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Methodist Healthcare System of San Antonio
Challenges
Providing High Quality Care
in a Volatile Market
Like most healthcare organizations,
Methodist Healthcare faces a range of
pressures in an industry challenged in
recent years by declining reimbursements
and a slew of new operating requirements
mandated by healthcare reform.
With revenues and margins at risk of
shrinking, the healthcare system has
been focused on reducing ancillary
expenses wherever possible and
redirecting the savings into patient care.
“When we think about patients, we think
about how we can save money so we
can take those dollars and put them into
clinical care,” said Geoffrey Crabtree,
senior vice president at Methodist.
“We’ve got to find new and innovative
ways of cutting down our ancillary costs”
Adapting to Healthcare Reform
The Affordable Care Act is requiring
providers like Methodist to meet a host
of new operating requirements. Reimburse-
ments from Medicare and other govern-
ment programs (the source of 60% of
Methodist’s revenue) are increasingly
tied to performance metrics like patient
readmission rates. As a result, Methodist
has had to spend more time educating
patients after they leave the hospital to
ensure they don’t return.
“With the Affordable Care Act, we will be
spending more time concentrating on
better educating our patients about what
they should be doing when they get home
out of the hospital,” said Palmira Arellano,
vice president of marketing and public
relations at Methodist. “That means
developing and printing of more manuals,
brochures, and fact sheets, which arms
our patients with the information they
need to keep them out of the hospital.”
Driving Growth
Growth has been central to Methodist’s
success in the last two decades. But that
growth also led to operational challenges,
including how to support the
“It is often said that location is everything.
Having the Print Center on-site in the corporate
office right next door to marketing absolutely
increases productivity.”
Healthcare
Business Benefit Assessment
– Geoffrey Crabtree, Senior Vice President
Methodist Healthcare System of San Antonio
Study Highlights
Methodist Healthcare System’s
investment in Xerox products, solutions
and services are projected to generate
$262K net benefits for YTD May 2014.
• 21% return on investment (ROI) for
YTD May 2014
• Managed growing print center
operation with no increase in staffing
• Print on demand production model
enabled zero inventory on hand
• Achieved 100% compliance with
branding, legal, and compliance
requirements
• 95% of all print requests returned
within five business days (meeting or
exceeding service level agreement)
• Reduced print-job submission time
from 1–2 minutes to less than
30 seconds
Fifth Largest U.S. Healthcare System Teams with
Xerox to Save on Printing Services and Sharpen
Focus on Patient Care

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organization’s expanding need for print
services. Methodist executives reasoned
that by improving the patient experience
compelling after-care education, the
healthcare system would attract new
patients and stimulate growth.
Getting Lean and Flexible
Methodist also sought faster and more
flexible ways of meeting the printing
demands of its expanding organization.
One way it could do this was by bringing
printing services in-house and creating
a lean, just-in-time delivery model to
minimize waste, better manage inventory,
and speed turnaround.
On-demand printing makes sense for
healthcare organizations that need to
keep up with constantly changing regula-
tions. Printing and storing forms that
quickly become outdated can create a
cost burden for the organization, while
delays in distributing new documents
can lead to bottlenecks in delivering
care and filing for reimbursements.
Solution
Introducing Xerox®
Centralized
Print Services
Methodist addressed these challenges by
forging a comprehensive partnership with
Xerox. “We wanted to find someone in the
printing business who understood
healthcare,” said Crabtree.
One of the partnership’s most important
initiatives was creating a centralized print
services organization. Originally run out of
a local warehouse, Methodist later moved
the print center to its corporate head-
quarters to more effectively serve the
needs of department heads as well as
revenue-generating “walk-ins” from
businesses around San Antonio.
In addition to the central print center,
Methodist deployed a fleet of 275
Xerox®
printers and multifunction devices,
of which more than half are currently
connected to the healthcare organiza-
tion’s network. Xerox®
multifunctional
devices continue to provide value while
reducing the environmental impact of
print as Methodist continues to grow
and expand.
Seamless Partnering That Delivers
Excellence
Now into its second decade, the partnership
between Methodist and Xerox continues
to uphold the shared values of the two
organizations. “This is one of those partner-
ships that we brag about a lot,” Crabtree
said. “It’s two organizations that think alike.
