Jim Schwamb, BayCare Health System

Jim Schwamb, BayCare Health System

Thomas Yoesle, Orlando Health

Jose Rivera, Orlando Health



Formed 2004 with support of PwC



Dynamic survey of industry KPIs



Membership Requirements

◦
One billion in net revenue

◦
Operating CBO

◦
Able to identify and report representative KPIs



Purpose:

◦
Share valid KPIs on annual basis

◦
Share responses to challenges

◦
Share best practice approaches


No benchmarking tool that was valid

◦
Ability to collect and share data annually

◦
Ability to discuss/agree on KPI definitions

◦
Ability to revise KPI definitions as our industry shifts



No tool that was specific to large CBOs



Need to network

◦
Without distractions



Need to improve performance

◦
Share successes and “non
-
successes”




Twenty
-
four CBOs



In Florida

◦
BayCare

◦
Lee Memorial

◦
Orlando Health

◦
Shands



Other states represented (NE, MN, KY, MO, VA,
PA, CO, OK, LA, TN, IA, NC, GA, IL, TX, and Al).







Review of annual KPI Survey

◦
Time to discuss KPI definition/interpretation changes


5010 & ICD
-
10 readiness


Patient Access quality issues

◦
Policy & Procedure discussion

◦
Regulatory requirements & how we have addressed them


Biometrics for patient ID


Time of service estimates & solutions


W
ho has implemented what vendor? How was the
implementation?


Vendor discussion


Who are you using?


For what?


How is the performance?


What KPI’s define success for the vendor?





Predictive analytics for charity and form 990H


What BI systems are being used for predictive analytics?


Employee turnover & retention strategies


What training programs are being used/outsourced?


What incentive program structures are effective?


Accountable Care preparedness


What I.T. infrastructure can handle an ACO model?


Productivity enhancers


Carrot vs. Stick? Automation is key!


Selling Bad Debt


What does the market look like across the country?


Round table discussion






Each System Reports The Following:


◦
Services billed (i.e. hospital, physician, homecare)

◦
Systems Software Used

◦
Cost to Collect (Total, CBO, PAS, HIM)

◦
First Bill Pass Yield

◦
Net A/R Days

◦
DNFB & Hold Days

◦
Collection % by Payer

◦
Bad Debt & Charity Write
-
offs

◦
Uninsured and Prompt Pay Discounts

◦
Denials

◦
Upfront Cash Collection to gross revenue (ER & other)

◦
FTEs per 1000 claims (by function)

◦
Salary Survey







Things are not going to get any easier


Medicare and Medicaid spending cuts


Technology changing rapidly


Larger Health Systems


Standardization more difficult


Our patients are changing


New healthcare models




CBOs with the most outsourcing have the
higher cost to collect (FTEs aren’t bad)


Training and managing quality of registrars is
key


Assertive upfront cash collection translates to
lower A/R days


The annual meeting has had many wins

◦
Learning new approaches

◦
Networking

◦
Seeing different shops

◦
“best two day meeting I have ever attended”