Helena Lefkow is seasoned at identifying the practical implications of Medicaid law, regulation, and policy on hospital and health systems revenue cycle operations. She has extensive experience working with state agencies, health plans, associations, and other stakeholders to resolve Medicaid managed care and commercial payer billing and payment issues.
Prior to joining HMA, Helena served as senior director of Managed Care Policy at the Illinois Health and Hospital Association (IHA), where she was responsible for developing legislation, policy positions, and advocacy strategies to address a wide range of government and commercial managed care payer issues. In this role, she helped craft meaningful legislation to reform the Medicaid managed care program and secure telehealth coverage for commercially insured Illinoisans. She worked closely with state agencies and health plans on the implementation of new laws and regulations affecting hospitals and health systems, including the development of administrative rules on Illinois’ Medicaid managed care provider dispute resolution process and hospital readmission policies.
Helena also oversaw IHA’s Patient Financial Services program, which provides hospitals and health systems with current information on regulatory and administrative changes affecting revenue cycle operations; a forum for sharing best practices and addressing collective revenue cycle concerns; and technical assistance on a variety of Medicare, Medicaid, and private payer billing and payment issues. In this role, she led IHA’s efforts to resolve hospital billing and Medicaid managed claims processing errors, which led to creation of a comprehensive billing manual for hospital services and helped reduce the claim denial rate from 10 percent in 2018 to 5 percent in 2020.
Helena received a Master of Public Affairs, with a concentration in health policy, from the University of Wisconsin-Madison, and a bachelor’s degree in history from Northwestern University. She has served as a member of the Illinois Workers’ Compensation Medical Fee Advisory Board and the Illinois Child Welfare Advisory Committee convened by the Illinois Department of Healthcare and Family Services.