Xerox is looking at ways to save us money,
and we are looking to Xerox to help us
save money.”
Methodist Healthcare
System at a Glance
• Largest provider of health services
in San Antonio and South Texas
• Fifth largest healthcare system
in the U.S.
• Operates network of nine hospitals
and dozens of clinics and ancillary
facilities
• Second largest private employer in
the area with more than 8,000
employees.
• In 2013, Methodist Healthcare
provided services to 86,000 inpatients
and 366,000 outpatients.
• More than 2,500 physicians in all
specialty areas have privileges to
treat patients at Methodist facilities.
“We’re in the healthcare
business, we’re not in the
printing business.”
– Geoffrey Crabtree, Senior Vice President

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Although they are technically Xerox
employees, print center personnel wear
the same badges as regular Methodist
employees and enroll in many of the
same training classes.
No value is more important to Methodist
than excellence; in fact, “Methodist
Excellence” is one of the organization’s
most popular maxims. Not surprisingly
this value has been woven into the culture
at the print center, where Xerox staff
members are encouraged to think of new
ways to boost production quality and serve
customers — and to freely implement
improvements. Far from just taking print
orders from Methodist staff, print center
employees frequently contribute to the
creative process. “When we sit down with
the print center manager, any and all
printing ideas are fair game for modifica-
tion and enhancement,” said Palmira
Arellano, Methodist’s vice president of
marketing and public relations. “The end
product is always fabulous and almost
always better than the idea I had when
I walked in.”
Benefits
Cost Savings and Revenue
Enhancements
After introducing process automation and
streamlined workflows at its print center,
Methodist captured significant savings
and enhanced revenue flows. In 2014
the healthcare system is tracking a 21%
ROI and $262K YTD May 2014 net cost
savings by taking advantage of steep
discounts in color, black and white, and
offset printing services available through
the Xerox-managed, in-house production
model. Currently the print center can handle
virtually every request for graphically rich
marketing and educational materials,
enabling Methodist to avoid paying
extra for outsourced services.
Running an in-house print center allows
Methodist to capture additional revenue
from outside businesses. This year to
date (2014) the center pulled in more
than $10K per month of walk-in revenue,
putting Methodist on track to exceed
its annual revenue estimate.
Process Efficiencies
Using an online workflow portal introduced
by Xerox, Methodist employees now submit
print jobs in about 30 seconds on average,
compared to 1-2 minutes before, giving
them extra time to devote to other tasks.
Employees simply enter their user ID and
the system automatically fills in their
contact information; users then choose
from a menu of service options, such as
selecting a particular form they need
printed, or uploading files.
The Xerox system tracks the entire produc-
tion process, ensuring accurate chargebacks
to the originating department and
providing visibility into key service-
performance metrics, such as turnaround
time. Methodist reports that the print
center is exceeding its service level
agreement, which calls for fulfilling all
print requests within five business days.
Consistently Fast Service
Currently the print center fulfills 95% of
all print requests within five business days,
consistently meeting or exceeding Xerox
and Methodist’s service level agreement.
Methodist attributes this achievement
to a combination of joint commitments,
including the online job-submission and
workflow system, centralization of services,
continuous print technology and process
refinements, and ongoing staff training.
Print Services
Cost
Avoidance
$1,246K
$85K
Revenue
Generation
Services
$1,331K
Total
Benefits
$1,069K
$262K
Central
Print Services
Cost
Net
Benefits
Figure 1. Project Cost and Benefit Analysis (YTD May 2014)
“Xerox lives the mission, vision, and values of Methodist.”
– Geoffrey Crabtree, Senior Vice President

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Regulatory Compliance
Methodist executives say that the central
printing model has been instrumental in
helping the healthcare system meet
complex legal and regulatory requirements,
including mandates from Medicare,
Medicaid, the Joint Commission, and
other bodies. Recently, for example,
Medicare mandated that all physician
signatures also include a date and time,
forcing modifications to existing forms.
Using online tools, the print center easily
updated hundreds of forms to ensure
immediate compliance. And because the
print center prints nearly everything on
demand — and maintains no physical
inventory — Methodist can avoid the waste
of throwing out stockpiles of old forms.
