1. Mission Impossible? (can I get music from Mission Imp theme song to play audio behind this?) Presented by: Kathryn D. Roby etc

2. Your mission, should you choose to accept it…is to insure the survival of your home health and/or hospice agency despite decreasing reimbursement, increasing competition and intensive scrutiny.

3. Will your Agency be a Survivor? (use the Survivor show graphic) (Outsmart-Outperform, Outlast) from their advertising (conference theme)

4. My Mission To provide you with : – Overview of currently available tools – Performance strategies – Corporate culture for success

5. Our Objectives Identify the Fiscal, Quality, Compliance outcomes that support “top performance goals” Identify the Fiscal, Quality, Compliance management tools that produce those goals Identify the strategies that foster success Identify the characteristics of a “survivor” agency culture

6. Strategic Planning: A Roadmap to Success A necessary investment Allocate sufficient time, staff, resources Utilize a structured logical process Base the plan on solid objective information Without effective, complete Strategic Planning, your “mission” will lack focus, resources and is at high risk of failure.

7. Who’s on Your Team? Your Survivor Team – Board Members 1-2, Executive/Officers and 1 other “Subject Matter Expert” (Physician, Attorney, Finance) – Senior Management CEO/Clinical Administrator/CFO/HR – Clinical Management 1 Clinical Manager/Quality Manager – Staff 1 Nurse/1 Therapist/1-2 Aides/1-2 Administrative office staff – Community 2-3 Consumers (lay people and referral sources)

8. The Foundations of your Plan Financial/Demographic Data Clinical Data Cultural Assessment Environmental Assessment

9. What is your “Survivor” goal? Do you intend to be the “last man standing”? Will your agency be the one that others see as their strong competitor? Will you be the agency others want to merge with? Or will your agency be the most desirable potential merger partner in your area?

10. The Roadmap Now that you have established the terms of your “mission”….. What are the three strategic goals that will accomplish it? – A financial goal provides the resources to do the work – A quality outcome goal insures you outperform the competition and increases referrals – A compliance goal insures that you will remain in the game – Goals need to be measurable, attainable, realistic

11. For example: A Financial goal: Positive growth in the financials with sufficient capitol to reinvest in technology and training for future needs. A Quality goal: Care Outcomes equal to or better than National benchmarks combined with positive HHCAHPS drives referrals A Compliance goal: Clean surveys insure smooth operations and no financial negative impacts.

12. “Its All About the Data” What do you need to know to accomplish these goals? How will you know if you have truly achieved them? Targeted tools will enable you to assess progress from beginning to “Mission Accomplished”

13. The Toolkit Fiscal Management Tools – Finance and Accounting Software with enhanced reporting capabilities – Full clinical to financial integration – Electronic billing/Remittance – OASIS Scrubbers for maximizing accuracy, revenue and utilization – Internal and External “Subject Matter Experts”

14. The Toolkit: Quality Management Optimize your performance against National/Regional Benchmarks – CASPER/HHCAHPS/Home Health Compare “Outperform” the competition for better market positioning by: – Chronic Care Management – Patient Self-Management Education

15. The Toolkit: Compliance Management Qualiance: Web based software for compliance scorecards – Insures positive outcomes on Survey – Reduces potential financial risk of failed Mobile Medical Review or Enhanced Enforcement audits

16. Strategies for Success Change is hard No-I mean true sustained change is really hard-but you can do it The real question is: how do I succeed in making positive change and keeping it going? Strategies for success can be found in the same tools we use with patients

17. Technically speaking…. “Instill motivation” (the desire to do it) “Rapid cycle incremental change” (small steps) “Positive reinforcement” (the pat on the back) “Frequent small wins” (keep it going) but what does this really mean in your agency?

18. It means….. S M A R T goals are not just for care plans! Specific: clear goals are articulated Measurable: defined and objective targets Attainable: realistic and acceptable to all Relevant: each links back to the primary “Mission” Time Based: progressive linked acheivable steps

19. The Trickle Down S M A R T goals apply at all levels Agency – Team Discipline – Individual staff Success builds upward and promotes itself

20. What does a “Survivor” culture look like?

21. In a “Survivor” culture, Staff voices were and are being heard Staff feel their actions make a difference The urgency they feel is for the survival of the agency They are part of the process The agency’s success is their success Each small step in the right direction is celebrated

22. Its not about Size Unlimited financial resources The latest technology Flashy advertising Promotional gimmicks or referral inducements

23. In a “Survivor” culture The agency is mission driven The staff clearly understand the mission They are all equally committed to the success of the mission They have the tools and the desire to complete the mission They share their mission success with everyone

24. In a “Survivor” culture.. Communication is the key Data is shared Training and support is available The S M A R T goal is shared with everyone Progress is tracked visibly in posters, charts, stuffers Success are rewarded

25. A “Real Life” Example Once upon a time, not so long ago,….. A small community based non-profit agency was acquired by a small community based hospital system. Surrounded by 3 large hospital systems with large home health/hospice agencies and one large chain provider, survival was in doubt.

26. Their “Mission”? Answering this question: What next? Close? Be acquired by a larger system? Merge with another agency? Or Thrive and grow?

27. The answer… Over a period of time: -Annual Revenues grew from $1.5 to $9.8 million -Average Daily Census grew from 150 to 700 -EMR/E-Patient Satisfaction fully implemented -OBQI/OBQM scores achieved National Benchmarks -Patient Satisfaction achieved the 95 th %

28. Mission Accomplished But how? Strategic Planning: – Immediately and at 3 year intervals A Goal Driven Implementation Plan – Specific, objective, targeted – Identified teams and dates Full Staff Involvement – Everyone had a role to play-from Managers to billing to aides, even the community volunteers Open communications – Posters, bulletin boards, frequent step achieved rewards – Internal and external publicity of goals met – Every success celebrated

29. Their Tool box A User Friendly EMR system Fazzi Patient Satisfaction Survey system Clinical/Financial Integration – Weekly Case Management Teams with Fiscal input An OASIS Scrubber (integrated into the EMR) – Staff/Team and Agency level performance goals Monthly CASPER reports – Reviewed at Clinical Staff and Management levels Intense Focus on communications/rewards

30. Sssh…..its a secret….. Who was that agency and where are they now? It was my agency…and today, they continue to thrive….and survive. They accepted the mission.

31. WILL YOU CHOOSE TO ACCEPT THE MISSION?

32. Can you bring together the right tools, the right information and the courage to use them? Will your agency “outperform” your competitors? Will your agency “outsmart” the others? Will your agency “:outlast” the others? Will your team be: THE SURVIVOR? (survivor logo and Mission Impossible music))