Creating Synergy Between Finance and Operations Through Business Intelligence

Transcription

1 Creating Synergy Between Finance and Operations Through Business Intelligence Cindy Bauling - Vice President, Home Health Belinda Muck Chief Financial Officer J.J. Guedet Division Director of Business Intelligence FINANCE PERSPECTIVE Belinda Muck 1

2 Finance Revenues are down and expenses are up! What are you doing about it? Operations We are taking care of the patients the numbers are your problem. Does this sound familiar? Here is how we addressed the problem. Reports sent to Managers on a monthly basis: Detailed department income statements Accounts Payable Detail Detailed statistical metrics 2

3 Detailed Income Statement Account Account Current Period Year to Date Prior Number Description Budget Actual Variance Budget Actual Variance YTD Variance Home Health Revenue Salaries and Wages 274, ,952 (10,406) 3,333,770 3,253,154 80,616 3,633,926 (380,772) Shared Employees 2,195 3,129 (934) 26,339 27,324 (985) 36,622 (9,298) Pharmaceuticals (340) 2,148 5,701 (3,553) 2,740 2, Othr Med Care Materials - Supp 14,375 19,009 (4,634) 173, ,453 (17,453) 147,513 42, Office and Admin Supplies 1,808 1, ,696 9,263 12,433 15,821 (6,558) Forms 0 1,857 (1,857) 300 8,786 (8,486) 196 8, Purchased Computer Equipment (45) (473) Other Non-Medical Supplies 1,300 1, ,000 5,642 11,358 9,493 (3,852) Purchased Maintenance ,207 3,987 (2,780) 1,749 2, Other Purchased Svcs 3,394 5,639 (2,246) 40,823 32,429 8,394 33,778 (1,349) Purch Svcs - Computers (574) 0 1,064 (1,064) 0 1, Purchased Labor Clinical 0 15,573 (15,573) 0 59,460 (59,460) 0 59, Rental/Lease Costs - Buildings 7,695 24,281 (16,586) 92, ,484 (12,144) 86,295 18, Rental/Lease Costs - Equipment 3,182 3,651 (469) 38,188 31,059 7,129 35,662 (4,603) Utilities - Other 1,780 (1,256) 3,036 21,360 22,432 (1,072) 26,474 (4,043) Licenses-Taxes (Not On Income) (413) 5,004 5,557 (553) 5, Telephone 1,546 3,203 (1,657) 18,557 40,656 (22,099) 24,449 16, Cellular Telephone 4,979 10,112 (5,134) 59,744 69,334 (9,590) 47,287 22, Dues and Subscriptions , , (665) Outside Training Sessions 0 (2,200) 2, (320) Travel 40,523 21,990 18, , , , ,897 (119,743) Recruiting 734 1,646 (913) 8,802 6,224 2,578 3,761 2, Postage and Shipping 1,822 2,534 (713) 21,859 35,768 (13,909) 31,395 4, Entertainment 5 27 (22) (380) Total Expense 360, ,383 (37,803) 4,375,785 4,212, ,929 4,562,562 (349,705) Gross Margin Accounts Payable Detail Dept Account Description Invoice # PO # Vendor ID Vendor Name Item Year Per GL Unit Amount Fringe Benefits - Employee Act E ONE WORLD -001 Expense Distribution H0190 $ Other Professional Fees P OPTIMAL PH-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Pharmaceuticals OSF HOME I-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp FISHER HEA-001 Expense Distribution ib ti H0190 $ 6, Othr Med Care Materials - Supp DEKROYFT M-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp DEKROYFT M-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp FISHER HEA-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp FISHER HEA-001 Expense Distribution H0190 $ (96.48) Othr Med Care Materials - Supp DEKROYFT M-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp DEKROYFT M-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp DEKROYFT M-001 Expense Distribution H0190 $ Othr Med Care Materials - Supp SAMMONS PR-001 Expense Distribution H0190 $ Office and Admin Supplies STAPLES AD-001 Expense Distribution H0190 $ Forms STANDARD R-001 Expense Distribution H0190 $ Forms GRAPHIC EX-001 Expense Distribution H0190 $ Forms STANDARD R-001 Expense Distribution H0190 $ Forms STANDARD R-001 Expense Distribution H0190 $ Other Non-Medical Supplies AMSAN LLC-001 Expense Distribution H0190 $ Other Non-Medical Supplies AMSAN LLC-001 Expense Distribution H0190 $ Other Non-Medical Supplies AMSAN LLC-001 Expense Distribution H0190 $ Other Non-Medical Supplies AMSAN LLC-001 Expense Distribution H0190 $ Other Non-Medical Supplies IN OMNI MED S-001 Expense Distribution H0190 $ Automobile Expense EXP RPT 7/7-7/29/ DOERR CHRI-001 Expense Distribution H0190 $ Other Purchased Svcs WARNER PLU-001 Expense Distribution H0190 $ Other Purchased Svcs ILLINOIS O-003 Expense Distribution H0190 $ Other Purchased Svcs PDC SERVIC-001 Expense Distribution H0190 $ Other Purchased Svcs MARKLEYS P-001 Expense Distribution H0190 $ Other Purchased Svcs I GETZ FIRE -001 Expense Distribution H0190 $ Other Purchased Svcs GREEN PLAN-001 Expense Distribution H0190 $ Other Purchased Svcs ILLINOIS R-001 Expense Distribution H0190 $

