POINT OF SERVICE COLLECTIONS

OUR JOURNEY

Scripps Memorial Hospital Encinitas May 4, 2015

Bessie Bennett, Access Manager - SMHE

Our Mission

Scripps strives to provide superior health services in a caring environment and to make a positive, measurable difference in the health of individuals in the communities we serve.

We devote our resources to delivering quality, safe, cost effective, socially responsible health care services.

Scripps Memorial Hospital Encinitas

SMHE – By the Numbers

• 194 Licensed Beds• Patient Days – FY15 Annualized 45,822 (average 3,818

per month)• Discharges – FY15 Annualized 11,234 (average 936 per

month)• ED Visits – FY15 Annualized 45,704 (average 3,808 per

month)• Surgeries – FY15 Annualized 4,798 (average 400 per

month)• Deliveries – FY15 Annualized 2,054 (average 171 per

month)

POS Collections

$50

$150

$250

$350

$450

$550

2008 $176 $187 $222 $290 $205 $250 $151 $150 $159 $237 $146 $287

2009 $226 $126 $185 $244 $215 $215 $184 $305 $130 $360 $212 $251

2010 $153 $547 $142 $179 $229 $282 $212 $191 $183 $208 $221 $274

2011 $170 $135 $251 $283 $204 $330 $159 $183 $252 $278 $254 $437

2012 $256 $265 $274 $366 $324 $309 $310 $245 $246 $244 $252 $214

2013 $263 $193 $227 $339 $228 $276 $268 $232 $345 $261 $228 $337

2014 $284 $167 $178 $263 $292 $235 $271 $342 $194 $209 $233 $286

2015 $228 $258 $264 $267 $224 $277

Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

FY 08 - $2.5M (52% increase from FY 07)

FY 09 - $2.7M (8% increase from FY 08)

FY 10 - $2.8M (6% increase from FY 09)

FY 11 - $2.9M (4% increase from FY 10)

FY 12 - $3.2M (9% increase from FY 11)

FY 13 - $3.2M

FY 14 - $3.0M

FY 15 - $3.0M annualized

$3M POS Collection Milestone - on track for 4th consecutive year

SMHE POS vs Best in Practice

2015 BudgetFY15

Annualized Variance

Net Patient Revenue 239,657,260$ 250,836,945$

Best in Practice 0.72% 0.72%

Best in Practice POS $ $1,725,532 $1,806,026

POS Collections $1,725,532 $3,033,789 $1,308,257

% of Net Collected 0.72% 1.21% 0.49%

Academy of Healthcare Revenue

Healthcare Transformation

• Healthcare Industry Changes

• The Healthcare Reform

• Increased Health Care Costs

• Higher Patient Financial Obligations

• Stringent Regulations

• Payer Requirements

• Patient Expectations

Identifying Stake Holders

• Senior Leadership

• Nursing Leadership

• Case Management

• Social Workers

• Clinical Staff

• Patient Financial Services

Point of Entries

• Outpatient Rehab

• Radiology

• Imaging Center

• Maternity

• Main Admitting

• Emergency Department

Challenges

• High Healthcare Costs– Insurance to Employers– Employers to Employees– Premiums, Limited Benefits, Higher Out-of-

Pocket Costs

• ED Unpredictable Environment

• EMTALA Regulations

• ED Utilization as Primary Care Setting

Challenges Cont..

• Technology• Collecting Revenue while Reducing Cost• Budget • Patients Cannot Afford to Pay • Patients Unwilling to Pay• Patients High Expectations • Staffing – High Turnover• Hiring the Right Staff

Collaborative Efforts

• Executive Leadership

• Nursing Leadership– Staff Meetings

• Case Management and Social Workers– Revenue Cycle Management

• Clinical Staff Participation and Feedback

• Patient Financial Services

• Public Resource Specialist

Emergency Department Redesign

•Reduce Overcrowding in the ED•Provide Timely Patient Care •Decrease Patient Wait time•Improve the Rate of Patients Leaving without Treatment•Patient Satisfaction

Emergency Department Redesign

Hospital Leadership, clinical and non-clinical participation in early planning of the ED. The redesign improved relationships among Access, physicians, nurses, etc.

Point of Service Collections Program

• Assist Patients in Understanding their Financial Obligations

• Collecting Revenue while Reducing Cost

• Increase Cash Collections

• Improve the Patient Experience by Assuring that “We Care”

• Screening Patients for State Programs, Charity or Payment Arrangements

Enhancing POS Collections Program

• Financial Counseling Policies

• Prompt Pay Discount Policies

• Monthly and Fiscal Year Targets

• Team and Individual Goals

• State Programs– Identify patients who qualify for Financial Assistance,

Increase Enrollment and Net Revenue

• Know your Payer Mix

Continue…

• Hiring the Right Staff– Utilize Behavioral Interviews– Positive Attitude, People Skills

• Staff Professional Development – Access Career Path

• Training, Scripting • Clear Expectations • Patient Satisfaction - Press Ganey Survey

• Standardize Financial Counseling Process• Payment Options

Continue…

• Communication Boards– POS Collections Report

• Weekly • Monthly

• Emails– Collection Tips– Top Collectors

Celebrate Success

• Incentive Programs – Monetary Bonuses– Quality and Human Resources Policies

• Non-monetary Rewards

• Recognition Program - Excel Together – Top Collectors– Top Performers– Customer Service

Celebrate Success

• Promote Healthy Competition – March Madness – Games

• Mile Stones– Quarterly– Semi Annual– Fiscal Year End

Final Thoughts

• Always have a Contingency Plan

• Adjust to Industry

• Have the Right People at the Table

• Explore Best Practices

• Persistent, Flexible, Diligent

• Creativity, Innovation and Fun!