIC must also be financially prosperous in order to sustain her mission and fulfill her aggressive growth plans. As a business owner, she must focus on care while also giving adequate attention to the administrative and operational tasks that make an organization vibrant. As Hicks offers in her own words, “I can’t afford to have someone play with my money.”
When Hicks first opened dialogue with Nobility to discuss the company’s revenue cycle management services, she did so because she had been contracting with another billing company. A team of 10 people from that company supported her organization, but their behaviors and performance outcomes weren’t meeting her expectations.
“I had lost trust in that billing company,” said Hicks. “My employees have mouths to feed, so I have to make payroll. I can’t be patient while insurance companies delay payments. I need my billing partner to be aggressive about collections.”
Her first interaction with Nobility was with Brian Flynn, the company’s vice president of Business Development. Flynn introduced Hicks to other integral team members, including Vice President of Revenue Cycle Operations Faisal Bhatti and Operations Director Haroon Rashid, who worked side-by-side with Hicks to inform a strategy that would move her company’s RCM in the right direction. Hicks was in the process of introducing new practice management software into LIC, which added further complication to an already complex situation.
Hicks speaks to the importance of competence on a number of levels and how it influenced her evaluation of Nobility. Financial competence is an obvious requirement. Also critical is cultural competence, which suggests a recognition of the diversity within or between groups and also a true understanding of the differences that exist as a result of that diversity. In the case of her developing relationship with Nobility, she acknowledges it was bumpy at the start.
“I’m a New Yorker. I use a quick and direct tone,” said Hicks. “Add that I come from a different generation and ethnicity than some members of the Nobility team, and we had to work through our unique perspectives.”
The ultimate difference: Everyone was willing to communicate with each other, offer full transparency on processes and expectations, and collaborate to build a solution that could scale with LIC’s growth. Hicks wanted to learn exactly how billing worked, so she could monitor it with fidelity. She needed to understand what should and should not happen with her organization’s revenue cycle management, and she sought a partner who would teach her.
“Haroon taught me how to understand the billing and do it myself,” Hicks remarks. “I don’t have to pay anyone else because I can do it on my own. But I also recognize that handling our billing is not a one-person job nor is it the best use of my skills. Having confidence in Nobility’s handling of my revenue cycle has freed me up to mentor and support my staff and ensure my former and current clients are successful.”
Hicks gives Nobility’s team high marks, and she readily admits she only gives credit where it’s due. She believes the team under Haroon Rashid’s leadership is impeccable with its analytics and that Rashid himself has exceptional intelligence and the ability to comprehend forensically how to accomplish precisely what Hicks needs done.
“It was a miracle to find Haroon,” said Hicks. “He understood what we needed in the same way that I knew what we needed, but he had the analytics to prove it.”
Hicks has gained so much confidence in Nobility’s performance, she is now readying to open up two additional locations in different states. She and Rashid also enjoy a unique relationship, one marked by trust and respect.
“Haroon understands me now, and he knows when to be quiet and listen and when to offer his expertise,” comments Hicks. “He also knows I don’t have time to worry about people’s feelings when I’m owed $1 million from the insurance companies and I need to make payroll. His team aggressively works to collect the money I’m due.”
The key performance indicators used to evaluate Nobility’s performance for LIC illustrate that aggressiveness. Nobility has achieved an extraordinary 99.88% first-time pass rate. The days in accounts receivable is a full 10 percent lower than the average industry performance for this specialty and also lower than the Medical Group Management Association’s Gold Standard benchmark. Further, Nobility has completed the credentialing requirements for Medicaid and managed care organizations on behalf of Hicks’ practice in record time. All this has been accomplished while scaling with LIC’s dramatic growth, reflected by the nearly 100 percent increase year-over-year in patient visits.
Hicks also notes that the service is not inexpensive, but the quality of the work justifies the investment. She considers Nobility the “Mercedes of billers” and believes this high performance partnership between her organization and Nobility has been a contributing factor to her swift and remarkable success.
Hicks’ ultimate take on her RCM partner? “Nobility is a ‘bring it’ team.”