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”