HomeTown 2011 Fall Meeting LEARNING OUTCOMES OF PRESENTATION: 1.Describe the findings of the 4 policy maker field trips that included 28 hospital facilities. 2.Out of the 28 hospitals visited during the policy maker field trips, identify the best practices among them. Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting. LEARNING OUTCOMES OF PRESENTATION: Describe the findings of the 4 policy maker field trips that included 28 hospital facilities. Out of the 28 hospitals visited during the policy maker field trips, identify the best practices among them. - PowerPoint PPT Presentation
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Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall MeetingLEARNING OUTCOMES OF PRESENTATION:
1. Describe the findings of the 4 policy maker field trips that included 28 hospital facilities.
2. Out of the 28 hospitals visited during the policy maker field trips, identify the best practices among them.
3. Discuss the upcoming legislative session.
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Premise of HomeTown Health Findings1. 27 Hospital visits May 2011-October 20112. Six Hospital Board Interventions Oct-Nov 20113. About 50 webinars 20114. Input from 5000 HTHU enrollees
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
What 10 years will do!1) Cost to Charge Ratio fall has created major
damage to CAH’s2) PPS at 85.6% of cost has done irreversible
damageThey got the message!
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall MeetingTypical CAH
Typical CAH Hospital Actual Data
Payor % cost reimbursement % Net Revenue by PayorWeighted Reimbursement by Payor
Net Revenue Cost Profit$22,000,000.00 $23,357,044.27 -$1,357,044.27
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall MeetingWe Learned Current State of Rural Hospital Affairs
a. Cash flow first half 2012 awfula. Add-onsb. DSH only half distributedc. Unsettled cost reports – several hundredd. Outlierse. Qualified Medicare Beneficiaries
b. 17 hospitals in “Transition”c. DSH only half distributedd. CEO Turnover and Turmoil
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings - Cons1. Overall Financial Crisis Among Rural Hospitals
A/R less than 5 days for many hospitals Minimum cash reserves
Payables over acceptable days
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons2. Lack of readiness for EHR in many cases
Have not filed with stateWho is Terri Brannigan?
The closest thing to the silver bullet!
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons3. C-suite Denial of severity of problems
Slow to reduce FTE’s or fix physician contracts
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons4. Poor Physician contracts - no RVU
Compensation Models or Performance Basis Contracts
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons5. Hospitalists programs being forced on
Hospitals
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons6. CMO Denials have wiped out cash
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Cons6. Failure to believe the following
a. $103,000 Net Revenue/FTEb. 43% salaries for net revenuec. Bad Debt at 8-10%d. Net A/R less than 50 dayse. 33%-35% commercialf. 40,000 population required to support a hospitalg. Baby Deliveries must exceed 350 AnnuallyOtherwise translates into necessary subsidy from DSH,
UPL or County
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
Findings Pros1. Excellent best practices identified
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall MeetingBest Practices Observed on Trips
1. MSO’s2. Quadax3. nTelagent4. Health Trust Purchasing5. Telemedicine – Blue Tooth6. DSH – HS&R’s7. EHR Plan for attestation8. CMO Appeal process9. Business Partner adoption
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall Meeting
THERE IS NO SINGLE SILVER BULLET OF RELIEF So .. what is the answer? Bundles of little Silver bullets!
1) Absolute control of Revenue Cycle2) Trend is employment of Docs with RVU contracts3) CAH’s MUST manage variance while squeezing dollars4) Consolidation and elimination of duplicative services5) Adoption of known Best Practices6) Develop leadership at local level7) Go to a new level of board and political education
Jimmy Lewis CEO, HomeTown Health, LLC , 10-21-2011
HomeTown 2011 Fall MeetingLEARNING OUTCOMES OF PRESENTATION:
1. Describe the findings of the 4 policy maker field trips that included 28 hospital facilities.
2. Out of the 28 hospitals visited during the policy maker field trips, identify the best practices among them.