Post on 14-Dec-2014
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“Put me in Coach” Creating the Finance and Operations
Dream Team
Presented by David Wildebrandt
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Let’s Relate
Not Compare
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© Baptist Leadership Group, MMIX. All rights reserved.
Our problem is
not just
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ACHE Top CEO Concerns 2009 • Financial challenges 77% • Patient safety and quality 43% • Care for the uninsured 41% • Physician-hospital relations 32% • Personnel shortages 30% • Governmental mandates 26% • Patient satisfaction 22% • Capacity 16% • Technology 9% • Issues about not-for-profit status 2% • Malpractice insurance 2% • Disaster preparedness 1% • Patient safety NA • Quality NA
2008 2007 70% 72% NA NA 38% 37% 35% 40% 30% 30% 22% 23% 17% 16% 11% 11% 8% 8% 4% 3% 2% 3% 1% 1% 29% 27% 33% 29%
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Nor is our issue just the
loss of funding
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Healthcare is not what it used to be • HCAHPS • VBP • Accountable Care • Reform • Meaningful use • Social Media • Hospital Compare • Recession • There is an App for that
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Challenged?
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Top 10 Financial Challenges
• Reimbursement • Bad debt/Charity care • Access to capital • Collection of co-pay • Labor Rates • Supply cost • Volume • Productivity • Marketing cost • Contract labor
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© Baptist Leadership Group, MMIX. All rights reserved.
How can operations and finance
join forces?
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The Answer is You!
We are a team of passionate employees
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What Do Employees Want from their Jobs? Managers 1 2 3 4 5 6 7 8 9 10
Good wages Job security Promotion/Growth Opportunity Good Working Conditions Interesting Work Personal Loyalty Tactful Discipline Full Appreciation for Work Done Sympathetic to Personal Problems Feeling “in” on things
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Managers Employees 1 5 2 4 3 7 4 9 5 6 6 8 7 10 8 1 9 3 10 2
Good wages Job security Promotion/Growth Opportunity Good Working Conditions Interesting Work Personal Loyalty Tactful Discipline Full Appreciation for Work Done Sympathetic to Personal Problems Feeling “in” on things
What Do Employees Want from their Jobs?
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Create Clarity of Vision
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“If you don’t know where you’re going, you might end up someplace
else.”
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Which way do you go?
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© Baptist Leadership Group, MMIX. All rights reserved.
Our challenge is!
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Margin Improvement Teams
• BHC’s innovation to empower our people to impact results
• Established in 2010 with the objective to empower the entire workforce to achieve financial results
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Margin Improvement Teams
• Senior Management Involvement • Not a “Project or Initiative” • Team Composition is Critical • Bonus Potential for Team Leaders • 3:1 Rule
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Margin Retention/Improvement 2010/2011
Steering
Committee Chair-
Supply Chain Value
Analysis Team
Clinical Quality
Value Analysis Teams (CQVAT)
Facilities & Support Services
Value Analysis Teams
Labor & Benefits
Value Analysis Team
Streamline the
Business Value
Analysis Team
Improved Net Revenue Per
Unit Team Incremental
Volume Team
Bi-Weekly meetings with one VAT reporting results to Steering Committee each meeting.
