The Buckeye ConnectionOctober 2006

h f m aThe Business of Caring

Inside This Issue

President’s Message ...................1

Get Involved/Stay Connected ....3

Want More Cash in YourBusiness Offi ce? ..........................4

Flying is a Payne .........................6

Information Technology—Making the Most of WhatYou’ve Got ...................................8

Interested in assisting with the newsletter? Please contact Holly Lockard (614-232-7969) or Joe Gioffre (614-232-7230).

President’s MessageBy George M. Gevas, President

Central Ohio Chapter

Greetings! It’s hard to believe how cold it has become in central Ohio for the month of October – I think we are skipping the fall season and heading into winter. On a positive note, the Buckeyes continue to win decisively and the Michigan game in November should be a showdown of the number 1 and number 2 teams in the country. Go Bucks!

The National HFMA organization is comprised of regions and the Central Ohio Chapter is a member of region six. Region 6 consists of 7 chapters from Ohio and Michigan. Once a year, the Chapter Presidents, President-Elects, Regional Executive and a National HFMA Offi cer get together for a two day fall Presidents’ meeting to discuss regional and national business. It was our Chapter’s turn to host the event and we held the conference at Easton on September 18th and 19th. Margaret Shuler, President-Elect and I attended the conference.

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Chapter Offi cersCHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER

Lola PopcevskiPRESIDENT AND CHIEF OPERATING OFFICER

George GevasPRESIDENT-ELECT

Margaret SchulerSECRETARY

Brad CheltonTREASURER

Preston Belding

Board Members Luke Brown Bob Martin Frank Phillips Bernie Ostrowski George Gevas Ken Stoll Spence Fisher Randy Allen Karin Cain

EX OFFICIO BOARD MEMBER

John Callender

REGIONAL EXECUTIVE

Ted Anderson

Committee ChairsPROGRAM/EDUCATION COMMITTEE

Brad Chelton, Chairperson Preston Belding, Co-Chairperson Margaret Schuler Karin Cain Elizabeth SeeligSOCIAL COMMITTEE

Preston Belding, Chairperson Chris Peters, Co-Chairperson Jonathon BrownNEWSLETTER EDITORS

Holly Lockard, Chairperson Joe Gioffre, Co-ChairpersonCORPORATE SPONSORSHIP COMMITTEE

Ken Stoll, Chairperson Will Sharp, Co-ChairpersonMEMBERSHIP SERVICE PLAN/DIRECTORY COMMITTEE

Jackie Nussbaum, ChairpersonMEMBERSHIP COMMITTEE

Geroge Gevas, ChairpersonAWARDS COMMITTEE

Elizabeth Seelig, ChairpersonAUDIT COMMITTEE

Dawn Stark, ChairpersonCONSTITUTION AND BYLAWS COMMITTEE

Michael K. Gire, ChairpersonNOMINATING COMMITTEE

George Gevas, ChairpersonWEBSITE COMMITTEE

Joe Gioffre, Chairperson Margaret Schuler, Co-ChairpersonJOB REFERRAL COMMITTEE

Luke Brown, ChairpersonCERTIFICATION COMMITTEE

Eric L. Young, Chairperson

The fall golf outing was held on October 2nd at Marion Country Club. Despite the unseasonably cold and rainy weather, we had a record attendance of 84 golfers! We added some new enticements including great door prizes. One of the door prizes was a 32” LCD television and Ron Bachman was the lucky winner.

The program committee has been busy since early summer establishing educational events for each month of the year. Our Chapter is the co-sponsor of the Ohio Society CPA Annual Healthcare Conference to be held on November 13th and 14th. On December 18th, Ernst & Young is presenting an accounting and auditing update followed by a happy hour at the Blue Jackets vs. Redwings hockey game (additional details for this event will be announced the fi rst week of November).

Please review the programming calendar for the events scheduled for the remainder of the fi scal year on our website at www.centralohiohfma.org. Also, if you are not on a committee, I would encourage you to join a committee of your choice by contacting the respective chairperson listed on the website.

I look forward to seeing you at our next two events and please call or send me an email if I can be any assistance.

President’s Message (continued)

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2006-2007HFMA Central Ohio Chapter

Corporate Sponsors

Platinum Sponsors

Ernst & Young

National City

Plante & Moran

UCB, Inc.

Gold Sponsors

Fifth Third Bank

HTP

MedAssist

Peck, Shaffer & Williams, LLP

Silver Sponsors

Cleverly & Associates

Data Image

Kreg Information Systems

Bronze Sponsors

General Audit Corporation

Lawrence, Evans & Co., LLC

OSI

Professional Collectors & Billing Services

The SSI Group

Get Involved!!!

