Q&A with Dominic Foscato of Sift: A data-driven approach to financial engagement


AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the patient billing and payment space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

Milwaukee-based Sift expands on basic payment portals and propensity-to-pay scores with its predictive analytics that provide actionable insights about patient responsibility and create a clearer picture of which patients will pay and when. AI-powered tools segment patients and generate individualized recommendations to help health systems reach out to patients in the right way with the most impactful content. Sift’s C-Suite intelligence tools leverage propensity-to-pay analytics and other data to provide powerful insights into patient populations, with 360 degree views of patient behavior and utilization trends.

Vice President of Growth and Client Operations Dominic Foscato is a healthcare industry veteran, with more than 20 years of experience advising healthcare executives through market disruption, innovation, consolidation and growth. Prior to joining Sift, Dom served as Vice President of Provider Operations for Olive, Managing Director at GE Healthcare Partners, and a Senior Director for Healthcare at Huron Consulting Group. In his leadership role with Sift, he leads a team that delivers scalable and intelligent revenue cycle automations for healthcare organizations across the country.

Q: Can you tell us about your company and the challenges you are solving within the patient billing and payment space?

A: More than ever, health systems need to adopt a data-driven approach to patient payments. Patients payments account for up to 30 percent of hospital revenues, but collecting from patients is often much harder than obtaining reimbursements from payers due to complexity, regulation, and patient means. Sift Healthcare equips health systems with an integrated data-driven toolset to drive patient financial engagement, which allows health systems to: 

  • Pre-clear patients upfront
  • Get more patients on payment plans, earlier
  • Execute omnichannel contact across the entirety of the patient journey, so the right patients receive the right messages through the right channels
  • Help patients commit to meeting their financial obligations before service
  • Utilize an integrated view of insurance-patient responsibility to present and early and accurate summary of patient responsibility and optimize account resolution
Q: How does your company differentiate from other vendors addressing patient billing and payment?

A: Sift leverages providers’ own historical data to deliver tailored patient financial engagement recommendations. Our platform uses advanced analytics and machine learning integrations to provide detailed patient account segmentation and recommendations for the best course of action for individual accounts. 

  • Several vendors score patient accounts, but Sift goes way beyond propensity-to-pay scoring–while a score is a nice touchpoint, it doesn’t affect outcomes. Our AI scores and segments, but goes a step farther to interpret and recommend the appropriate action.. 
  • Sift’s solution applies true machine learning that encompasses more data points than competitive solutions. Our robust approach to data normalization allows Sift to segment patients more precisely and deliver highly tailored payment plan recommendations and insights for providers. 
  • Our integrated and dynamic approach makes daily adjustments to patient segments, work strategy and payment plan recommendations.
  • The Sift platform is system-agnostic. Our technology seamlessly integrates into existing workflows.
Q: What are some of the biggest changes your company has seen around how health systems are approaching patient billing and payment, given the changes in the landscape over the past couple of years?

A: In order to allocate resources more effectively, health systems are looking to limit patient collection outsourcing or at least employ a more strategic approach. Strategic outsourcing is only possible with precise data on how different accounts will perform and the corresponding segmentation. When health systems have data-driven insights to predict how accounts will perform, they can better manage costs related to labor and outsourcing. In addition, hospitals already invest immense amounts of time and money into EHR deployments–they want to deploy this existing infrastructure to drive patient collections. Solutions that can integrate predictive analytics into EHR-based workflows have become a major point of interest for health systems. 

Q: What does an ideal client look like? How are health systems best organized for success in advancing their patient billing and payment capabilities?

A: Sift’s most successful health system clients typically take in more than $600 million in net patient service revenue, with strategic imperatives to reduce costs or increase cash. They also have sufficient internal capacity to provide leadership, data, and change management.

In addition, our ideal clients recognize the value of their payment data and want to leverage that information. These health systems emphasize proactive financial engagement and are committed to working with patients to help them meet their obligations. Appropriate IT resources are another major asset–the biggest hurdle we encounter is the ability of health systems to provide data.

Q: What measurable outcomes have you seen from your clients?

A: In a side-by-side test for a $5.5 billion NPR health system, Sift was matched against the provider’s existing propensity-to-pay vendor. Sift’s patient scoring and segmentation, workflow optimizations and detailed operational reporting increased patient balance liquidation and facilitated more strategic outbound calling efforts. During the 120-day test, Sift drove a 6.5 percent increase in collections across all accounts, which represented an annual impact of $3.9 million. 

In a similar test for a $2.7 billion NPR health system, Sift drove a 2 percent increase in dollars collected across all patient accounts, which represented an additional $1.5 million in absolute dollars collected. This client also saw a 3.2 percent increase in patient payments with Sift’s targeted “payment plan” segment. Sift also reduced outbound patient collection calls by roughly 20 percent for this client–while increasing right patient contact rate by 8.5 percent.

Q: What major functional enhancements and/or product investments are you making in the near term to keep up with evolution in the market?

A: Sift’s work in Extended Business Office payment plan provisioning with 18 different health system clients has demonstrated that payment plans translate into more payments in less time. In 2023, we’re partnering with a $4.9 billion NPR health system to launch a pilot program that integrates payment plan recommendations into their patient engagement platform. This partnership will empower the health system to leverage Sift’s analytics and recommendations to offer flexible payment options as early as scheduling or registration. Offering payment options earlier and more often in the patient journey leads to better financial engagement and increased account resolution.

Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to better patient billing and payment experiences?

A: EHRs are aggressively launching patient-facing payment technology and taking business from non-EHR patient engagement platforms. Health systems should develop strategies to leverage EHR tools with data-driven intelligence and analytics in order to improve patient collection outcomes, increase efficiency, and better manage the cost to collect.

Many providers have come to rely on third-party financing companies to help patients pay for care. But this can be costly to providers, who are paid discounted amounts upfront while patients are liable to a third-party company. Increasingly, providers understand the need to own the patient relationship. With the right analytics, they can capture more upside while reducing their cost to collect. These benefits will only magnify as borrowing costs continue to increase.

Q: How do you see patient billing and payments evolving in the next two to five years and beyond?

A: Increasingly, patient payments are moving earlier in the billing process. This shift will continue in the years ahead with continuing demands for price transparency, enforcement of no-surprise billing legislation, and more broadly, consumer expectations around billing estimates and more manageable payments. Providers will have to adopt strategies and solutions that allow them to deliver estimates early and drive financial engagement at the front end of the patient journey.

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