<Confidential>1

TheFuture is Now:

Maintainingpractice profitabilitywithout sacrificing

patient care

<Confidential>2

The Landscape

Increasing Legislative & Regulatory Requirements

Reimbursement Uncertainties

New Payment Models

New Delivery Models

Physician Alignments

<Confidential>3

Welcome to The New Healthcare Paradigm

Maximize Patient Care Time

+

Minimize EVERYTHING ELSE

=

Better Quality Care

+Decreased Risk

+Better Reimbursement

<Confidential>4

Get ready for Value-Based Purchasing

In 2016, CMS will apply Value-Based Payment formulas for Medicare fees All physician practices with 10+ eligible professionals Payments based on national quality of care and cost

of care benchmarks

Quality/Cost Low Cost Average Cost High Cost

High Quality +2.0x* +1.0x* +0.0%

Medium Quality +1.0x* +0.0% +1.0%

Low Quality +0.0% =1.0% -2.0%

*Eligible for an additional +1.0x if reporting clinical data for quality measures and average beneficiary risk score is in the top 25% of allbeneficiary risk scores.

<Confidential>5

Reinventing your Practice

Risks

Operational

Clinical

Regulatory & Technology

MPL & Legal

Financial

<Confidential>6

Operational Risks

Question: What is the most valuable asset in your practice?

Answer:The Provider's Time!

<Confidential>7

The Value of a Practice Minute

Schedule

$1.49

Check-In

$1.30

Room-In$1.62

Patient Visit$7.50

In-Office

Follow-Up

$1.62

Check-Out

$1.30

Post-Visit

Follow-Up

$1.75

Billing$1.74

Total=$18.32Source: Mary S. Applegate, MD, FACP, FAAP, Clinical Asst. Professor of Medicine, The Ohio State University College of Medicine

<Confidential>8

Workflow Analysis

-An established process describing:

A series of tasks (activities) How they are accomplished (steps) By whom (people) In what sequence (order) At what priority

that accomplishes a defined step(s) in an activity

<Confidential>9

Workflow Analysis

What's In It for My Practice? Health Insurance Exchanges Value Based Purchasing v. Fee

For Service Patient Engagement Streamlining Practice Based on DATA New Technology Works for Practice

<Confidential>10

Workflow Analysis

What we've learned from CARE Certification Program on-site sessions: Management Attitude: “Everything is fine” Time Constraints Call Volume & Triage Duplicative Efforts Lack of Coordination between Front & Back Office Lack of Teamwork Patient Non-Compliance Physician Attitude:

“We don't have time for customer service.” “We tried that & it doesn't work.”

<Confidential>11

Workflow Analysis

How To Do a Workflow Analysis1. Select a Process – Start Small!2. Involve Staff! Collaborate!3. Identify Current Activities/Steps – List or

Graphic4. Identify Issues/Bottlenecks

Data!

5. Identify Improved Activities/Steps – List or Graphic

6. Test (PDSA) Data!

7. Modify & Train

<Confidential>12

Workflow Analysis

Processes To Analyze Patient Flow Through Office (through-put)

1. Scheduling/Appointments

2. Reception

3. Waiting

4. Rooming

5. Clinical Exam

6. Check Out

7. Follow Up/Care Coordination

Revenue Cycle Management/Billing/Claims Referrals Diagnostic Testing

<Confidential>13

Workflow Analysis Example

<Confidential>14

Continuous Workflow Improvement

Do Study

Act

Plan

<Confidential>15

Workflow Analysis

Resources: Capko, Judy, Secrets of the Best-Run

Practices, Greenbranch Publishing Cohen, Frank, Lean Six Sigma for the

Medical Practice – Improving Profitability by Improving Processes, Greenbranch Publishing

Institute for Healthcare Improvement, PDSA Worksheet, http://www.ihi.org/resources/pages/tools/plandostudyactworksheet.aspx

Woodcock, Elizabeth, Mastering Patient Flow Using Lean Thinking to Improve Your Practice Operations, MGMA

<Confidential>16

The Results

Increased reimbursements

Improved quality of care

Higher patient & staff satisfaction

Lower risk of malpractice

<Confidential>17

For Details

For a personal presentation, contactSusan Lieberman, MBA

Vice President, Risk ManagementConventus Inter-Insurance Exchange

877-444-0484, x466slieberman@nipgroup.com

www.conventusnj.com