Get Your House In Order! Doug Barry, President. Agenda Common Observations – Need Help? –Recognizing The Signals –Internal Resources & Limitations –Technology.

Get Your House In Order!Get Your House In Order!

Doug Barry, President

Agenda

• Common Observations – Need Help?– Recognizing The Signals – Internal Resources & Limitations– Technology– Human Capital

• Getting There– Developing the Plan

• Considerations for Partnering – Style Preference– Big Box– Focused Talent

Financial Performance Signals

• Declining Volume• Cash Comparison to Net Revenue• Bad Debt• Days in A/R• Cost to Collect• Vendor Expense

Financial Performance Signals

• Failure to Report and Evaluate Trends over 3 to 4 Year Period can result in a Miss-diagnosed Structural Issues.

• Also can help to identify root causes and a be a tool for building consensus with next steps

Failure to Forecast Operating Results to include Course Correction Initiatives Opens the Doors for Over/Under Reactions.

Patient Access Signals

• Administrative Denials• Reworking or Rebilling • Minimal Measurement Abilities• Minimal Accountability• Accuracy Rates of < 98%• Point of Service Collections are Minimal

Business Office Signals

• Cash Collections• Denials• Days in A/R• Bad Debt• DNFB• Reworking Claims

Business Office Signals

Uninsured Management Signals

• Minimal Pre-Service Financial Counseling Effort• Lacking Presumptive Eligibility Tools• Lacking Patient Liability Estimation Tools• Outsourced Services Unchecked• Minimal Outpatient Advocacy• Technology Needed• Customer Service Challenges• Patient Complaints • Emergency Department E&M Levels

Vendor Usage Signals

• Vendors Usage Lacks Optimal Results • Duplicative Conversations• Patients Confused• High Cost – Low Return • Performance Measurement Seems Secondary • Missing Accountability - Teeth• Not Aligned with Market Rates• Reporting Needs Not Being Met

Looking at Resources

• Existing Staff and Applicable Skills • Capacity to add Space and Equipment• Budget to Invest in the Right Technology• Staff Experienced Using Technology Solutions• Return on Investment• Financial Priorities

Planning the Project

• Determining the Budget• Setting Time Line Expectations• Gaining Management Support• Carve Out Where External Support is Needed

Selecting the Right Partner

• Big Box vs. Focused Talent– Scale– Time Line– Budget

• Level of Knowledge Needed– Broad– Detailed

• Key References• Tools Needed• Return on Investment

In-Source, Multi-Vendor, United Solution

End Game

• Managed Care Contracts are Claims Friendly• Vendor Contracts Reflect Market Rates and Contain

Performance Guarantees• Financial Performance Accountability at All Levels• Bad Debt is Trending Downward• Cash is 99% aligned with Net Revenue• Self Pay Cash Improves• Patient Satisfaction Scores Improve• Reporting Allows for Action

Questions?Questions?

Doug BarryPresident of Cardon Outreach

[email protected]

Phone: (281) 296-1771

Toll-Free: (800) 417-4845