Process Improvement Project (PIP) Who we are Kootenai Medical Center (KMC)  Full service hospital owned by residents of Kootenai County (pop.  42,601 ER visits in 2002  232 beds Idaho Dept of Health & Welfare (IDHW) Reg. 1  Medicaid below 133% FPG  14,000+ on Medicaid U-19  S-CHIP 133%-150% FPG  1,400+ on S-CHIP

Goal Statement What we are doing now 2002  KMC assisted in 136 S-CHIP and Medicaid U-19 applications  Approvals resulted in $235, paid to KMC accounts 2003 (through Oct.)  KMC assisted in 54 S- CHIP and Medicaid U-19 applications  Approvals resulted in $135, paid to KMC accounts

Process Improvement Strategies (PIP) What we are doing now  KMC patients are assisted with S-CHIP/ Medicaid applications when ability to pay is a problem  REACTIVE  Other family members of the patient could benefit from application assistance  NO TRACKING SYSTEM IN PLACE

Project Goals  Increase approval rates of KMC-assisted S-CHIP and Medicaid accounts  Increase approval rates of KMC-assisted non- patient accounts  Create a follow-up process for KMC-assisted non- patient accounts  Study renewal rates for all KMC-assisted accounts  Consider wellness behaviors of KMC test population  Improve communication between KMC & IDHW

Process Improvement Strategies (PIP) Focus for the future  KMC could benefit from continuous coverage  to be processed again when family applications needing has an emergency  Patients and family members could benefit from continuous coverage through preventive care  PROACTIVE

Changes What we can do differently  Track KMC-assisted non-patient applications  Develop streamlined application process with a feedback loop for denials/denial codes  Develop tracking method for renewal prior to renewal date  Communicate with test population about importance of renewal  Develop KMC assistance program for renewal paperwork