Process Improvement Project (PIP) Who we are

1. 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 Process Improvement Project (PIP)Who we are

2. 2002 KMC assisted in 136 S-CHIP and Medicaid U-19 applications Approvals resulted in $235,610.76 paid to KMC accounts 2003 (through Oct.) KMC assisted in 54 S-CHIP and Medicaid U-19 applications Approvals resulted in $135,934.65 paid to KMC accounts Goal StatementWhat we are doing now

3. 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

4. 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

5. 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

6. ChangesWhat 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 30-60 prior to renewal date • Communicate with test population about importance of renewal • Develop KMC assistance program for renewal paperwork