HFMA is always looking for new individuals to get involved and join the committees. There is a variety of different committees and they are all looking for new people to get involved and be active within the chapter. Anyone interested in inquiring about joining a committee can contact Brad Chelton at (614) 232-7222 or via e-mail at bradford.chelton@ey.com.

Stay Connected - Visit Our Homepage

For all of the latest news, contacts to HFMA members, and our new classifi eds section, please check out our local homepage. The web address is www.centralohiohfma.org.

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Of course we all want more cash and we want it as quickly as possible! As the healthcare business becomes increasingly sophisticated, we recognize the need to improve the performance of your portfolio of accounts receivable. Any strategy that can reduce days outstanding is worth serious consideration. Then how do we determine what types of accounts to focus our internal resources on and which ones to outsource for collections?

Of all the fi nancial classes your business offi ce handles, self-pay receivables eat up more resources for less money than any other fi nancial class. According to current industry fi gures, self-pay accounts have the highest number of gross days outstanding of any class of hospital receivable - 208 days. This compares to a national average for overall gross days revenue outstanding of 64 days. As hospitals seek ways to improve their operational performance, you can see why outsourcing self-pay receivables is generating a lot of interest. Many healthcare organizations fi nd that their outsourcing business partners provide needed experience, knowledge and resources. They are also benefi ting from access to new technology that helps to reach patients faster, improve the recovery processes and facilitate cash fl ow.

These are some key reasons to outsource your self-pay receivables: 1. Employers are shifting healthcare costs to the

employee through dramatic increases in employee deductibles and coinsurance liabilities. With the increasing patient fi nancial responsibility, hospitals are seeking ways to address collections from patients while at the same time remain in compliance with laws governing fair debt collection practices. According to current industry fi gures, hospitals typically collect about 9-12 % of the patient’s fi nancial obligation, including instances where there are no front-end or back-end collection initiatives in place.

Want More Cash in Your Business Offi ce?Bryan Hogan

Vice President of AllianceOne

2. With the rising volume of self-pay collections, business offi ces are burdened with following up and collecting outstanding monies on high-volume, low-yield accounts. Typically, 15-20 percent of business offi ce resources are devoted to self-pay collection activities that may represent only 0.5% - 3.0% of a hospital’s revenue. The inability to cost justify suffi cient staffi ng to accommodate these increasingly large number of accounts has burdened business offi ce staff preventing proper account follow-up activities. Also in this environment, staff inexperience in

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proper collection techniques may lead to patient dissatisfaction with billing issues and hinder collection success.

3. Outsourcing business partners provide needed experience, knowledge, resources and/or technology to improve self-pay processes and cash fl ow.

4. Business offi ce staff can focus internal resources on low-volume, high yield accounts.

5. In virtually every instance the benefi ts of a self-pay outsourcing program outweigh the cost of doing business internally and provide a lower variable costs basis (labor, supplies, etc.) than the hospital’s internal business offi ce would incur. In this environment the vendor is free to focus on performing services on behalf of the hospital’s business offi ce, typically at a fi xed cost, such as a contingency fee or fl at rate per account.

The patient is a key component in the revenue cycle process, especially when collecting directly on the patient’s liability. Hospitals looking to gain and maintain strong revenue cycle performance and improved patient satisfaction should focus on the patient when designing and implementing your self-pay outsourcing program. A well conceived and executed program undertaken by your business offi ce in partnership with your outsourcing vendor will help patients understand their fi nancial obligations for services they received. Processes for self-pay receivables should refl ect the hospital’s collection and customer service guidelines coupled with a desire to improve overall net cash collections. In this way the hospital controls the impact that its collection program has on its patient constituency.

Achieving fi nancial gain through outsourcing isn’t automatic. For optimal results when outsourcing your self-pay receivables, providers need to be actively involved in the process by carefully screening the vendor, coordinating activities to allow for a seamless transition and implementing a system that accurately and continually tracks results both fi nancial and customer care.

Want More Cash in Your Business Offi ce?(continued)

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Recently I was on a fl ight from Seattle to Raleigh, NC with four of the worst behaved children on the planet. You know there’s going to be trouble when you take off and these kids throw their arms up in the air and scream like you’re on a roller coaster.

These children were named; Phoenix, Dakota, Madison, and Payne, with the last one obviously having the most appropriate name. And the mother had no control over the three older kids, choosing instead to sit in her seat, drinking beer, yelling their names; “Dakota!,” “Madison!,” “Phoenix!,” as if she were answering geography questions on Jeopardy.

Coming out of the bathroom at the back of the plane I see two year old Payne standing in the isle at the front. He throws his baby bottle, it rolls along the fl oor, coming to rest at my feet. I pick it up, noticing hair and dirt stuck to the nipple. Payne is running down the aisle screaming, “Mine, mine!” When I explain the bottle needs to be cleaned before he puts it in his mouth, Payne doubles up his fi st, and hits me right in the thigh.

