Assessing The Value of Web 2.0 on Knowledge Management A HEALTH CARE REIMBURSEMENT STUDY ICELW CONFERENCE JUNE 2013

Agenda About Me Research – KM and Web 2.0 The Industry The Organization KM Challenges Web 2.0 / KM System Qualitative / Quantitative Analysis Limitations

About Me Undergraduate in Management Work in Financial Services, Insurance, Healthcare MBA – Healthcare / Marketing MS – Industrial Relations (Economics) Adjunct Professor  Traditional, Online, Hybrid DBA – Operations and Information Management  Impact of Web 2.0 on KM  Mixed Methods Research  Expected 2015

Knowledge Management (KM) Strategies and practices used to identify, create, represent, distribute, and enable adoption of information and experiences Focus on objectives such as improved performance, competitive advantages, innovation, the sharing of lessons learned, integration and continuous improvement. Overlap with organizational learning includes a focus on knowledge as a strategic asset. Charlie’s Story…

Charlie’s Consulting Service Hitting Valve With Mallet……………………………………………….... $ 1.00 Knowing Where and How Hard………………………………………….$ 24, Total Due………………………………………………………………………... $25,000.00

SECI Model

Web 2.0 Second Generation of the World Wide Web. Collaboration and Information Sharing Online. Web 1.0 Static => Web 2.0 Dynamic Open Communication, Web based Communities Communities Of Practice/Knowledge Wisdom of Crowds Blogs, Wikis, Social Networks

Industry Overview Health Care Funding  Physician / Hospital Payments Third Party Payers  Government (e.g. Medicare, Medicaid)  Insurers (e.g. Commercial Payers)  Self Pay Negotiated Contracts Participating Physicians Large (and Growing) Physician Practices

Payment Process Physician Renders Service Claim Submitted to Payer Payer Processes Claim Payment Made to Physician

Payment Failure Points Physician Renders Service Claim Submitted to Payer Payer Processes Claim Payment Made to Physician Failure Coding error Output error Contract Error Administrative error Processing error Application error

Commercial Payers & Managed Medicare

The Organization - Consultant Services Understand Contractual Agreements  Virtually always changing  Administered incorrectly Review Billing and Payment Data  Monthly cyclical process Identify Physician Underpayments Work with Payers to Make Physicians Whole Payment on Contingency basis Account Managers Compensated on Successful Payment Recovery

The KM Challenge Know 10 – 12 Clients and 20 – 30 Payers  Different Contractual Agreements  Different Requirements  Multiple Projects in Flight  Monthly Data changes Understand the Impact of Regulatory and Administrative Changes Contract Renewal Dates Important Milestones  Rate Increases Coding Changes Knowledge Sharing across Clients and Payers

– Collaborate More Easily Work with Coworkers, Clients, and Vendors. Create, Follow and Contribute Discussions Make Announcements Share Documents, Coordinate Calendars Hold Web Meetings Manage Tasks, Build Web Databases Implemented and Developed Over Present

Home Page

Contract Models

Ad Hoc Reports

Task Tracker

Issue Tracker

Discussions

Reimbursement and Coding Updates

Client Issues

Quantitative Analysis Identify Contributions to Database Measure Results in Performance Tracked Monthly Results  42 Months worth of data Measure Correlation using SPSS  Pearson Product-Moment Correlation  -1 is a Reverse Correlation  0 is Absolutely No Correlation  +1 is a Positive Correlation

Client 1 / Payer 1 - Correlation

Client 2 / Payer 2 - Correlation

Qualitative Analysis Interviews with Individuals Increased Autonomy Convenient place to house information Good reference tool; less information to remember Ability to search Downloadable information for analysis Easy to use Consistent format data entry

Employee Engagement Increase in Employee Engagement Less dependence on asking the question More reliance on the data base More autonomy in work More continuity if people not available Increase in documentation “How did we get buy without it?”

Study Limitations Small Company size Specific Industry / Specialized Work Early inconsistent use of WebOffice Early inconsistent tracking of Monthly Financial & Operational Data Difficulty Coding Data Contributions  Timing and Quality Additional Study Opportunities  Comparing Separate Organizations or Industries

Questions? I hope to be back next year with additional information!