1 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Transforming Data Into Results June 25, 2015

2 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Presenter Ron Barrera

3 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES What is Accounting? Definition of Accounting –The art of recording, classifying, and reporting financial data for use by owners or leadership in decision making. Many leaders struggle with how to use accounting information to bring about financial and operational improvement.

4 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Can You Get it right and soon Make it useful Get it to decision makers timely Make active decisions with the data

5 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Actual Case Study

6 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Actual Case Study

7 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Does Data Relate to Dollars? Volume / Revenue

8 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES

9 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Does Data Relate to Dollars? Active Census/ Possible DC HOME HEALTH BRANCHMANAGED CAREMEDICAREMEDI-CALGRAND TOTALS Home Health Pending Reported Census Last Visit >30 Days % Poss DCPending Reported Census Last Visit >30 Days % Poss DCPending Reported Census Last Visit >30 Days % Poss DCPending Reported Census Last Visit >30 Days % Poss DC Location % % % % Location % % % % Location % % % % Location % % % % Location % Location % % % % Location % % % % Location % % % Location % % % % TOTALS % % % %

10 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Does Data Relate to Dollars?

11 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Does Data Relate to Dollars?

12 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES How Does Data Relate to Dollars? Direct Expense Factors affecting productivity  Length of Stay  Cases per clinician  Time Available to visit  Software / Hardware Issues  Duplication of paperwork

13 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Get Information to Decision Makers Financial statements only sent to top executives aren’t helping your organization Many organizations do not provide department financial information to line operating managers Providing line managers with a financial statement –Do not know what they have –Do not know what to do with it –Do not know how to use to manage real change

14 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Get Information to Decision Makers –Educate yourself on operations –Explain which revenue or expense drivers they have control over –Solicit their input and advise them on how to effect change –Provide them with key indicator reports that allow them to effect change

15 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Key Clinical & Financial Indicators Revenue Medicare Number of start and ending episodes LUPAs Case Mix Weight Visits per Episode by discipline Days to RAP & Final Unlocked OASIS Outstanding F2F or orders Managed Care Admissions Visits per episode by discipline Medicaid Admissions Visits per patient by discipline Gross Margin Gross margin percentage Salaries Visits per episode by discipline Direct cost per visit Productivity by discipline (un-weighted) Days available to visit Number of patients per case manager Patients per team Average Length of Stay Mileage or Transportation Average miles per visit Medical supply Cost per patient or day Number of supplies ordered off formulary Indirect Expense Indirect expense percentage Administrative salaries Clinical Supervisors per team Clinical support per team Intake staff Referrals per day Authorizations per day Revenue Cycle Billing & collection FTEs based on revenue billed by payer Unbilled by payer Cash collections by payer DSO by payer Denials by payer Rent, utilities, office supplies, etc.

16 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES What Do You Measure

17 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES What Do You Measure KISS Method Most critical need Use daily or weekly KPI reports –Caution ---- Death by Reports –Monitor no more than 5 indicators Meet regularly with managers and staff to keep it at the top of everyone’s mind – Weekly – Monthly – Quarterly Consider having weekly “Huddle Meetings” to focus on major initiatives –30 minutes maximum –Have the right people attending –Solutions based agenda

18 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Daily Monitoring Example Admissions Avg/day Tot Referrals Avg/day MCR Admissions Avg/day# of daysTargetVariance 3/1 - 3/ (1) 3/1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/ /1 - 3/

19 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES Weekly KPI Example

20 | SOLVING YOUR CORE HOME CARE AND HOSPICE CHALLENGES PROPERTY OF SIMIONE HEALTHCARE CONSULTANTS 20 Simione™ Healthcare Consultants provides solutions for your core home care and hospice challenges – organizational, financial, sales & marketing, technology, and mergers & acquisitions. Over 1000 organizations use our practical insight and tools to reduce costs, mitigate risk and improve efficiencies to steward the way they conduct business. Ron Barrera, Director Financial Consulting 4130 Whitney Avenue Hamden, CT Questions Thank You For Joining Us Today!