Presentation on theme: "Jim Schwamb, BayCare Health System Thomas Yoesle, Orlando Health Jose Rivera, Orlando Health."— Presentation transcript:
Jim Schwamb, BayCare Health System Thomas Yoesle, Orlando Health Jose Rivera, Orlando Health
Formed 2004 with support of PwC Dynamic survey of industry KPIs Membership Requirements ◦ One billion in net revenue ◦ Operating CBO ◦ Able to identify and report representative KPIs Purpose: ◦ Share valid KPIs on annual basis ◦ Share responses to challenges ◦ Share best practice approaches
No benchmarking tool that was valid ◦ Ability to collect and share data annually ◦ Ability to discuss/agree on KPI definitions ◦ Ability to revise KPI definitions as our industry shifts No tool that was specific to large CBOs Need to network ◦ Without distractions Need to improve performance ◦ Share successes and “non-successes”
Twenty-four CBOs In Florida ◦ BayCare ◦ Lee Memorial ◦ Orlando Health ◦ Shands Other states represented (NE, MN, KY, MO, VA, PA, CO, OK, LA, TN, IA, NC, GA, IL, TX, and Al).
Review of annual KPI Survey ◦ Time to discuss KPI definition/interpretation changes 5010 & ICD-10 readiness Patient Access quality issues ◦ Policy & Procedure discussion ◦ Regulatory requirements & how we have addressed them Biometrics for patient ID Time of service estimates & solutions W ho has implemented what vendor? How was the implementation? Vendor discussion Who are you using? For what? How is the performance? What KPI’s define success for the vendor?
Predictive analytics for charity and form 990H What BI systems are being used for predictive analytics? Employee turnover & retention strategies What training programs are being used/outsourced? What incentive program structures are effective? Accountable Care preparedness What I.T. infrastructure can handle an ACO model? Productivity enhancers Carrot vs. Stick? Automation is key! Selling Bad Debt What does the market look like across the country? Round table discussion
Each System Reports The Following: ◦ Services billed (i.e. hospital, physician, homecare) ◦ Systems Software Used ◦ Cost to Collect (Total, CBO, PAS, HIM) ◦ First Bill Pass Yield ◦ Net A/R Days ◦ DNFB & Hold Days ◦ Collection % by Payer ◦ Bad Debt & Charity Write-offs ◦ Uninsured and Prompt Pay Discounts ◦ Denials ◦ Upfront Cash Collection to gross revenue (ER & other) ◦ FTEs per 1000 claims (by function) ◦ Salary Survey
Things are not going to get any easier Medicare and Medicaid spending cuts Technology changing rapidly Larger Health Systems Standardization more difficult Our patients are changing New healthcare models
CBOs with the most outsourcing have the higher cost to collect (FTEs aren’t bad) Training and managing quality of registrars is key Assertive upfront cash collection translates to lower A/R days The annual meeting has had many wins ◦ Learning new approaches ◦ Networking ◦ Seeing different shops ◦ “best two day meeting I have ever attended”