We have helped clients to achieve success in their performance improvement and growth initiatives and consolidation and turnaround efforts. Examples of some of these engagements include:
Business Development [return to top]
We have delivered solutions for problems requiring evaluation of business opportunities, strategic, business and operational planning, competitor profiling and identification of industry benchmarks. Some examples include:
|Problem: Health system based social service agency operating with a $600,000 deficit needed assistance to provide a strategic plan that addressed a growing deficit and system dependency.
Solution: Worked with board and administration to develop a unified vision and goals. Developed a five year written strategic and operating plan. Provided recommendations that would permit agency to achieve a break-even position by year two.
|Problem: Group of physicians wished to explore the resources required to establish a clinic.
Solution: Evaluated feasibility of starting a clinic. Identified the financial and staffing resources required. Assessed market demand for facility. Recommended alternative strategies for serving population targeted.
Problem: A university wished to expand its student health services program to meet the needs of a growing and diverse student population.
Solution: Designed a model for doubling the capacity of student health services. Provided a profile of comparable institutions. Coordinated the implementation of new services.
Problem: Major medical center had to determine if there was a need for additional rehabilitation services.
Solution: Provided a market demand study for inpatient services. Developed a comparative overview of competitor institutions. Determined current and future bed demand for market area. Study led to the merger of two facilities.
Problem: Hospital system required coordination and analytical support to develop a written strategic plan and presentation for board of directors.
Solution: Coordinated the development of the strategic planning process. Provided a written strategic plan and presentation. Designed a tracking tool to measure results on a quarterly basis by key result area.
Problem: A healthcare consulting firm requested assistance in comparing operational and financial performance to assess competitor strengths and weaknesses.
Solution : Identified industry accepted financial and operating indicators to assess competitors for a hospital system. Developed a document that compared performance of hospitals.
Process improvement/Project Management [return to top]
We have delivered solutions for problems requiring mapping, evaluation and re-design of workflows to improve efficiency, new software product development, and analysis of root causes:
Problem: Two hospital-based physician practices experienced significant financial losses and excess capacity. The medical center requested assistance to consolidate the practices, re-design work processes and improve the financial position of the new practice.
Solution: Coordinated the physical consolidation of the two practices. Assisted with implementation of a new patient billing system. Assessed and recommended new staffing model. Re-designed multiple operational processes (i.e. registration, charge capture) resulting in greater efficiency. Total improvements recommended totaled a $500,000 net financial gain. Implemented a system of key measures to assist management with the daily and monthly monitoring of operational and financial performance.
Problem: A Fortune 500 software company required assistance with their efforts to develop software products that would meet the needs of its hospital clients.
Solution : We provided mapping and evaluation of hospital department workflows. Recommendations were provided for developing needed information system functionality. Additional opportunities were identified for improving the hospital’s operational processes and efforts to capture revenue.
Problem: A multi-site FQHC needed assistance to expand the delivery of pharmaceutical services.
Solution: Provided project management support that included creation of a project plan to measure status including deadlines, deliverables and outcomes. Evaluated operational and financial feasibility of collaborating with a national pharmaceutical distributor to provide 340B assistance. Mapped existing workflows, and revised policies and procedures to identify and address barriers to successful implementation. Designed audit tools needed to monitor objectives once implementation occurred.
Problem: Physician practice requested assistance to improve the process for answering patient and physician telephone calls.
Solution : Completed a root cause analysis identifying issues impacting the answering of 1,000 + telephone calls a day with recommendations for re-engineering the call answering process.
Problem: Physician practice required start-up assistance.
Solution: Served as project manager coordinating the credentialing process, outfitting of office, recruitment and hiring of office staff and recommendation of marketing steps needed to grow practice.
Problem: A medical center needed assistance in closing of a physician practice following sale.
Solution: Coordinated operational changes necessary for departure of internal medicine practice.
Problem: FQHC required assistance in coordinating the implementation of multiple clinical and financial process improvement initiatives necessary to support recent growth.
Solution: Served in role as project manager. Created a project plan and facilitated administrative team in addressing conflicts and identifying critical steps to implementation. Monitored deadlines, benchmarks and outcomes.
Problem: Medical center required oversight of a move of offices and labs to a new facility.
Solution: Served as project manager. Developed a plan to identify key logistical steps and coordinated all personnel involved to successfully relocate 16 research labs and 20 offices.
Revenue cycle enhancement [return to top]
We have provided evaluation and re-design of workflows to address barriers to revenue capture and evaluation of fee schedules. Examples of some of these solutions are described:
Problem: Hospital-owned physician practice experienced excessive charge lags in collection of office and hospital revenues.
Solution: Identified factors in workflow responsible for charge lag. Re-designed workflows, revised inpatient and outpatient billing forms, and initiated monitoring tools resulting in improved capture of revenue and 30% reduction in charge lag.
Problem : Multiple physician practices have requested review of fee schedules to insure market competitiveness.
Solution: Evaluated fee schedules and made recommendations for revisions to keep fees more in line with marketplace.
Problem: Multi-specialty practice wanted to determine the effectiveness of the billing and accounts receivable office.
