POS Collections. Changing the Culture at Oconee Medical Center

Transcription

1 POS Collections Changing the Culture at Oconee Medical Center

2 Presenters Donna M. Smith o Director, Patient Financial Services o Oconee Medical Center, located in Seneca, South Carolina o 28 Years Experience Gary D. Patterson o Director, Advisory Solutions o MedAssets, located in Alpharetta, Georgia o 23 Years Experience 2

3 Presentation Objectives Client Demographics The Challenge Project Workplan Project Execution Lessons Learned Project Results Keys to Success 3

4 Oconee County, SC Population 75,000 Borders Georgia and North Carolina Beautiful mountains, lakes and waterfalls Part of Greenville, SC metro statistical area 120 miles from Atlanta, Georgia 4

5 Oconee County, SC Per Capita Income $18,965 Median Household Income $36, % Population Below Poverty Line 14.1% Unemployment Rate (January 2010) 5

6 Oconee Medical Center (OMC) Opened 1939 JCAHO Accredited 160 Licensed Beds 1,400 Employees 125 Affiliated Physicians Services Include: Med/Surg, OB/GYN, Emergency, Cardiology, Rehabilitation, Pain Management, Long Term Care and Infusion Therapy 6

7 Past POS Collection Efforts Initial effort was internally driven Performed POS collections training in March 2011 Saw short term increase then results fell off Change of CFO led to MedAssets engagement 7

8 Challenge Impact of recent recession on local economy: Increase in charity consideration requests Increase in self-pay patients (from 3% to 10 %) In partial response to this negative trend, Oconee Medical Center, completed a revenue cycle consulting assessment with MedAssets to determine ways to improve its overall revenue cycle performance. 8

9 Challenge We recognized a need to bring a stronger culture of collections to OMC to help us implement best practices for POS collections. Incomplete patient access and registration staff knowledge and training, along with lack of key performance metrics and indicators, caused missed revenue opportunities, as well as missed opportunities to educate patients about their liability responsibility and available payment solution options. - Kevin Herbert OMC Chief Financial Officer 9

10 POS Collections Project October

11 Initial Assessment Findings - Feb 2011 Collection Month 10/31/ /30/ /31/2010 1/31/2011 2/28/2011 3/31/2011 4/30/2011 5/31/2011 6/30/2011 7/31/2011 8/31/2011 9/30/2011 Grand Total POS as % of Total Cash POS as % of Patient Payments 0.51% 6.61% 0.45% 6.53% 0.44% 6.62% 0.57% 7.92% 0.63% 10.04% 0.40% 6.20% 0.51% 7.87% 0.44% 6.40% 0.50% 7.00% 0.48% 7.20% 0.54% 7.40% 0.51% 7.00% 0.50% 7.21% 11

12 Initial Assessment Findings - Feb 2011 Implement POS Collections Program Implement Financial Clearance Policy Consolidate Pre-Services Workflow Centralize Registration Activities 12

13 Project Implementation October Week Engagement On-site Consultant Project Manager Data Analytics Support Patient Access Leadership Team C-Suite Support 13

14 Project Team From left to right: Krystal Eagle Pre-Services Supervisor, OMC Gary Patterson MedAssets Advisory Solutions Mary Forrester Patient Access Manager, OMC Donna Smith Patient Financial Services Director, OMC 14

15 Project Plan Kick-Off October 2011 Review Assessment Findings Review Current PFS Training Materials Shadow Staff in All Registration Areas Identify Pre-Service Productivity Roadblocks Document POS Collection Patient Encounters Review Existing PFS Polices and Procedures Identify Additional Areas for POS Opportunity Develop Implementation Roadmap 15

16 Deep Dive Assessment Findings Inconsistent POS Collections Scripting Revenue Cycle Knowledge Gaps Need for Standardized Training Lack of Payment Policy Signage Inconsistent Use of Verification Tools Untimely Pre-Registration of Scheduled Patients Additional POS Opportunity for Inpatient, OB and Diagnostic Testing Areas 16

17 Project Timeline November 2011 December 2011 January 2012 Feb-Dec 2012 Detailed Assessment Shadow Staff Post Training for Feedback Executive Summary Presentation Quarterly Site Visits Weekly Status Calls Comprehensive Recommendations Update PFS Policies Transition KPI Reporting Ongoing Revenue Cycle Education Develop POS Training and Job Aids Implement New POS Collection Opportunities Set Follow-Up Schedule Celebrate Success Address Challenges Deliver POS Training Initiate Weekly KPI Meetings Project Close Plan for New POS Opportunities 17

18 Addressing Revenue Cycle Knowledge POS Collections Staff Training to Address: Patient Liability Fundamentals Importance of Collection to Hospital Margin What to Collect How to Determine Patient Liability Psychology of Collections POS Collections Scripting Responding to Patient Objections Role Playing Exercises Corresponding Job Aids for Staff Reference 18

19 Post POS Collections Training Follow-Up Shadowing Staff Post Training Coaching for improved performance Leadership rounding Reviewed Positive and Negative Encounters What worked well? What didn t? Guage Staff s Buy-in Who needs more coaching? 19

20 POS Collections Support POS Collections as Monthly Staff Meeting Topic Posting POS Results on Bulletin Boards Signage for Check In Areas Blasts to Staff Leadership Rounding Payment of co-pays or coinsurance is expected at time of service. Thank You! 20

