“put me in coach”: creating the finance and operations dream team

© Baptist Leadership Group, MMIX. All rights reserved.

“Put me in Coach” Creating the Finance and Operations

Dream Team

Presented by David Wildebrandt


Let’s Relate

Not Compare


Our problem is

not just


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%


Nor is our issue just the

loss of funding


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


Challenged?


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


How can operations and finance

join forces?


The Answer is You!

We are a team of passionate employees


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


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?


Create Clarity of Vision


“If you don’t know where you’re going, you might end up someplace

else.”


Which way do you go?


Our challenge is!


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


Margin Improvement Teams

•  Senior Management Involvement •  Not a “Project or Initiative” •  Team Composition is Critical •  Bonus Potential for Team Leaders •  3:1 Rule


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.


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


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


Streamline the Business VAT Chair

Exec. Sponsors

Non Core Business Financial and Community

Benefit Assessments

Core Business Improvements


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


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


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


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


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____


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


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


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%


Albert Einstein

“Vision without execution is a hallucination.”


$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


Free T-Shirt Giveaway!!!


“All Finance cares about is __________?”


How can we leverage culture to

execute strategies?


Total Performance Score

30%

70%

Process of Care

Patient Experience of

Care


A Zero Sum Game

VBP is Budget Neutral


2011 Results for Value Based Purchasing

•  Baptist is planning to receive 150% of VBP dollars based on HCAHPS Results


2.00%

1.10%

2.40%

Actual Budget Prior

Operating Margin


Medicaid Reductions = $7.0 Million

Medicare Reductions

= $0.5 Million

47% of our income wiped away


$40,000 $800


$40,000 $28,000


Owners or Renters?


Can you tell the difference?


"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


Perseverance… Even the Pros Mess Up


How do we stay connected to the patient?

“put me in coach”: creating the finance and operations dream team

Health & Medicine