Cbo consortium evolution of best practice sharing
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CBO Consortium-Evolution of Best Practice Sharing. Jim Schwamb, BayCare Health Systems Thomas Yoesle, Orlando Health . Large Health System CBO Consortium. Formed 2004 with support of PwC Dynamic survey of industry KPIs Membership Requirements One billion in net revenue Operating CBO

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CBO Consortium-Evolution of Best Practice Sharing

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Cbo consortium evolution of best practice sharing

CBO Consortium-Evolution of Best Practice Sharing

Jim Schwamb, BayCare Health Systems

Thomas Yoesle, Orlando Health


Large health system cbo consortium

Large Health System CBO Consortium

  • Formed 2004 with support of PwC

  • Dynamic survey of industry KPIs

  • Membership Requirements

    • One billion in net revenue

    • Operating CBO

    • Able to identify and report representative KPIs

  • Purpose:

    • Share valid KPIs on annual basis

    • Share responses to challenges

    • Share best practice approaches


Cbo consortium evolution of best practice sharing

Why?

  • No benchmarking tool that was valid

    • Ability to collect and share data annually

    • Ability to discuss/agree on KPI definitions

    • Ability to revise KPI definitions as our industry shifts

  • No tool that was specific to large CBOs

  • Need to network

    • Without distractions

  • Need to improve performance

    • Share successes and “non-successes”


Membership

Membership

  • Twenty-four CBOs

  • In Florida

    • BayCare

    • Lee Memorial

    • Orlando Health

    • Shands

  • Other states represented (NE, MN, KY, MO, VA, PA, CO, OK, LA, TN, IA, NC, GA, IL, TX, and Al).


Typical meeting agenda

Typical Meeting Agenda

  • Review of annual KPI Survey

    • Time to discuss KPI definition/interpretation changes

  • 5010 & ICD-10 readiness

  • Patient Access quality issues

    • Policy & Procedure discussion

    • Regulatory requirements & how we have addressed them

    • Biometrics for patient ID

    • Time of service estimates & solutions

    • Who has implemented what vendor? How was the implementation?

    • Vendor discussion

      Who are you using?

      For what?

      How is the performance?

      What KPI’s define success for the vendor?


Typical meeting agenda cont

Typical Meeting Agenda (cont.)

  • Predictive analytics for charity and form 990H

    • What BI systems are being used for predictive analytics?

  • Employee turnover & retention strategies

    • What training programs are being used/outsourced?

    • What incentive program structures are effective?

  • Accountable Care preparedness

    • What I.T. infrastructure can handle an ACO model?

  • Productivity enhancers

    • Carrot vs. Stick? Automation is key!

  • Selling Bad Debt

    • What does the market look like across the country?

  • Round table discussion


Kpi benchmarks

KPI Benchmarks

  • Each System Reports The Following:

    • Services billed (i.e. hospital, physician, homecare)

    • Systems Software Used

    • Cost to Collect (Total, CBO, PAS, HIM)

    • First Bill Pass Yield

    • Net A/R Days

    • DNFB & Hold Days

    • Collection % by Payer

    • Bad Debt & Charity Write-offs

    • Uninsured and Prompt Pay Discounts

    • Denials

    • Upfront Cash Collection to gross revenue (ER & other)

    • FTEs per 1000 claims (by function)

    • Salary Survey


New challenges

New Challenges

  • Things are not going to get any easier

  • Medicare and Medicaid spending cuts

  • Technology changing rapidly

  • Larger Health Systems

  • Standardization more difficult

  • Our patients are changing

  • New healthcare models


Lessons learned

Lessons Learned

  • CBOs with the most outsourcing have the higher cost to collect (FTEs aren’t bad)

  • Training and managing quality of registrars is key (

  • Assertive upfront cash collection translates to lower A/R days

  • The annual meeting has had many wins

    • Learning new approaches

    • Networking

    • Seeing different shops

    • “best two day meeting I have ever attended”


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