1. Using HFMA’s MAP App to Improve Practice Management Daniel J. Marino Health Directions 10/28/2012

2. Urgency for Change Need to reduce the loss per physician-owned practice Industry focus shifting to ambulatory facilities Better information to help manage physician practices Aligning physician compensation with organization’s goals Shift from encounter-based reimbursement to value- driven performance Reimbursement reform 2

3. Challenges for Physician Practice Leaders Identifying Return On Investment (ROI) from employed practices Minimizing the loss of physician owned practices Managing a physicians practice is different than managing a hospital Identifying the value that the physician practices bring the health system Hospital compensation programs are typically less results oriented than independent physician compensation programs 3

4. Top Three Goals For Improvement HFMA Research Confirms that Practice Financial Performance is a Top Improvement Goal 4

5. Impact on Revenue Cycle New Paradigm in Revenue Cycle Management –New systems –New processes –New payment distribution models –New reporting requirements –New key performance metrics The goal is to create efficiencies through best practices in order to maximize contribution and performance. 5

6. The Value of Business Metrics Business metrics are an important component in driving performance improvement Trending indicators can quickly diagnosis problems and measure solutions Financial indicators allow for projecting revenue and measuring results Tying business metrics to operational processes can lead to proactive management Positively impact behavioral change and performance through the use of business metrics 6

7. Peter Drucker Data Drives Performance If you can’t measure it, you can’t manage it. 7

8. HFMA’s MAP For Physician Practice Management Identifies key indicators that drive performance Tracks and improves performance Recognizes excellence Translates to different practice settings Shares successful practices Allow leaders to track, trend, and compare outcomes against colleagues and benchmarks 8

9. Physician Practice Management Map Keys Patient Access Revenue Integrity Claims Adjudication Management Map Keys 9

10. 10 PUTTING IT ALL TOGETHER: A CASE STUDY 10

11. Case Study: St. Mark Mercy Healthcare is a 12 hospital system; one of the hospitals, St. Mark, is a 163 bed not-for-profit hospital St. Mark owns 5 primary care clinics and 2 multispecialty clinics

12. St. Mark’s Employed Clinic Keys Charge Lag Days Denial RateCash Collection Percentage Delnor Clinic (P)6.22.7%103% Mary Clinic (P)3.913.8%105.5% Isaac Clinic (P)3.311%97.4% Lukes Clinic (P)2.76.9%98.1% Ingrid Clinic (P)6.84.9%106.9% Elizabeth Health (S)4.74.5%102.3% Joseph Clinic (S)13.721.3%75.4% 12

13. 1. Charge Lag Days: Practice Trend 13

14. 1. Charge Lag Days: Practice Trend vs. Peers 14

15. 2: Payment Denial Rate: Practice vs. Peers 15

16. 3: Cash Collection Percentage: Practice vs. Peers 16

17. Key Successes Charge Lag –Office charges were submitted within 1 day of service, and hospital within 5 days. The billing office reviewed/coded the charges within 1 day. Denial Rate –Main source of denials was insurance coverage issues. The practice began to verify insurance prior to service, using the electronic clearinghouse solution. Cash Collection Percentage –The front desk staff was trained and scripts were provided to assist them in collecting all outstanding patient balances as well as all copayment amounts. 17

18. What Can You Do? Select metrics most meaningful to your organization Elevate the importance of physician practice performance by incorporating data into the enterprise’s dashboards and scorecards Use performance data to change behaviors –Set meaningful targets that cascade from leadership to front-line staff –Regularly communicate progress to help identify performance weaknesses and opportunities for improvement 18