Financial Opera,ons Track: ROI vs. ROCE (Return on Customer Experience) Speaker: Robert Lane, Strategic Sourcing Manager, Premier Health Partners

Financial Opera,ons Track: ROI vs. ROCE (Return on Customer Experience) Speaker: Robert Lane, Strategic Sourcing Manager, Premier Health Partners

INTEGRATION: Merging internal and external excellence into the best possible pa,ent experience. AGENDA: Three unconven,onal examples of how we combined internal and external assets to create the best possible pa,ent experience. Print Management: Record Storage: Medicaid Eligibility: A template for cultural change. Blending old and new technology. Internalizing an external service.

EXAMPLE ONE: Print Management

Print Management Context (2009-2011): We have 12,000 people producing over 84 million sheets of 8x11 paper each year. (50% desk top/50% Copiers & MFD s) We had 2,300 desk top printers and fax machines and an addi,onal 900 MFD s & Copiers. Total cost per month $130K (opera,ng). Desk top cost per month average = $67K. MFD cost per month, average = $70K. Four vendor rela,onships covered total output without sharing a common goal. Total asset value = $4.85 million ($4.5mm MFD s/$350k Desk- top Printers). Over 1,100 printer repairs per year. Goals: To move to a cost effec,ve print plaaorm that supports clinical staff & pa,ent care while elimina,ng non- value add burden. Deliver a single point for tracking all copy and print stats across the enterprise Aligning IT goals with cost avoidance. Streamline the management of prin,ng/copying supplies, volumes, and costs and drive out the inefficiencies.

Print Management ImplementaFon (2011): Categorize all devices (Desk- top Printers/Fax machines/mul,- func,onal Devices/ Copiers). Quan,fy burden by device type, including break down cycles and device age. Test and select mul,ple plaaorms that are IT Friendly. Define support to minimize burden and down,me, and op,mize quality of care. Select a supplier that understands our business needs and has a hardware and sogware support structure to meet those needs. Result (2011 2012): Today we have partnered with Ricoh. They manage 900 connected MFD s, maintain (toner and repair) 1,900 desk- top printers that support 14,000 people across six hospitals. All inventory, moves, and acquisi,ons of output devices are handled by Ricoh staffing. We have removed 400 of the 2,100 printers, moving that print volume to the MFD cost basis. Opera,ng cost is down by $20K per month and clinical down,me is about half of previous levels.

EXAMPLE TWO: Record Storage

Record Storage Context (2000-2012): We have 26 Super Users calling for records every day. HIM (one department) made up 50% of volume of boxes and daily ac,vity. Had 190,000 boxes of paper in storage. Es,mated 3 million pa,ent records. Being changed by episode by our supplier. Spending on average $750K per year with our previous supplier (60% of the spend going to storage holding ). In 2012 we fully implemented EPIC changing the need for tradi,onal record recall Average record recall was next day. Goals: Modernize our physical record reten,on prac,ce to match our EPIC system, delivering beler pa,ent care with respect to speed, quality of service, and cost.

Record Storage ImplementaFon: Set a standard of service driven by pa,ent/clinician need using EPIC as the anchor point. Take inventory of the volume we had accumulated over the past 21 years. Select a supplier that understood the storage needs and response,mes appropriate for today s healthcare standard. Select a supplier that could grow/flex their business to match our dynamic needs. Result (2011 2012): Selected a local supplier that was sized appropriately for our needs. Selected a supplier that could provide same- day informa,on delivery. Selected a supplier that capped our annual cost to $240K per year.

EXAMPLE THREE: Medicaid Eligibility

Medicaid Eligibility Context [Atrium Medical Center 280 Bed Hospital, Middletown Ohio] (2010): Supplier was interviewing all poten,ally Medicaid eligible pa,ents. We were paying an average of $450.00 for every patent that was enrolled into Medicare. Supplier was interviewing an average of 370 people per month. Supplier was filling out an average of 170 applica,on per month. Supplier was enrolling an average of 92 people onto Medicaid per month. Supplier was dedica,ng 1.5 FTE s to this ac,vity each. We were paying an average of $41,400.00 per month. Quality and service was excellent. Goals: Internalize the service making our pa,ent financial team the primary contact for all conversa,ons and punng the external supplier in the secondary support posi,on allowing us more control over the en,re process.

Medicaid Eligibility ImplementaFon (2011): Our team shadowed the supplier for two months prior to sourcing this service. Supplier was reluctant to give up control, but through the sourcing process, we nego,ated this control point. Opera,ons worked with each pa,ent financial representa,ve to build a level of comfort and exper,se in their interviewing skills. We decided that a pass off process would be best for our team. Result (2011 2012): We became the first contact across the board at AMC. If the Pa,ent Financial Representa,ve got into a hard place, they had the control to pass the pa,ent to the supplier. Long term care pa,ents get Medicaid pending numbers immediately, where we use to wait up to 5 days. The first month, we internalized 79% of the Medicaid applica,ons. $464,000.00 just at Atrium Medical Center. We have spread this to all other loca,ons, saving $1,400,000.00 system- wide, annually.

INTEGRATION RECAP: KEY POINTS: Assessment of internal and external strengths are cri,cal. Suppliers want to be adjunct employees in the pa,ent experience. Most non- clinical service / support suppliers need to be taught how to fit into the pa,ent experience. Opera,onal leadership is looking for extra hands (service supplier) but there is a perceived control gap when managing external people. The way we bridge this gap is by crea,ng custom feedback loops that links supplier performance to opera,ons showing total performance; volume, quality an value which is,ed to the pa,ent experience.

THANK YOU