Solution: Assessed revenue capture and front and back-end collection processes. Recommended solutions for changes to the registration, billing, AR processes and staffing structure with a potential for $160,000 in additional annual revenue.
Problem: An FQHC had an operating loss and issues with efficiency of work processes that impacted revenue capture.
Solution : Conducted an assessment of factors affecting productivity levels, efficient patient flow, staff utilization and revenue capture. Recommended actions to recover $100,000 in claims from State Medicaid program and improve workflows.
Expense reduction [return to top]
We have assisted clients with solutions that have included vendor contract review, exploration of outsourcing options and review of budgets and salary structure for appropriateness. Examples of some outcomes are described:
Problem: Medical center wanted an evaluation of possible expense reduction options within a physician practice.
Solution: Identified $50,000 worth of potential annual savings opportunities by reviewing terms of vendor contracts and evaluating budget expenditures.
Problem : FQHC needed a better understand of their cost per unit of service.
Solutions: Implemented a process for evaluating programmatic cost using an RVU based cost structure methodology.
Problem: Health system based social services agency wanted a better understanding of the impact of outsourcing opportunities.
Solution: Evaluated financial viability of outsourcing specific services.
Compliance [return to top]
We have provided due diligence reviews, operational and financial assessments and other administrative support to law firms and hospitals as they address issues related to regulatory compliance:
Problem: Law firm required support for its due diligence efforts as it represented hospital clients in the sale of physician practices.
Solution: Conducted operational assessments and provided analytical support for the due diligence involved in the sale of 25 + healthcare entities including physician practices, ambulatory surgical centers and other entities. Identified issues affecting the value of the transaction. Provided financial projections of value.
Problem: An academic medical center faced suspension of its research efforts because of issues related to compliance with federal research regulations governing the Institutional Review Board (IRB) processes.
Solution: Provided administrative project support to the Office of Research Affairs in addressing issues related to compliance with federal research regulation. Assessed internal and external factors affecting successful operation of the Office. Designed and tracked implementation of a system for documenting IRB activity. Developed job descriptions and interviewed potential candidates as office was re-structured. Identified potential candidates to serve as community members of the IRB.
Problem: To insure compliance with regulations, a department of an academic medical center wished to improve their current systems for the monitoring of salaries and expenses charged to federal research grants.
Solution : Systems were set up to monitor allocations of faculty and staff to funds. Implemented processes for review of all expenses to insure adherence to regulations.
Problem: An academic medical center was concerned that salary levels for executive and medical staff were non-compliant with IRS and other federal regulations.
Solution: Identified all sources of compensation for personnel involved. Compared total salary levels to accepted fair market values. Recommended changes to salaries identified as out-of- range for the market.
Problem: A law firm required assistance in understanding corporate structure and history of hospital and physician transactions in order to address issues related to federal regulations on referral guidelines.
Solution: Analyzed hospital/physician transactions in light of fraud and abuse legislation. Developed models to demonstrate relationships.
Problem: Parties involved in sale of a hospital system requested assistance to review salary levels of hospital executives affected by the transaction.
Solution: Provided research and analytical support to provide market comparison of executive salary levels for systems of this size.
Training [return to top]
We have provided design of course content and delivery of training or education materials. Some examples include:
Problem: An academic medical center needed to train faculty and staff on the federal regulations governing research activity involving human subjects.
Solution: Designed and conducted a training presentation for faculty and staff to introduce federal regulations governing the protection of human subjects.
Problem: An FQHC needed assistance in training management staff on the importance of professional development time management and supervisory techniques. Designed and presented a management training curriculum.
Solution: Developed and provided training sessions three sessions for mid-level and senior management covering time management, supervisory techniques and professional development.
Problem: On-line developer of internet proficiency testing required assistance in developing material to assess skill level of non-profit administrators.
Solution: Provided subject matter expertise in the development of a testing tool used to evaluate core competencies achieved by administrators of non-profit organizations.
Problem: A healthcare consulting firm required industry expertise in developing a manual to assist analysts in how to assess market demand using the firm’s software.
Solution: Served as a subject matter expert collecting and synthesized internal knowledge about the product under development. Provided case studies needed to illustrate software functionality. Developed a manual u sed to train healthcare analysts in the use of the planning software.
Problem: Graduate program in healthcare law requested assistance in presenting industry experience to students on reimbursement processes and models of care.
Solution: Provided two lectures; one on the basics of reimbursement, a second on alternative models to delivering ambulatory care.
Personnel Recruitment [return to top]
We have provided assistance to clients in the recruitment and hiring of administrative, clinical, technical and clerical personnel:
Problem: Hospital department undergoing re-organization needed assistance to properly identify, interview and recommend candidates to new positions.
Solution: Revised job descriptions, interviewed candidates and recommended a short-list for hire. Hired and supervised temporary staffing to meet short-term needs.
Problem: Clinic needed assistance in identifying appropriate candidates to fill management and staffing functions to support the billing function.
Solution: Developed job descriptions, identified sources for recruiting potential candidates.
Problem: FQHC wanted to determine if provider staff was being paid at market levels. Client also wanted information on productivity models of reimbursement.
Solution: Evaluated competitiveness of physician salary structure and recommended changes. Provided a summary of models of compensation with recommendations on steps necessary for implementation.