Hospital Management Solutions for Weathering the Storm of Healthcare Challenges

1. Top 10 12 Solutions required to Weather the Storm Jimmy Lewis Kathy Whitmire

2. 1) Manage to performance benchmarks • Critical Indicators • Salaries, Wages & Benefits – 43% • Days in A/R - 38 • Supplies – 11% of Net Revenue • $103,000 Net Revenue per FTE

3. 2) Telemedicine • Telemedicine is the Future of Rural Medicine • Leverages specialty services and brings them to your community for small cost • Reduces cost to deliver services to Nursing home, mental health, prisons, etc with same reimbursement.

4. 3) CEO Involvement in the Front end • The foundation of your A/R • The key to a successful bottom line • Business Office Director resists change and may turn down new technology/solutions in order to prevent change or learning new processes • Need full analysis of Patient Access and Business Office processes annually

5. 4) Political grass roots • The evidence is in the passage of HB1055 • Hospital Field trips with Governors Office Staff and budget writers

6. 5) Implement Technology Solutions • STREAMLINE – • IMPROVE EFFICIENCY – • TRACK EVERY DOLLAR – • ENSURE COMPLIANCE • Technology makes data available • Benchmarking & Work Flow Tools Like– • QUADAX • BENCHMARK REVENUE

7. 6) Cash flow management • THREATS TO HOSPITAL CASH FLOW: • Recovery Audit Contractors • CAHABA Prepayment review hold -CMS Rules • HB 1055 Provider Payment Program • MMIS Conversion from ACS to HP/EDS • Cost Report Settlements

8. 7) Webinar & HTHU Participation • Education required in this constantly changing environment • The survivors will: • Make education a priority for Management & Staff • Participate if FREE webinars giving updates on Medicaid / Medicare / RACS • Make recommended changes to improve • TRAIN – TRAIN - TRAIN

9. 8) Regionalization & Networking Opportunities • Understand that it takes a demographic of 35,000 – 40,000 to support a full service hospital • Network with neighboring hospitals to identify needs of the larger demographic community and how you can work together to continue to meet those needs • Create alliances

10. 9) HTH Network Leveraging • Central Chargemaster – in development • Electronic Interqual Group Buy • Reducing cost of electronic admissions criteria from $30,000 to $5000 • SHIP grant Programs - like RAC/ HITECH • Ensuring access to $2Million for HIS / EHR • Central Online Payment Portal – • reducing transactions fees by 30 – 35% • Benchmarking Data – Executive Dashboard • Aggregate data to negotiate pricing as a group • BENCHMARK REVENUE

11. 10) HITECH EHR Funding • $2,000,000 for Hospitals ($666,000) • $44,000 per Eligible provider ($18,000) • 1st payment made April 2011 • EHR PARTNERS • Healthland - NextGen • HMS - Ingenix • Siemens - Ingenious Med • HTH SHIP HITECH EHR Program

12. 11) Crisis Management Plan • PLAN AHEAD – When the crisis happens its often too late • COMMON HEALTHCARE CRISIS: • Payroll • Cash Flow Disruption • Medicaid Conversion • New provider numbers

13. 12) BUSINESS PARTNER SOLUTIONS • HomeTown Health Partner Program • Does the reference checking • Proven Best Practice Solutions • HTH holds partners accountable

14. NO BRAINERS • Healthtrust Purchasing Group (HPG) • 15% - 30% Savings on total spend • nTelagent– • Upson - $100,000 Up Front Cash Collections in March • Quadax – • Cash Flow Mgmt & Denials Mgmt (AT NO EXTRA COST for HTH hospitals) • Cboss – • ONLINE Payment Processing • Commerce Bank • Accounts Payable Funding with rebate of 1.5% • INGENIX – No Upfront Cost and $200/month for Physician EHR