Jimmy Lewis Kathy Whitmire

 Critical Indicators ◦ Salaries, Wages & Benefits – 43% ◦ Days in A/R - 38 ◦ Supplies – 11% of Net Revenue ◦ $103,000 Net Revenue per FTE

 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.

 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

 The evidence is in the passage of HB1055  Hospital Field trips with Governors Office Staff and budget writers

 STREAMLINE –  IMPROVE EFFICIENCY –  TRACK EVERY DOLLAR –  ENSURE COMPLIANCE  Technology makes data available ◦ Benchmarking & Work Flow Tools Like–  QUADAX  BENCHMARK REVENUE 

 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

 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

 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

 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

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

 PLAN AHEAD – When the crisis happens its often too late  COMMON HEALTHCARE CRISIS: ◦ Payroll ◦ Cash Flow Disruption ◦ Medicaid Conversion ◦ New provider numbers

 HomeTown Health Partner Program ◦ Does the reference checking ◦ Proven Best Practice Solutions ◦ HTH holds partners accountable

 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