Wholistic Health systems operates 39 hospital facilities and clinics. The executive team has been reviewing the key metrics over the last year and identified a need to improve Point of Service. The POS is a patient payment that is received within 7 days after discharge. Increasing POS is important for HHS because hospital are 60% less likely to receive payment once the patient leaves the hospital. the cost to collect on the patient's acct. continues to go up while the chance of collecting payment goes down if there is a delay in collecting the payment after the patient's discharge. Therefore, it is better to not delay collecting the payment. Increasing POS reduces bad debt, provides better cash position, reduces expenses, and increase patient satisfaction when conducted properly. POS is calculated by dividing POS payments for Total Patient Cash collected. HHS has identified the industry medium benchmark for POS as 13.6% and the top 10% POS benchmark as 41,4%. HHS current POS performance is 35.6% and the executive team has determined that a 5%-point increase is needed to stay competitive. (target=40.6%). POS is a metric that heavily relies on the patient Access team or PA. PA is responsible for several tasks, patient scheduling, registration, and financial clearance. The "scheduling" tasks are typically completed by a centralized PA team for multiple hospital facilities. During scheduling. PA reps. receive a doctor's order for a patient. The order is like a permission slip for specific medical services the doctor deems necessary. the doctor or even the patient related to the order can call scheduling reserve an appt. for services that correspond to what is written in the order. PA reps. need to verify that order is finish and accurate, coordinate time for services and provide patients with per-service instruction. After patient's information is logged into the scheduling system, it will queue up to the PA registration team to complete the registration process. PA will call the patient and confirm the identity, collect demographics such as dress, family, emergency contact etc. PA registration will also confirm the patient's health insurance providers. PA registration can be completed at a hospital facility will verify health benefits to ensure they exist and to determine if the procedure or service that the patient is covered. If authorization is required, the PA financial clearance will request authorization for services from the health provider. Services performed without authorization leas to rejected claims. Also, during PA financial clearance, the PA rep will counsel the patient about their liability (how much insurance provider says they need to pay for services) and collect payment. Any payment received is considered POS since it's before 7 days post discharge. Financial clearance can also be performed at the hospital facilities or by a centralized team. Summary patient data got HHS 39 hospital facilities for a year is present in Table 1. The table also indicates if the PA team for each facility and the if the PA tam for each facility is centralized or not. Table 2 provides an overall monthly trend for POS performance. The team identified the facilities with POS performance above the target and research the activates they have in place hoping to find commonalities or key drivers. They are: 1. ensure proper patient education on benefits and liability 2, ask for payment 3. have a financial counseling policy 4. reduce number of patients that leave without financial clearance 5. have an accurate tool to help estimate patient liability or responsibility 6. utilize devices that allow patient collections at patient bedside This is the explanation of the problems the HHS system is looking for.

Exercise 1. Process stability- Using the data given in Table 2, determine if the POS performance is stable using a control chart.

Exercise 2 Scope Opportunity- Using the data given in Table 1, how would you scope the focus area of the project?

Exercise 3 Testing a theory-Use the data from Table 1 and conduct a hypothesis test to determine if centralized teams impact POS collections

Exercise 4 Solution Categories-Based on the information provided what could be affinity categories for the key drivers that impact POS performance? Analyze Holistic health systems point of service collection performance. The need is to determine if the process is in control. Use the facility performance data to identity where the most opportunity is available and also test a theory to discover if a specific factor impacts performance

Table 1

2015 POS

Facility POS pymt All patient pay POS% Centralized team

FVR $1,372,015 $6,860.07 20% Y

LAK $1,301,746 $3,348,748 39% Y

PLA $2,964,730 $6,854,164 43% Y

CGH $625,428 $1,709,452 37% Y

FLO $849,646 $2,141,211 40% Y

DEL $2,324,347 $7,824,857 30% Y

GSM $2,624,347 $9,710,312 37% Y

PBG $1,713,107 $6,062,173 28% Y

SMH $5,936,564 $10,355,241 57% Y

HIA $1,215,112 $2,250,807 54% Y

PGH $2,234,134 $5,395,099 41% Y

MAN $1,311,286 $3,611,438 36% Y

MOD $2,997,636 $7,494,091 40% Y

WBO $2,273,401 $8,743,582 40% Y

LOM $2,358,653 $8,133,287 29% Y

BAR $1,457,038 $5,286,184 28% Y

DES $2,676,236 $9,581,654 28% Y

IND $1,076,377 $2,979,026 36% Y

DHW $2,145,483 $5,249,186 41% Y

ECH $2,428,480 $7,833,806 31% Y

HHH $2,253,084 $7,080,024 32% Y

SCH $548,628 $1,739,024 32% Y

GBH $2,455,353 $7,262,268 34% Y

BMC $3,486,532 $13,946,130 25% Y

CYF $4,524,470 $10,796,357 42% N

DHF $2,416,085 $4,624,894 52% N

FRH $2,182,243 $6,929,016 31% N

HMN $5,600,722 $12,446,048 45% N

LPX $3,379,727 $9,134,398 37% N

NMC $1,946,885 $4,378,487 44% N

PPH $1,969,620 $3,939,240 50% N

PRV $6,015,807 $12,253,503 49% N

SES $1,940,017 $4,971,199 39% N

SPH $3,254,250 $7,850,558 41% N

SIE $3,051,755 $6,999,804 44% N

SRM $2,658,292 $10,909,840 24% N

SVM $1,606,482 $6,573,344 24% N

TWI $1,297,858 $5,225,755 25% N

Table 2 2015-16 POS trending

POS Payment All patient pymt

14-Jan $8,198,401 $22,105,614

14-Feb $6,409,335 $20,449,785

14-Mar $7,452,507 $25,357,473

14-Apr $7,853,058 $24,320,414

14-May $7,277,831 $24,815,250

14-Jun $8,975,092 $20,309,240

14-Jul $7,349,353 $24,904,316

14-Aug $6,804,829 $23,349,092

14-Sep $7,898,465 $20,829,620

14-Oct $7,888,816 $18,506,142

14-Nov $5,834,679 $17,386,881

14-Dec $9,021,591 $18,659,237

15-Jan $8,717,536 $18,956,764

15-Feb $6,623,228 $19,008,749

15-Mar $7,696,772 $22,971,163

15-Apr $8,312,773 $23,437,612

15-May $9,028,170 $21,358,646

15-Jun $7,436,050 $22,168,016

15-Jul $7,852,119 $21,971,591

15-Aug $6,933,100 $23,650,610

15-Sep $8,623,086 $26,860,403

15-Oct $7,850,627 $21,346,585

15-Nov $7,691,110 $23,004,295

15-Dec $8,602,245 $22,939,623