4 Detailed Statistical Metrics May 2010 May 2011 Referrals Admissions Episodes Begun in Month Episodes Ended in Month Recert Rate 29.4% 38.5% Avg. Visits per Episode Avg. Nursing Visits per Episode W/O Lupa End Case Mix Nursing w/o Lupa ending Case Mix Therapy w/o Lupa ending Case Mix Lupa % 13.2% 10.8% Therapy % Including Lupa 56.3% 67.1% Therapy Range % (Less Lupas) % 13.2% 3 2.9% 3.2% 4 1.8% 1.1% 5 1.8% 5.3% 6 5.8% 5.3% % 13.7% % 3.2% % 13.2% % 3.2% % 5.8% % 2.1% % 4.2% RN Nursing Productivity Physical Therapy Productivity Occupational Therapy Productivity Speech Therapy Productivity Home Health Aide Productivity Social Worker Productivity Other Metrics Discussed: Cancelled Admissions FTEs Nonproductive Time Overtime Visits it by Disciplinei Visits by Payer Net Revenue by Payer Accountability Monthly department variance meetings held CFO Senior Accountant VP Home Health Business Intelligence Director Marketing Director Division Director Home Health Home Health Site Manager Therapy Manager Oasis Coder Director of Quality 4

5 Meeting Discussion Items Income Statement Expense Variances to Budget Discussion on Operating Metrics Volumes Case Mix LUPAs Therapy & Non-Therapy Productivity Overtime Visits per Episode Therapy Range Percentages BUSINESS INTELLIGENCE J.J. Guedet 5

6 HOW DO WE DO IT? Listen Investigate Analyze Share Report Ak Ask Questions Ask Questions Ask Questions Ask Questions BUSINESS INTELLIGENCE YEAR 1 Phase I Reporting Phase II Analysis Phase III Dashboards Phase IV Data Creation Major Changes New solutions New thought processes New expectations Evolution BI Pushed to leaders BI Used by leaders BI Pulled by leaders The pursuit of BEHAVIOR CHANGE 6

7 KEYS TO SUCCESS Identifying Needs Understanding di Fundamentals to Meeting Needs Understanding Data Where is it stored? What does it look like? How can it help? Thinking Creatively to solve problems Empowering / Encouraging Leaders WHAT WE ALL NEED - MASLOW 7

8 BI S ULTIMATE OUTCOME Improved Leadership Focus resources on problem areas Rapid projects to solve tough problems Increased Awareness and Participation Everyone involved Everyone accountable Improved Financial Performance Improved Clinical Outcomes OSF HOME CARE AND BUSINESS INTELLIGENCE 8

9 FIND YOUR CHAMPION(S) Qualities of a Strong Champion: Must have AUTHORITY Must BELIEVE in what you are doing Must hold others ACCOUNTABLE for performance Must be RESPECTED by those asked to change Must be PASSIONATE about improvement Must have VISION OSF HOME CARE CHAMPIONSHIP TEAM CEO CFO Vice President of Home Health Vice President of Hospice Vice President of HME & HIP 6 Sigma / Performance Improvement Team 9