21 Leadership Involvement Scheduled Rounding in ALL Areas Project Plan Presentation to Hospital Leadership Weekly KPI Meeting with Patient Financial Services Director Candid Discussions Regarding Staff Culture Creative Communication of Results Weekly KPI Report Distributed to Staff and CFO Competition for Emergency Department Shifts Celebrating Success 21

22 Untapped Cash Created Pre-registration Process for OB Patients Revised Process for Financial Counselors Benefit Review, Pricing Admission Patient Liability Discussion Payment Plan Discussion Requesting Payment During ABN Discussion Deposits for Diagnostic Testing (PPO, Indemnity) 22

23 Increasing Pre-Services Productivity Trust Insurance Verification Tool Inservice on interpreting results Reduce unnecessary phone calls Reduce manual account documentation Daily Team Huddles Measure today s volume and adjust resources 23

24 Increasing Pre-Services Productivity Focus on Value Added Activities Authorization for add-on procedures Reduce phone calls for patients with no liability Shifting work to other areas 24

25 Developing KPI Reporting Measure Results Weekly blast to staff Bulletin boards Leadership Review Total Cash Collections 8-week trend line ED Cash Collections Breakdown by shift Pre-Services Productivity Days out by service line 25

26 Self-Pay Surgery Gate Keeping Hospital Leadership Support Physician Communication Financial Clearance Process Pricing Payment arrangements Postponement when necessary 26

27 Policy and Procedure Updates Corporate Wide Financial Clearance Policy Departmental Policies Supporting Initiative POS Collection Guidelines and Scripting Patient Liability Payment Options Estimating Patient Liability Guidelines for Liability Estimation Tool Self-Pay Surgery Policy 27

28 Project Close January Week Onsite Engagement Ends POS Collections Training Completed Updated Policies Adopted KPI Measurements Instituted New Cash Opportunities Implemented Increased Pre-Services Productivity Post Project Follow-Up Plan Identified 28

29 Post Project Support 2012 Weekly Leadership KPI Call with MedAssets Review Results Discuss Challenges Explore Solutions Quarterly Site Visits by MedAssets Present Revenue Cycle Education at Staff Meeting Rounding with Leadership and Staff 29

30 POS Collections Project Lessons Learned 30

31 What Worked Well? Developing a Culture of Collections Weekly leadership rounding Staff feedback Weekly KPI staff communication Weekly KPI leadership meetings Success celebrations Executive support Educating the Community Increased consistency in obtaining payment Identifying New POS Cash Opportunities Increasing Teamwork in Pre-Services 31

32 What Didn t? Support for Inpatient Collections Hospital nursing staff Family member complaints Obtaining Support for Self-Pay Surgery Policy Stakeholder buy-in timeframe Pre-Services Staffing Daily fluctuations affecting productivity 32

33 Current Status Pre-Services Teamwork Daily huddle to guage work and adjust resources Cross training for short staffing situations Working supervisor Educated and Engaged Staff Collection culture is now who we are Friendly Competition in Emergency Department Weekly report of shift collections keeps staff motivated 33

34 Current Action Plans Pre-Services Team Cross Training Support New Hire POS Training in Place Results Communicated Regularly Weekly Leader Rounding 34

35 Project Results January

36 POS Year Over Year Collections 79% increase over 2011 $1,200,000 $1,000,000 $800,000 $600,000 $400,000 $200,000 OMC Year over Year POS Cash Collections $ ED $117,149 $187,240 $177,099 $257,705 Pt Access $314,383 $329,781 $416,758 $806,691 Total $431,532 $517,021 $593,387 $1,064,396 36

37 POS Collection Results 2012 Year End =.95% of Total Cash Project start average was.50% 2012 Year End = 12.41% of Patient Payments Project start average was 7.21% 37

38 Oconee s New POS Paradigm $140,000 OMC - Monthly POS Cash Collections $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2010 $30,937 $32,715 $50,512 $40,731 $53,772 $45,909 $45,425 $45,499 $46,346 $45,817 $41,103 $37, $44,193 $59,132 $41,061 $49,612 $35,511 $41,455 $41,299 $49,109 $41,919 $46,394 $61,461 $82, $131,062 $92,611 $103,495 $67,502 $96,135 $87,043 $75,562 $82,986 $89,977 $77,625 $97,326 $61,815 38

39 Project Success Keys Project Team and C-Suite Support for Rapid Implementation Staff Buy-In of Project Goals Instructor Led Training for POS Collections Job Aids for Overcoming Patient Objections Removing Roadblocks to Pre-Services Process Communication of KPIs to Staff and OMC Leadership Updated Policy and Procedures for Financial Clearance Capitalizing on Additional POS Collection Opportunities 39

40 Project Success Keys Project Team and C-Suite Support for Rapid Implementation Staff Buy-In of Project Goals Instructor Led Training for POS Collections Job Aids for Overcoming Patient Objections Removing Roadblocks to Pre-Services Process Communication of KPIs to Staff and OMC Leadership Updated Policy and Procedures for Financial Clearance Capitalizing on Additional POS Collection Opportunities 40

41 Questions Donna Smith Gary Patterson Booth #117 41