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Chairman’s 4th Message
by Imp. Sir Douglas Maxwell, Posted on February 27th, 2010

Subject: 3rd Party Pay... "Revenue Cycle Committee" & Shriners Hospitals plan for helping the "Children of Haiti"

My Dear Fellow Noble,

Happy New Year & Happy Ground Hog Day….

This is going to be a “Good Year” for our philanthropy… I truly believe that…

We are now moving forward with the two major legislation changes that were voted for in San Antonio

  • 3rd Party Pay/ “Revenue Cycle”
  • Changes in our Hospitals “Models”/ “Care Presence” in some of our 22 locations

    We have just concluded the “Leadership Seminar” in Tampa.

    Our 22 hospitals leadership teams;

  • the Chairman and Vice Chairman of the Board of Governors,
  • our Administrators,
  • our Chiefs of Staffs,
  • and our Directors of Patient Care Services, DPCS

    come together to exchange thoughts and ideas… and learn what are the latest issues that are affecting our system.

    The “first presentations of the seminar" were on the new models of “Care Presence” at some hospitals (Item 18 on San Antonio’s call)

  • First up were the changes planned for our Erie and Twin Cities hospitals
  • And then the proposed regionalization of our Houston and Galveston Hospitals. (See Chairman’s 3rd Message Nov 17, 2009, for details)

    We then moved into an… open “Brainstorming Forum”… similar to last year's “Associations Meetings” around the country…we discussed

  • what might work for additional cost efficiency in the running of our hospitals, and moving on to
  • “Revenue Enhancement” from our hospital buildings…

    Such as leasing areas of our structures (to medically related organizations)…that we are not currently using.

    One other subject that preceded the “Main Seminar Topic” was “Cost Reduction of Patient Transportation for our Shrine Temples”.

    In December, I formed a new committee, Chaired by Bob Smith…with the mandate

  • To study ways to still give our children the same… “wrap-around care”… that we are so well recognized for…
  • But… to lower the travel cost of this “Follow Up Care” … borne by our Shrine Temples.

    This “Committee” is made up of all the disciplines that are involved in this procedure: from Hospital Chairman, to Administrators, to our Doctors, to our Nurses, and to our Care Coordination Managers.

    The main recipients of this information, as it develops, will be our Potentates and Chief Rabbans of our Shrine Centers.

    And now…the “Main Event”

    3rd Party Pay…Revenue Cycle Group

    On Tuesday July 7th, 2009…Item 27 on the Call of the 135th Annual Shrine Meeting relating to 3rd Party Pay, was brought forward for consideration.

    After discussion…this legislation was overwhelmingly passed…and Shriners Hospitals for Children was to begin a new era.

    The question was then asked of all the voting representatives…

    Do you want to… “Study this for a year”…or… “Go for it…now”…

    The response was very clear… “Go for it Now”…

    The Chairman of this new “Revenue Cycle Committee”, Imperial Sir Alan Madsen is doing exactly that.

    The Goals of Imperial Sir Al’s committee for a successful… Revenue Cycle… were stated as;

  • A Robust, Compliant revenue stream
  • Supports the… Shriners Mission and Brand
  • “Shriners Control”… of Performance and Patient experience
  • Patient Decisions determined by… “Quality of Care”…not financial implications
  • Patient-centric processes…ensuring a…”Painless Patient Experience”
  • Shared Services…that provide Economies of Scale

    The Revenue Cycle Committee is initially divided into three Main Sub-committees:

    The Front End Committee…Chaired by Portland Administrator Rick Cagen…is responsible for setting up areas like;

  • Appointments
  • Scheduling
  • Insurance Verification
  • Financial Counseling
  • Registration and Admissions

    The Middle Committee… Chaired by Spokane Administrator Gene Raynaud… is responsible for;

  • Clinical Coding
  • Document Integrity
  • Doc Imaging and Transfer
  • Order Entry
  • Case Management

    The Back End Committee…Chaired by Philadelphia Administrator Ernie Perilli… is responsible for;

  • Account Resolution
  • Electronic Data Interface
  • Billing
  • Payment Posting
  • Reports and Metrics

    These Three “Lead Committees” have determined that this Revenue Program should;

  • Maximize revenue stream by facilitating the “implementation” of a Turnkey revenue cycle solution.
  • Using initially the short term approach of “Decentralization through Outsourcing” and then
  • The long term approach of “Where Cost Effective… System Centralization”

    The Committee feels that Short Range initiatives should not come at the expense of the better long range solutions.

  • Streamline this implementation by building on our “Existing Capabilities”

    And also… strategic “Outsourcing Opportunities."

  • Strike “appropriate balance” between speed of implementation and risk.
  • And definitely Preserve the Existing Shriners Hospital Culture and Mission

    The Revenue Cycle Committee is on a path to begin our first “Billings” in 5 months … July 1st, 2010 for our Phase 1 group

  • Phase 1 Hospitals…Cincinnati, Philadelphia, Lexington, and Portland.
  • Phase 2 Hospitals…Spokane, Erie, Tampa, and Salt Lake City… beginning on Oct 1st, 2010
  • Phase 3 Hospitals…Springfield, Boston, Chicago, and St Louis… beginning on Jan 1st, 2011

    And the remaining eight U.S. Hospitals will be in Phases 4 & 5, starting during 2011.

    With this Plan of Implementation… the projected Return on Investment (ROI) as calculated by our Consulting Group… “Price Waterhouse Cooper”

  • “Net Revenue” for Year 1…$12.5 million,
  • Year 2…$108.8 million, and rising in
  • Year 3…to $172.6 million.
  • Years 4 & 5…estimated to exceed $175 million per year

    After seeing this ROI analysis

    Our new Executive Vice-president at HQ Keith Gardner, stated “I’m very Optimistic for the future of Shriners Hospitals for Children."

    With what we have done in this area of “Revenue Enhancement” And our exploring of new “Care Models” for some of our locations I echo Keith’s sentiments of being very “Optimistic."

    By providing this “New Revenue from Insurers” and “by Reducing the Demand on our Endowment Fund” It should allow us “new opportunities” for helping children. If we do this well the hope is that it will help reduce the current deficit between “Traditional Revenues and Expenses” and allow us in the future to be able to help additional children.

    As your Chairman of the Board of Trustees I look forward to traveling to many of our Spring “Regional Shrine Association Meetings” and give you updates on the “Changing Face” of SHC.

    Yours in the Faith,
    Doug Maxwell
    Chairman of the Board of Trustees

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