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POINT OF SERVICE COLLECTIONS
OUR JOURNEY
Scripps Memorial Hospital Encinitas May 4, 2015
Bessie Bennett, Access Manager - SMHE
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Our Mission
Scripps strives to provide superior health services in a caring environment and to make a positive, measurable difference in the health of individuals in the communities we serve.
We devote our resources to delivering quality, safe, cost effective, socially responsible health care services.
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Scripps Memorial Hospital Encinitas
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SMHE – By the Numbers
• 194 Licensed Beds• Patient Days – FY15 Annualized 45,822 (average 3,818
per month)• Discharges – FY15 Annualized 11,234 (average 936 per
month)• ED Visits – FY15 Annualized 45,704 (average 3,808 per
month)• Surgeries – FY15 Annualized 4,798 (average 400 per
month)• Deliveries – FY15 Annualized 2,054 (average 171 per
month)
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POS Collections
$50
$150
$250
$350
$450
$550
2008 $176 $187 $222 $290 $205 $250 $151 $150 $159 $237 $146 $287
2009 $226 $126 $185 $244 $215 $215 $184 $305 $130 $360 $212 $251
2010 $153 $547 $142 $179 $229 $282 $212 $191 $183 $208 $221 $274
2011 $170 $135 $251 $283 $204 $330 $159 $183 $252 $278 $254 $437
2012 $256 $265 $274 $366 $324 $309 $310 $245 $246 $244 $252 $214
2013 $263 $193 $227 $339 $228 $276 $268 $232 $345 $261 $228 $337
2014 $284 $167 $178 $263 $292 $235 $271 $342 $194 $209 $233 $286
2015 $228 $258 $264 $267 $224 $277
Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep
FY 08 - $2.5M (52% increase from FY 07)
FY 09 - $2.7M (8% increase from FY 08)
FY 10 - $2.8M (6% increase from FY 09)
FY 11 - $2.9M (4% increase from FY 10)
FY 12 - $3.2M (9% increase from FY 11)
FY 13 - $3.2M
FY 14 - $3.0M
FY 15 - $3.0M annualized
$3M POS Collection Milestone - on track for 4th consecutive year
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SMHE POS vs Best in Practice
2015 BudgetFY15
Annualized Variance
Net Patient Revenue 239,657,260$ 250,836,945$
Best in Practice 0.72% 0.72%
Best in Practice POS $ $1,725,532 $1,806,026
POS Collections $1,725,532 $3,033,789 $1,308,257
% of Net Collected 0.72% 1.21% 0.49%
Academy of Healthcare Revenue
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Healthcare Transformation
• Healthcare Industry Changes
• The Healthcare Reform
• Increased Health Care Costs
• Higher Patient Financial Obligations
• Stringent Regulations
• Payer Requirements
• Patient Expectations
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Identifying Stake Holders
• Senior Leadership
• Nursing Leadership
• Case Management
• Social Workers
• Clinical Staff
• Patient Financial Services
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Point of Entries
• Outpatient Rehab
• Radiology
• Imaging Center
• Maternity
• Main Admitting
• Emergency Department
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Challenges
• High Healthcare Costs– Insurance to Employers– Employers to Employees– Premiums, Limited Benefits, Higher Out-of-
Pocket Costs
• ED Unpredictable Environment
• EMTALA Regulations
• ED Utilization as Primary Care Setting
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Challenges Cont..
• Technology• Collecting Revenue while Reducing Cost• Budget • Patients Cannot Afford to Pay • Patients Unwilling to Pay• Patients High Expectations • Staffing – High Turnover• Hiring the Right Staff
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Collaborative Efforts
• Executive Leadership
• Nursing Leadership– Staff Meetings
• Case Management and Social Workers– Revenue Cycle Management
• Clinical Staff Participation and Feedback
• Patient Financial Services
• Public Resource Specialist
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Emergency Department Redesign
•Reduce Overcrowding in the ED•Provide Timely Patient Care •Decrease Patient Wait time•Improve the Rate of Patients Leaving without Treatment•Patient Satisfaction
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Emergency Department Redesign
Hospital Leadership, clinical and non-clinical participation in early planning of the ED. The redesign improved relationships among Access, physicians, nurses, etc.
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Point of Service Collections Program
• Assist Patients in Understanding their Financial Obligations
• Collecting Revenue while Reducing Cost
• Increase Cash Collections
• Improve the Patient Experience by Assuring that “We Care”
• Screening Patients for State Programs, Charity or Payment Arrangements
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Enhancing POS Collections Program
• Financial Counseling Policies
• Prompt Pay Discount Policies
• Monthly and Fiscal Year Targets
• Team and Individual Goals
• State Programs– Identify patients who qualify for Financial Assistance,
Increase Enrollment and Net Revenue
• Know your Payer Mix
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Continue…
• Hiring the Right Staff– Utilize Behavioral Interviews– Positive Attitude, People Skills
• Staff Professional Development – Access Career Path
• Training, Scripting • Clear Expectations • Patient Satisfaction - Press Ganey Survey
• Standardize Financial Counseling Process• Payment Options
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Continue…
• Communication Boards– POS Collections Report
• Weekly • Monthly
• Emails– Collection Tips– Top Collectors
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Celebrate Success
• Incentive Programs – Monetary Bonuses– Quality and Human Resources Policies
• Non-monetary Rewards
• Recognition Program - Excel Together – Top Collectors– Top Performers– Customer Service
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Celebrate Success
• Promote Healthy Competition – March Madness – Games
• Mile Stones– Quarterly– Semi Annual– Fiscal Year End
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Final Thoughts
• Always have a Contingency Plan
• Adjust to Industry
• Have the Right People at the Table
• Explore Best Practices
• Persistent, Flexible, Diligent
• Creativity, Innovation and Fun!
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