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Assessing The Value of Web 2.0 on Knowledge Management A HEALTH CARE REIMBURSEMENT STUDY ICELW CONFERENCE JUNE 2013

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Agenda About Me Research KM and Web 2.0 The Industry The Organization KM Challenges Web 2.0 / KM System Qualitative / Quantitative Analysis Limitations

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About Me Undergraduate in Management Work in Financial Services, Insurance, Healthcare MBA Healthcare / Marketing MS Industrial Relations (Economics) Adjunct Professor Traditional, Online, Hybrid DBA Operations and Information Management Impact of Web 2.0 on KM Mixed Methods Research Expected 2015

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Knowledge Management (KM) Strategies and practices used to identify, create, represent, distribute, and enable adoption of information and experiences Focus on objectives such as improved performance, competitive advantages, innovation, the sharing of lessons learned, integration and continuous improvement. Overlap with organizational learning includes a focus on knowledge as a strategic asset. Charlies Story

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Charlies Consulting Service Hitting Valve With Mallet.... $ 1.00 Knowing Where and How Hard.$ 24,999.00 Total Due... $25,000.00

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SECI Model

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Web 2.0 Second Generation of the World Wide Web. Collaboration and Information Sharing Online. Web 1.0 Static => Web 2.0 Dynamic Open Communication, Web based Communities Communities Of Practice/Knowledge Wisdom of Crowds Blogs, Wikis, Social Networks

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Industry Overview Health Care Funding Physician / Hospital Payments Third Party Payers Government (e.g. Medicare, Medicaid) Insurers (e.g. Commercial Payers) Self Pay Negotiated Contracts Participating Physicians Large (and Growing) Physician Practices

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Payment Process Physician Renders Service Claim Submitted to Payer Payer Processes Claim Payment Made to Physician

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Payment Failure Points Physician Renders Service Claim Submitted to Payer Payer Processes Claim Payment Made to Physician Failure Coding error Output error Contract Error Administrative error Processing error Application error

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Commercial Payers & Managed Medicare

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The Organization - Consultant Services Understand Contractual Agreements Virtually always changing Administered incorrectly Review Billing and Payment Data Monthly cyclical process Identify Physician Underpayments Work with Payers to Make Physicians Whole Payment on Contingency basis Account Managers Compensated on Successful Payment Recovery

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The KM Challenge Know 10 12 Clients and 20 30 Payers Different Contractual Agreements Different Requirements Multiple Projects in Flight Monthly Data changes Understand the Impact of Regulatory and Administrative Changes Contract Renewal Dates Important Milestones Rate Increases Coding Changes Knowledge Sharing across Clients and Payers

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Collaborate More Easily Work with Coworkers, Clients, and Vendors. Create, Follow and Contribute Discussions Make Announcements Share Documents, Coordinate Calendars Hold Web Meetings Manage Tasks, Build Web Databases Implemented and Developed Over 2008 -Present

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Home Page

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Contract Models

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Ad Hoc Reports

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Task Tracker

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Issue Tracker

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Discussions

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Reimbursement and Coding Updates

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Client Issues

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Quantitative Analysis Identify Contributions to Database Measure Results in Performance Tracked Monthly Results 42 Months worth of data Measure Correlation using SPSS Pearson Product-Moment Correlation -1 is a Reverse Correlation 0 is Absolutely No Correlation +1 is a Positive Correlation

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Client 1 / Payer 1 - Correlation

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Client 2 / Payer 2 - Correlation

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Qualitative Analysis Interviews with Individuals Increased Autonomy Convenient place to house information Good reference tool; less information to remember Ability to search Downloadable information for analysis Easy to use Consistent format data entry

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Employee Engagement Increase in Employee Engagement Less dependence on asking the question More reliance on the data base More autonomy in work More continuity if people not available Increase in documentation How did we get buy without it?

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Study Limitations Small Company size Specific Industry / Specialized Work Early inconsistent use of WebOffice Early inconsistent tracking of Monthly Financial & Operational Data Difficulty Coding Data Contributions Timing and Quality Additional Study Opportunities Comparing Separate Organizations or Industries

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Questions? I hope to be back next year with additional information!