CBO Consortium-Evolution of Best Practice Sharing

1. CBO Consortium-Evolution of Best Practice Sharing Jim Schwamb, BayCare Health Systems Thomas Yoesle, Orlando Health

2. 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

3. 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”

4. 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).

5. 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?

6. 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

7. 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

8. 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

9. 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”