“Here, Payne, bon appetite.”

When we got to Raleigh, I noticed the North Carolina license plates say, “First In Flight”. After this fl ight, I couldn’t fi gure out if they’re bragging or apologizing. I’m convinced if the Wright brothers had known how annoying air travel would become, they would have dismantled the Kitty Hawk, and ridden their bicycles back to Ohio. Then what would the North Carolina license plate say? Of course, anything would be better than Oklahoma’s. Ours says, “You Gotta Live Somewhere”. (Actually it says, “Native America” which is a step up from the old motto, “Oklahoma is OK”——not great, mind you, just okay.)

I fl y Southwest Airlines and the reasons are best summarized by Gary Kelly, CEO of Southwest:

“There’s also a precision that customers want with their airline product. They want to be on time. They want to get to their destination with their bags. They want to be able to change their travel plans without being penalized for that. Those are all the things we deliver.”

Flying is a PayneKent Rader

One aspect of Southwest’s legendary customer service evident on most fl ights is the use of humor. Southwest Airlines has developed an environment that not only encourages humor in the work place, they actually search for people with a sense of humor during the hiring process.

On one fl ight, as the fl ight attendant familiarized passengers with the plane’s oxygen system, she said, “Although we never anticipate a loss of cabin pressure, if we had, we wouldn’t have come to work today.”

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Flying is a Payne(continued)

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Humor is a proven tool in not only relieving stress, but improving health, improving employee morale, increasing employee retention, building collaboration, and helping employees tap into their creative problem solving skills. These reduce costs and improve an organization’s profi ts.

Maybe the best argument for using humor at work is employees are happier. Colleen Barrett, President of Southwest Airlines believes happy employees makes good business sense.

“If our employees don’t feel good about their work environment and don’t feel they have the tools to do their job, what kind of exchange are they going to have with our passengers?”

I encountered another example of Southwest’s employees using humor on a fl ight from Houston to Orlando. One fl ight attendant, Juan, said, “You are being served today by the Orlando based fl ight crew of Juan, Peggy, and last month’s Flight Attendant of the Month, Julie. If there is anything that we can do to make your fl ight more enjoyable, don’t hesitate to ask Julie because you can’t expect much out of me or Peggy.”

Through humor, Juan made us see fl ight attendants as real people and not just nameless, faceless wait staff 30,000 feet in the sky. This is a wonderful lesson in working with co-workers.

The best aspect of humor is it doesn’t cost you a thing. In the cases cited above, Southwest Airlines employees made fl ying a little less stressful.

Bring more humor to your work because Gilda Radner was right when she said, “Laughter matters.” Remember this the next time you’re on a cross country fl ight with Payne.

Copyright © 2006 Kent A. Rader. All rights reserved.

Kent Rader is a professional speaker and comedian (formally a hospital CFO) helping people learn and experience how laughter matters in reducing stress. Known as “The World’s Cleanest Comdian,” Kent has made healthcare and comedy club audiences laugh from New York to Seattle. His stress reduction book title Let It Go, Just Let It Go and video clips are available by visiting www.kentraderpseaks.com or calling 405-209-3273.

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Information Technology—Making the Most of What You’ve Got

As we continue to become increasingly dependent upon information technology (IT) in day-to-day operations, the complexity of that technology is likewise increasing. Articles and press releases are available almost daily touting the benefi ts of healthcare IT. Given that most organizations are struggling to keep abreast of new developments with an already stretched staff, how can healthcare organizations optimize their IT resources, reduce IT costs, and continue to innovate to meet growing quality and service level demands? Here are several opportunities to consider.

Validate the service-level agreement between IT and the organization.

Too often, organizations are disappointed with IT’s value and cost, but neither IT nor the users ever agreed to what services they required or at what level of cost. For example, agree on response time and resolution time for the different types of requests the IT help desk will receive. Determine whether IT staff should be centralized or decentralized. Identify “hidden” IT resources and costs your budget. It’s crucial that IT and the organization can mutually agree on where and how IT resources will be optimized and what costs are appropriate or need to be reduced.

Evaluate the design, capacity, costs, and service levels of your data and voice networks.

If not documented, document the design of your networks; obtain assistance from your network service providers if necessary. Review bandwidth and speed against the needs of the organization, and review the service agreements in place, including costs and expiration dates. Opportunities may be available to renegotiate agreements to better align capacities and costs with required service levels.

Review your organization’s strategy for business application software.

