ALAMEDA HEALTH SYSTEM HB STABILIZATION HB KEY METRICS Status As of - PowerPoint PPT Presentation

ALAMEDA HEALTH SYSTEM HB STABILIZATION HB KEY METRICS Status As of 1/31 As of 1/24 Bottom Median Metric 13wk Top 73.1 Days $623.8M 74.6 Days $633.2M 75.1 Days 70.8 Days 63.1 Days Epic AR Days s 99.5% -$4.9M 99.2% -$8.4M 99% 99% 100.8% 104% Charging Variance s Payment Variance q -5.4 Weeks -$58.5M -5.9 Weeks -$63.2M -2.4 Weeks -1.5 Weeks -0.4 Weeks Epic Pmt Avg q 65.6% $7.1M 49.1% $5.3M 91.3% 95.2% 102.4% 22.2 Days $191M 21.6 Days $184.8M 8.5 Days 7.6 Days 5.6 Days Epic CFB Days q 1.1 Days $9.5M 1 Days $8.8M 2.5 Days 1.9 Days 1 Days Coding Days r 7.3 Days $62.9M 7.5 Days $64.1M 2.5 Days 2.1 Days 1.2 Days Claim Edit Days q 2 Days $17.3M 1.4 Days $12M 2.2 Days 1.8 Days 1.1 Days Open Denial Days s Status Key: Bottom Threshold for the 35th percentile for the metric at week 18 p = Better than top 25% s = Below median Median Median value for the metric at week 18 r = Better than median q = In the bottom Top Threshold for the 75th percentile for the metric at week 18 • Current Epic AR Days is 73.1 Days, down from 75.1 • Soarian AR Days were 78 on 06/30/2019. Best performance was 71 days on 12/31/2018

HB AR Breakdown Other Days 80 Outsourced Days 1.4 70 2.0 2.0 Credits Days 2.4 4.0 3.1 60 Self Pay Days 2.6 2.4 0.7 2.1 Open Denial Days 37.6 33.9 0.6 50 35.6 31.8 0.6 26.6 27.4 Outstanding Days 23.3 24.3 23.1 20.7 0.1 20.2 40 CFB Days AR Days 16.4 Baseline AR = 75.7 Days 0.1 13.4 9.6 Min Hold Days 0.0 30 6.5 In House Days 22.4 0.0 20.3 2.9 20.8 20.7 21.8 24.1 22.7 20.9 18.3 20.9 20.6 13.8 19.3 20 18.9 12.1 10.0 0.0 0.9 4.8 10 0.0 0.0 1.3 0 -10

Financial Activity 18 Total Payments 16 Baseline Pmts = $10.8M 14 Expected Payments Financial Activity (in M) 12 10 n Epic Payments 8 n Epic Adjustments n Legacy Payments 6 n Legacy Adjustments 4 2 0

Epic CFB Days Top Median Bottom Alameda Health System 30 25 20 AR Days 15 10 5 0

AR Breakdown Undistributed 60 Outstanding Statement Baseline AR = $52.8M 50 Pending Statement 3.3 1.7 2.9 1.7 1.3 Open Denial 40 1.2 Outstanding Claims 1.1 0.9 No Claim Status 0.7 30 AR Dollars (in M) 0.5 31.4 40.8 40.8 Claim Edit 40.1 38.7 0.8 34.3 31.9 Claims Pending 20 25.2 0.6 24.3 21.2 0.4 18.1 0.6 14.3 10 0.0 12.2 3.1 8.9 0.0 7.6 3.2 4.7 5.5 3.2 4.7 5.3 3.2 3.2 0.0 4.1 2.8 3.1 3.4 2.1 2.4 2.8 1.8 1.1 0.6 0.4 0.0 0.1 0 -10

Financial Activity 1.4 Total Payments 1.2 Expected Payments 1.0 Financial Activity (in M) Baseline Pmts = $1.2M n Epic Payments 0.8 n Epic Adjustments n Legacy Payments 0.6 n Legacy Adjustments 0.4 0.2 0.0

Epic CFB Days Top Median Bottom Alameda Health System 30 25 20 AR Days 15 10 5 0

• On-Site, Cross-functional Teams (IT, EPIC, Contractor) matched with Revenue Cycle leaders and their team. • Increase Elbow Support for Revenue Cycle • Additional onsite support from Epic • Additional Leadership support for targeted training, support and improve overall performance • ARCR biweekly “Hit List” huddles to review and address high level issues drive down CFB • Weekly Command Center Activities – Focused IT/Operations/Epic teams to drive down high level issues

• Manual ED Charge Review currently for all Level 4/5s • Improve documentation • Goal is to automate and perform regular audits • Working with ED and IT Teams to automate process • (Levels 1-3 have been automated for several months. Some Level 0’s have come through as a result of entry errors) • Unposted Surgical/Procedural Charges • Developing more efficient process to load new supplies/hardware into Epic on a regular basis • Working with various Clinical Teams to speed up process • Paper Attachments to Claims • Automating Electronic claims attachment functionality

• ABN Process (a compliance concern) • Work with Clinical Leaders, IT and Revenue Cycle to put in place • Will scientifically reduce write offs for our MediCare Claims • Contract Review • Ongoing workgroup to review contract discrepancies and payment variances • Additional System Automation • Now that we are stabilizing our new system we are turning on additional automation to replace many manual processes • Care Management • Increase concurrent review and improve documentation timing • CDM Review • Improving our CDM updating process and pricing