10 DAY 1 = LOTS OF QUESTIONS Where do we start? What is most important? What do we need? How much will it cost? How long will it take? Who is our audience? WHERE DO WE START? Solutions that drive Financial Performance Improvement Do it better with what you have No Volume Increases required for 1 st project success Quick to develop and deploy Easy to understand Impacts majority of leaders and clinicians LUPA Management Recert Management Productivity Mileage Expense Reduction Therapy Ranges 10

11 WHAT RESOURCES DO WE NEED? MS SQL Server MS Excel 2007 or 2010 Clinical Resource to ask clinical questions Financial Analyst to validate Financial Improvement Champion(s) Examples of Expense Reduction THE SOLUTION 11

12 LUPA ANALYSIS THERAPY LUPA ANALYSIS 12

13 NURSING PRODUCTIVITY Improved from 4.94 Visits per 8 Hours Worked to 5.49 Visits per 8 Hours Worked Financial Impact approx. $475K Savings HOME HEALTH TRAVEL EXPENSE REDUCTION Improved from 15.6 Miles per Visits 12.9 Miles per Visits Financial Current Month Volumes approx. $250K Savings Improved from 28.2 Travel Minutes to 22.3 Travel Minutes Financial Current Month Volumes approx. $525K 13

14 SPIN-OFF PROJECTS Routine Visit Time Analysis Charting in the Home Non-Productive Time Analysis Missed Visit Reduction Admitting Team Intake Process Re-Design Case Management Project What is possible? THE FUTURE 14

15 WHERE ARE WE HEADED? New Reporting Tools Excel 2010 Business Objects McKesson HBI Partnership with IT Project under way to disseminate information via Internet to all clinicians End-User Guides Face to face training i in agencies Integration with Corporate Solutions Epic Data Collaboration with Decision Support Process Improvement IT Operations Perspective Cindy Bauling, vice-president home health 15

16 What s in it for leadership? Life before business intelligence. Always looking in the rear-view mirror Assumptions made on gut feeling Problem identification not timely Any change made took days to measure Tireless hours spent on manually pulling information Inability to continue the measurement of the metric due to manual process. another fire takes precedence Affinity to work on what s comfortable or known to leader Interaction with CFO was limited What s in it for leadership? Life after business intelligence Data to support leadership What is happening? How did it happen? When did it happen? What should have happened? Who was impacted? Why did it happen? 16

17 What s in it for leadership? Key Performance Indicators at your fingertips Ability for leader to drill down to individual component of performance Time specific Target specific Real-time reporting Means for leaders to focus their management energy Data-driven decisions Data-driven actions Data-driven performance improvement Data-driven results Ability to give objective & meaningful feedback A collaborative work environment Use of Dashboards Clinician dashboard Weekly/monthly operational dashboard Non-admit data cube Utilization data cube LUPA data cube Therapy utilization Emergent/Acute Care Hospitalization cube 17

18 Meaningful use of Clinician Dashboard Clinician Dashboard Productivity Weight points executed Missed visit percentage Average record time Average visit time Average travel time Average miles/visit Average transfers/day Continuity Clinician Dashboard Example 18

19 Meaningful Use of Clinician Dashboard Meaningful use of Dashboards Results of using Dashboards Improved productivity i Reduced miles/visit Reduced travel time Improved and sustained LUPA rate Improved and sustained recert rate Increased leadership and clinician accountability of performance 19

20 What s in it for clinicians? Life before business intelligence. Inconsistent and incongruent messages Feedback from leaders Data is old by the time it is received Clinician can not recall patient situation from months ago Inconsistently provided measureable feedback on performance Performers/non-performers getting the same message Performance improvement New processes implemented yet lagging metrics Lack of clinician buy-in to individual performance metrics They must be talking about someone else My caseload is different I drive more miles than anyone else I give more thorough care What s in it for clinicians? Life after business intelligence Regular feedback on performance Weekly Monthly Ability to know how I m doing in comparison to other clinicians within the agency Ability to know how I m doing in comparison to other clinicians within the division Ability to identify areas to work on as well as having control of performance Ability to see progress with incremental changes Increased accountability on individual performance 20

21 QUESTIONS? Contact Information Cindy Bauling Belinda Muck J.J. Guedet 21