Our Footprint. Our Story. HISTORY Established January 1, 1993 Merged Four Practices Nine Doctors
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1 Our Footprint Our Story ISTORY Established January 1, 1993 Merged Four Practices Nine Doctors GUIDING PRINCIPLES Professional Management Economies of Scale Competition Leverage in Contracting Ancillary Services Our vision is to be the best choice for health care in our community. 1
2 Market Position Today Snapshot 230 Medical Providers 171 Physicians 59 ARNP s & PA s 3,000 Patient Encounters Per Day 750,000 Patient Encounters Per Year 33 Medical Specialties 2 Ambulatory Surgery Centers 4 Diagnostic Imaging Centers 2 Urgent Care Centers Physical Therapy Pharmacy Nuclear Medicine St. Joseph s ospital Main Bayfront ealth Dade City Florida ospital Zephyrhills St. Joseph s ospital North Florida ospital Wesley Chapel Florida ospital Tampa Florida ospital Carrollwood Tampa General ospital Brandon Regional ospital MARKET OVERVIEW 40 Locations 33 Medical Specialties 220 Medical Providers 750,000 Annual Patient Encounters 550,000 Square Feet 2
3 St. Joseph s ospital Main Bayfront ealth Dade City Florida ospital Zephyrhills St. Joseph s ospital North Florida ospital Wesley Chapel Florida ospital Tampa Florida ospital Carrollwood Tampa General ospital Brandon Regional ospital FIVE YEAR PROJECTION 70 Locations 375 Medical Providers 1.3 Million Annual Patient Encounters Florida Medical Clinic - Wiregrass 3
4 Florida Medical Clinic - Wiregrass Looking Ahead Strategic Initiatives What constitutes a high performing health system? Innovative solutions that not only improve outcomes, but fundamentally transform business objectives in order to succeed in a value-based healthcare environment. 4
5 Definition of a igh Performing Group: AMGA Organized System of Care Care Coordination Efficient Use of Services Florida Medical Clinic Quality Measurement & Improvement Activities Compensation Practices that Promote igh Quality & Low Cost Use of IT & Evidenced-based Medicine Accountability To achieve valued based care you must be a high performing group. Value Based Care IGEST QUALITY AT TE LOWEST COST EQUALS VALUE EIDIS Score ACO Quality Scores over 11,000 Medicare members BCBS United ealth Care Medicare Advantage over 12,000 members 5
6 Future Opportunities Clinically Integrated Network Ambulatory Surgery Center Program Development Stroke Program Orthopaedic Expertise Wound Care Spine & Spinal Deformities Infectious Diseases GI Center of Excellence Physician Recruitment Expanded Markets OUTSOURCING: EALTCARE S PANORA S BOX? 6
7 Outsourcing the Revenue Cycle REVENUE CYCLE CANGES As various facets of the revenue cycle become more difficult to manage and maintain, practices are tempted to seek outside expertise in order to maximize their effectiveness. What Are We Looking For? EXPERTISE Billing Collections Coding Optimization Patient Collections Contract Modeling Claims Adjudication Best Practices uman Capital Reporting/Analytics Compliance Continuing Education Feedback Loop Permanent or Temporary? 7
8 What Are We Looking For? VENDOR SELECTION PROCESS Recommendation Recognition Interview the team Senior Management Staff PRE-ENGAGEMENT REVIEW What is the data set? Outcomes (Error rate) Extrapolation Contracting Considerations COMPLETE/PARTIAL OUTSOURCING? Patient Collections At locations Outreach Customer service line OTER CONSIDERATIONS Term/Termination Provisions Measurement parameters and performance criteria Fees % of total Collections % of incremental collections Validation Other Patient Accounting and ER system IPAA Collections/Cash/Bank Accts/Payments 8
9 FMC s Experience: The Box is Open FMC s Experience: The Box is Open Unexpected Billing Challenges Unfamiliar with System Inconsistent staffing Coding mistakes No process for reconciling to Provider Bill Problems with Collection Process No vendor tracking of posted transactions Mis-posted/mishandling of unapplied Non-existent reporting 9
10 FMC s Experience: The Box is Open Coding Actual changes not nearly as dramatic as Free analysis Minimal bottom line impact Poor supervision Patient Collections Inappropriate Patient outreach Posting Incorrectly FMC s Experience: The Box is Open Contract Modeling support No appreciable expertise Provided as an after-thought Claims Adjudication Incorrect Blamed our system Severe Provider Dissatisfaction Gave Away Revenue No reduction in FMC staff involvement 10
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