Creating a Winning Application for the MAP Awards (GS1) Karen Godfrey, CPA, FHFMA Vice President, Revenue Management Baptist Health South Florida

Transcription

1 Creating a Winning Application for the MAP Awards (GS1) Karen Godfrey, CPA, FHFMA Vice President, Revenue Management Baptist Health South Florida Sandra Wolfskill, FHFMA Director, Revenue Cycle MAP HFMA

2 Overview HFMA MAP Awards Initiatives High Performing Revenue Cycle Applications and MAP Performance Improvement Applications 2014 Applications MAP Keys A Success Story Baptist Health South Florida In Closing 2

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4 Recognizing Excellence 4

5 MAP Awards High Performance HFMA s MAP Award for High Performance in Revenue Cycle recognizes healthcare organizations that are distinctive, innovative and effective in revenue cycle process improvements and patient satisfaction. In addition, it recognizes sustainable financial performance that serves the mission of the organization. Individual level awards System level awards 5

6 MAP Awards Performance Improvement HFMA s MAP Award for Performance Improvement in Revenue Cycle recognizes healthcare organizations that improve financial performance and patient satisfaction through strategic revenue cycle initiatives. Applicants may apply for recognition in one or more metric categories. Only Individual level awards System level awards not offered 6

7 MAP Awards Evaluation Criteria HFMA s MAP Keys (metrics) Most recent fiscal year HP Application Three consecutive years PI Application Best practices from the 2009 PFB research Patient satisfaction based on internal and external data 7

8 2014 MAP Application High Performance Multiple changes to the application forms Eliminating information not needed for the evaluation process Streamlining the data entry process Allowing supplemental attachments for all text boxes Adding demographic information (Yes/No) Adding one new metric Cost to Collect Adding one additional question under Culture 8

9 2014 MAP Application High Performance Requesting source documentation for KPI data at time of submission rather than after the review process Retaining pre-submission calculation of KPIs Retaining drop box definitions and suggested sources for all KPIs 9

10 MAP MAP Application High Application High Performance Performance New Data Table New Attachment Requirement 10

11 2014 MAP Application High Performance This Step Auto-Calculates 11

12 MAP Keys 2014 High Performance Net days in A/R Aged A/R as a percentage of billed A/R 90 days and greater Point-of-Service (POS) cash collections Cash collections as a percentage of adjusted net patient service revenue Total bad debt expense Total charity care write-off Days in total discharged not final billed (DNFB) Days in final billed not submitted to payer (FBNS) Cost to collect without IT 12

13 2014 MAP Application Performance Improvement Some changes to the application form Eliminating information not needed for the evaluation process Streamlining the data entry process Allowing supplemental attachments for all text boxes Adding demographic information (Yes/No) Adding one new metric cost to collect 13

14 2014 MAP Application Performance Improvement Requesting source documentation for KPI data at time of submission rather than after the review process Retaining pre-submission calculation of KPIs Retaining drop box definitions and suggested sources for all KPIs Anticipate opening the application window on March 1, 2014 check our website for details 14

15 If You Apply You May Win! Ask Karen 15

16 Our MAP Award Journey 16

17 Baptist Health South Florida At-A-Glance Six hospital not-for-profit health system providing services in Miami-Dade and Broward Counties and the Upper Keys. Two dozen medical plazas and outpatient facilities 15,000 employees $2.5 billion net patient service revenue Moody s Standard & Poors double A ratings 17

18 Baptist Hospital At-A-Glance Largest Baptist Health South Florida facility, located in South Miami-Dade County with 680 beds and 106,000 ED visits Campus includes Baptist Children s Hospital, Baptist Cardiac & Vascular Institute and Baptist Health Neuroscience Center $850 million net patient service revenue U.S. News & World Report Best Regional Hospitals and Magnet certified in nursing Most revenue cycle functions are centralized at the Baptist Health level Three-time MAP High Performance in Revenue Cycle Award Winner (2010, 2011, 2013) 18

19 Getting Started The hardest step is the decision to apply Give yourself some credit you have accomplished more than you realize HFMA provides ample application time and resources make the most of them It is not painful, I promise 19

20 Health systems: Moving Ahead Review the key performance indicators of individual hospitals based on the KPIs requested in the application Look for alignment of KPI performance with known process improvement achievements Select a hospital (or two) or apply for the entire health system Share the application questions with an initial brainstorming group 20

21 Moving Ahead Select processes and practices to feature: Think of the revenue cycle in broad terms Look for examples of: Cross-functional collaboration Innovative uses of technology Process improvements with measurable results Solutions to hot topics/emerging issues Don t overlook things you have always done well but have never had the chance to brag about Identify subject matter experts on the application topics to form an application team Establish a timeline and review process 21

22 Baptist Hospital 2013 MAP Award Highlights Patient satisfaction Overall hospital approach, expectations, monitoring and rewards Featured example of collaborative process improvement between Surgical Services and Patient Access to improve patient experience Leveraging technology Automation of Patient Access quality assurance Automation of patient refund processing Performance improvement and collaboration Emergency department collections Timeliness of Medicaid inpatient authorizations and short stay billing recommendations Unique practice/lessons learned Coding Career Ladder Program 22

23 Billing Recommendations A/R in Bill Hold 23

24 Billing Recommendations 24

25 Baptist Hospital 2013 MAP Award Highlights Patient satisfaction Overall hospital approach, expectations, monitoring and rewards Featured example of collaborative process improvement between Surgical Services and Patient Access to improve patient experience Leveraging technology Automation of Patient Access quality assurance Automation of patient refund processing Performance improvement and collaboration Emergency department collections Timeliness of Medicaid inpatient authorizations and short stay billing recommendations Unique practice/lessons learned Coding Career Ladder Program 25

26 You May Be Thinking We are very busy, why should we take the time to apply for an award? 26

27 The New Normal ICD-10 HCAHPS ACOs Patient responsibility 27

28 The MAP Awards Give Revenue Cycle Teams An opportunity to celebrate and reflect on success 28

29 The MAP Awards Give Revenue Cycle Teams An opportunity to celebrate and reflect on success Validation at a national level 29

30 The MAP Awards Give Revenue Cycle Teams An opportunity to celebrate and reflect on success Validation at a national level Incentive to keep moving forward 30

31 The MAP Awards Give Revenue Cycle Teams An opportunity to celebrate and reflect on success Validation at a national level Incentive to keep moving forward Something to show-off to your clinical colleagues 31

32 Don t Stick Your Head in the Sand! 32

33 Next Steps How to prepare for the 2014 MAP Awards: Adopt HFMA s industry-created performance indicators MAP Keys Identify revenue cycle performance metrics resulting in overall revenue cycle excellence and/or sustained revenue cycle improvement Evaluate current revenue cycle practices using MAP Key competencies Complete the 2014 MAP High Performing Revenue Cycle Application Opens October 30, 2013 Closes February 28,

34 Start the journey to your own MAP Award in 2014! 34

35 In Closing Questions? Contact Information: Karen Godfrey, FHFMA Vice President, Revenue Management Sandra Wolfskill, FHFMA Director Healthcare Finance Policy-Revenue Cycle MAP