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Clinical Quality CQVAT
Chair
Exec. Sponsor
Cardiovascular Leader
Exec. Sponsor
Laboratory Leader
Exec. Sponsor
Peri-operative
Leader
Exec. Sponsor
Pharmacy Leader
Exec. Sponsor
l
Patient Care Services
Leader
Exec. Sponsor
Imaging & Radiation
Exec. Sponsor
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Peri-operative Target $1,797,678 Implemented $2,053,748
Ortho Implants $876,401 Reprocessing $266,888 Neuro Implants $125,895 Endomechanicals $632,216
Example Outcomes
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Streamline the Business VAT Chair
Exec. Sponsors
Non Core Business Financial and Community
Benefit Assessments
Core Business Improvements
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Streamline the Business
• Performed systematic review of 32 “non-core” entities & services using specific criteria
• Financial
• Strategic
• Mission/Community Benefit
• Baptist Brand
• Political Issues
• Risk Factors
• Management Resources
Target $663,568
Implemented $500,000
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Streamline the Business
Ranking Process:
• Entity/Service rankings placed them in 3 categories
• Low Range à strongly consider divesture or repositioning
• Mid Range à further review and/or action plan required
• High Range à keep/maintain/grow
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Facilities and Support Services
Value Analysis Teams Chair
Executive Sponsor
Information Services Leader
Exec. Sponsor
Environment of Care - Facilities
Leader Exec. Sponsor
Purchase Services & Prof Fees
Leader Exec. Sponsors
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Purchased Service & Professional Fees Target $1,500,700 Implemented $1,143,692
Patient Satisfaction survey savings $17,928 Renegotiated maintenance contracts $99,159 Anesthesia Subsidy Reduction $1,000,000
Example Outcomes
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Improved Net Revenue Per Unit
Chair Andy Terry Exec. Sponsor
Kerry Vermillion
Point of Service
Collections Chair :
Exec. Sponsor____
Process Improvement
Chair:
Exec. Sponsor:
Managed Care Payment
Compliance Chair:
Exec. Sponsor
Scheduling and
Registration Workflow
Chair:
Exec. Sponsor
Reimbursement Team Chair:
Exec. Sponsor:
Charge Capture / Pricing Team
Chair: Exec. Sponsor____
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Revenue Cycle Target $10,548,000 Implemented $14,865,179
Strategic pricing impact $2,959,198 Charge Capture Process $1,179,380 Clinical Documentation $3,198,469 Internal Payment Compliance $988,000
Example Outcomes
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Incremental Volume Growth Team Exec. Sponsors
Target $8,455,450
Implemented $12,621,844
Cardiology Consultants $4,631,323 ED Admissions $1,535,255 Total Joint Program $892,010
Example Outcomes
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Margin Retention/Improvement Initiatives - 2011Steering Committee Summary Report
(1) (2)Steering Committees: Target In budget Stretch target Identified Implemented Validated
CQVAT Clinical Quality Value Analysis 4,122,064 3,122,064 1,000,000 4,536,412 3,553,351 4,074,550
FFSVAT Facility & Support Services Value Analysis 1,600,700 1,500,700 100,000 1,770,896 605,487 336,011
LBVAT Labor & Benefits Value Analysis 250,000 250,000 24,000 24,000 24,000
SSCVAT Supply Chain Value Analysis 914,187 664,187 250,000 1,014,129 1,010,654 1,075,371
SLB Streamline the Business Value Analysis 663,568 113,568 550,000 922,751 500,000 500,000
NRPU Revenue Cycle 10,548,000 8,248,000 2,300,000 18,390,983 15,593,693 14,865,179
V Incremental Volume 8,455,450 6,205,450 2,250,000 9,187,180 14,516,346 12,621,844 Total 26,553,969 19,853,969 6,700,000 35,846,352 35,803,532 33,496,954
Percent to target 134.99% 134.83% 126.15%
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Albert Einstein
“Vision without execution is a hallucination.”
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$13,809,826
$6,155,106
$19,452,592
$-
$5,000,000
$10,000,000
$15,000,000
$20,000,000
Actual Budget Prior Year
Baptist Hospital Net Income FYTD 2011
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Free T-Shirt Giveaway!!!
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“All Finance cares about is __________?”
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How can we leverage culture to
execute strategies?
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Total Performance Score
30%
70%
Process of Care
Patient Experience of
Care
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A Zero Sum Game
VBP is Budget Neutral
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2011 Results for Value Based Purchasing
• Baptist is planning to receive 150% of VBP dollars based on HCAHPS Results
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2.00%
1.10%
2.40%
Actual Budget Prior
Operating Margin
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Medicaid Reductions = $7.0 Million
Medicare Reductions
= $0.5 Million
47% of our income wiped away
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$40,000 $800
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$40,000 $28,000
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Owners or Renters?
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Can you tell the difference?
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"If you want 1 year of prosperity, grow grain. If you want 10 years of prosperity, grow trees. If you want 100 years of prosperity, grow people." Chinese proverb
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© Baptist Leadership Group, MMIX. All rights reserved.
© Baptist Leadership Group, MMIX. All rights reserved.
Perseverance… Even the Pros Mess Up
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How do we stay connected to the patient?