If you’re using one or several commercial vendor packages and are considering replacement within the next year, or if you aren’t seeing value from the vendor’s support or recent/planned upgrades, you might consider eliminating annual maintenance at the next renewal date. You may also have a signifi cant amount of custom-developed software that you’re retaining internal IT staff or external resources to

For Your Consideration

Here are a few things to consider to reduce costs and optimize IT resources:

Establish Service-Level Agreements

Evaluate Data & Voice Networks

Review Application Software Support & Maintenance

Assess Staff Skill & Compensation

Utilize External IT Resources

Promote Help Desk Effi ciency

Ensure Project Management Effectiveness

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Information Technology—Making the Most of What You’ve Got(continued)

Intelligent Receivable Solutions

giving healthcare providers the

resources to put patient care first

A recognized market leader in providing Intelligent Healthcare Receivable

Solutions designed to improve financial performance and patient relations.

5620 Southwyck Blvd., Suite 206 Toledo, Ohio 43614 (800) 866-6228 http://www.ucbinc.com

UCB pledges to provide paramount services for our clients, their patients

and each new and current relationship we develop and maintain.

support. If you’re considering replacing the software, this could provide an opportunity to reallocate internal, or discontinue the use of external, support resources. In addition, consider consolidating or standardizing applications across divisions/departments where appropriate to reduce support costs. Be sure to perform a thorough review of costs and functional requirements before selecting a strategy, as the chosen direction can have a signifi cant burden on personnel and fi nancial requirements, not to mention on the ability of your software to support the daily operations of your organization.

Assess the skill sets and compensation levels of the IT staff.

Given the growing pressures in IT, many departments are being asked to provide IT professionals who aren’t only technical, but also possess the business and behavioral competencies their organizations/users require. This skill migration is a signifi cant undertaking toward increasing effi ciencies and becomes the catalyst for training efforts, transitioning certain staff, considering outsourcing options, and evaluating performance measurement systems. Given the amount of change in position and skill requirements, compensation should be re-evaluated.

Consider the use of external IT resources.

Outsourcing certain IT functions can increase service levels and reduce costs. Often, organizations are outsourcing aspects of IT that are common in industry and don’t provide them any competitive advantage or differentiation (e.g., PC and server software and hardware support). In other cases, organizations utilize

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Information Technology—Making the Most of What You’ve Got(continued)

external technical resources when they need a network redesigned or installed or a unique software application custom developed using a technology with which their staff is unfamiliar. Be sure to establish a service-level agreement with each service and staffi ng provider.

Institute discipline in your IT help desk function.

In addition to project work, help desk activities are the other major category of IT staff activities (usually 60 percent to 70 percent). Many organizations are spending too much staff time managing and responding to help desk requests. Typically combined with realignment of IT support staff, implementing help desk software with request logging, asset inventory, and trend monitoring will help IT improve its service levels at a lesser cost.

Assess IT’s success in managing major IT projects/initiatives.

Though project work typically constitutes 30 percent to 40 percent of IT’s activities, the rest of the organization usually equates the value of their IT department with the results of their project work. Sure, users should be leading/co-leading many of an organization’s projects with IT, but IT should certainly promote the use of a repeatable methodology for planning, executing, controlling, and reporting of project work. IT should also work closely with the lead user(s) in developing the fi nancial justifi cation for a project so IT resources aren’t being allocated to low value projects.

IT is evolving rapidly, and many healthcare organizations are fi nding it diffi cult to keep up. If your organization is dissatisfi ed with the value or cost of IT or would like to discuss further how to do more with existing resources, please contact Dennis Bagley at 248.223.3348. We’re helping many healthcare organizations realize signifi cant cost savings while increasing their IT service levels.

For Additional Information

Plante & Moran’s Healthcare Technology Consulting & Solutions practice provides IT assessment & strategy, operations improvement, software selection, and implementation services to clients within the healthcare industry. For additional information please contact dennis.bagley@plantemoran.com

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The statements and opinions appearing in articles are those of the authors and not necessarily those of the Central Ohio Chapter HFMA. The staff believes that the contents of The Buckeye Connection are interesting and thought provoking, but the staff has no authority to speak for the Offi cers or Board of Directors of the Central Ohio Chapter HFMA. Readers are invited to comment on the opinions the authors express. Letters to the editors are invited but subject to condensation and editing. All rights reserved.

Newsletter Editors

Holly Lockard(614) 232-7969holly.lockard@ey.com

Joe Gioffre(614) 232-7230joe.gioffre@ey.com

Newsletter Design and LayoutLaura Dutton(614)232-7279laura.dutton@ey.com

Ernst & Young LLP1100 Huntington Center41 South High StreetColumbus, Ohio 43215

THERE AREHUNDREDS OFWAYS WE HELP HOSPITALS.HERE ARE SEVENOF THEM.

• Assurance services• Tax consulting and compliance• Financial projections• Operations improvement• Reimbursement• Coding and compliance• Information technologyDave Scheffler 614.849.3060Jordan Pace 614.849.3054plantemoran.com

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