1. P R E S E N T E D B Y: Corporate Reimbursement Strategies January 26, 2009 Eric Lucas Senior Director, Government Programs Mike Smith Director, Reimbursement

2. 2 Cost Report audit findings inconsistent throughout system Regulatory knowledge not utilized effectively Reimbursement opportunities ignored Vendor arrangements inconsistent between hospitals Compliance concerns Corporate Reimbursement: Early Observations

3. 3 1.Ensure Appropriate Reimbursement 2.Standardization & Best Practices 3.Maintain Program Compliance 4.Communicate Timely Program Information 5.Advocacy Objectives

4. 4 Reimbursement Managers covering multiple sites Out of the hospital and into the central business office More duties become managed under corporate initiatives/directive Communication and project management skills Reimbursement Personnel Trends

5. 5 Standardization & Best Practices Extract system benefits from local successes Identify unique skill sets in local markets for system-wide opportunities Adopt best practices into standardized procedures –Government reporting –Accounting

6. 6 Cost Reporting Accounting Reserves Compliance Disclosures Vendor arrangements Education & Training Policies and Procedures

7. 7 Maintain Program Compliance Work closely with Compliance Department P&P’s are reviewed periodically to address new or changing compliance issues Standardization Review

8. 8 Communicate Timely Program Information Stay current on government payment matters Identify appropriate recipients for regulatory information Consistent communication is key Strategic understanding of changes Resources

9. 9 Education : HFMA American Health Lawyers Association State Associations Publications & References CCH / Medi-Regs Dennis Barry’s Reimbursement Advisor Various Association Newsletters American Hospital Directory website Equally important to the Corporate team has been the external advisors in our networks. Resources

10. 10 Advocacy Commitment to this area has increased Recognize trends and policy proposals early Strategy and analysis Communication

11. 11 Ensure Appropriate Reimbursement Recognizing reimbursement changes; Collaborating with other departments; Developing procedures to identify appropriate reimbursement; Ensure all appropriate reimbursement is claimed “Make sure all the fruit is harvested”

12. 12 CHALLENGES Focus Getting it all done Staying current Remaining flexible

13. 13 CHARACTERISTICS Integrity Perseverance Optimism Experience

14. 14 AREAS OF CONCERN Group Appeals Individual Appeals Wage Index Bad Debts IME/GME Reopenings DSH

15. 15 CONCLUSION Keep focused Remain optimistic Never give up Questions?