Similarly, Methodist’s print center rapidly
redesigned a standard disclosure and
consent form to meet new medical
record requirements; and the center
stayed ahead of a new federal mandate
by proactively ordering supplies of
specialized security paper for writing
prescriptions – a move that also helped
boost security.
Brand Protection
The Xerox in-house print operation has
maintained 100% compliance with the
hospital’s branding guidelines as well
as legal and regulatory requirements.
Enforcing these standards is crucial,
executives said, because it ultimately
influences perceptions of Methodist’s
value in the marketplace. “When we give
patients information about their after
care, we need to ensure it’s sophisticated
in its approach and has a production
value that mimics the organization it
represents,” Crabtree explained.
The print center’s proactive attitude
extends to quality checking every piece
that goes out. Every person working at
the center is trained to understand and
enforce Methodist’s brand and publishing
standards, so when they receive a printing
request, workers routinely examine the
document for correct branding — such
as proper logo placement — and adjust
the layout as needed.
Waste Reduction
The print center team also watches out
for potentially wasteful printing requests,
and routinely questions jobs that consume
high quantities of paper or use color output
unnecessarily. Long-term stockpiling of
printed pieces is discouraged. Whenever
possible, the center tries to produce
materials on demand and just in time,
and it’s not uncommon for the center to
suggest smaller print runs to achieve
this goal. In some case, the staff will
recommend not printing a piece in favor
of digital alternatives.
Productivity Boost
Efficiency improvements and automation
made it possible for Methodist to keep
staffing levels at its printing operation
steady over time; and with Xerox’s help
it is constantly re-aligning resources to
squeeze out additional costs. For example,
most of the staff has been cross-trained
to work in different parts of the opera-
tion, adding flexibility to the production
“Maintaining consistency in the use of our logos and the names or our hospitals is
important. Xerox has been a great help in enforcing our graphical standards and
protecting our brand image.”
– Palmira Arellano, Vice President, Marketing and Public Relations,
Methodist Healthcare System of San Antonio
Looking Ahead
Xerox and Methodist continue to
brainstorm new ways to boost efficiencies
and promote employee collaboration and
creativity. Promising opportunities
include:
• Adding mobile print capabilities so
employees can print from their smart
phones, tablets and other mobile
devices while visiting different facilities.
• Connect more devices to the
network. Plugging the remaining
40% of non-networked printers into
the network will give employees
more output options and flexibility.
• Adding managed print services
(MPS) could offer Methodist more
savings through proactive
maintenance and consumables
replenishment and free employees
from fleet-management tasks.
Legacy
Environment
2 Minutes
1/2 Minute
Xerox
Environment
83%
Figure 2. Electronic Job Ticket
Submission (Minutes)

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©2014 Xerox Corporation. All rights reserved. Xerox®
, Xerox and
Design®
, and iGen4®
are trademarks of Xerox Corporation in the
United States and/or other countries. BR11811
process. A worker in the bindery area,
for example, may also be trained to run
the high-capacity Xerox®
iGen4®
Press.
Automation also has reduced the need
for additional labor. In the bindery
department, for example, new
programmable cutting and folding
machines made it possible for one
employee to handle the entire work-
load. The ability to run several pieces
of equipment simultaneously adds to
the efficiencies. Xerox also found that
by staggering job shifts, it could keep
the print center open longer and offer
personnel a wider choice of work
schedules, increasing satisfaction.
About Methodist Healthcare
System of San Antonio
For more than 50 years Methodist
Healthcare has provided high quality
care to patients from San Antonio,
its 26 surrounding counties and from
around the world. Methodist Healthcare
is recognized as the most respected and
preferred healthcare provider in San
Antonio because of its outstanding
team of nurses, medical professionals
and physicians. More San Antonians
turn to Methodist than any other
hospital or health care provider.
About Xerox
Since the invention of Xerography
75 years ago, the people of Xerox
have helped businesses simplify the
way work gets done. Today, Xerox is
the global leader in business process
and document management, helping
people be more efficient so they can
focus on their real business. Head-
quartered in Norwalk, Conn.,
United States, more than 140,000
Xerox employees serve clients in
160 countries, providing business
services, printing equipment and
software for commercial and
government organizations.
Centralized Print Services
in Action
Methodist relies on Xerox®
Centralized
Print Services to produce and
distribute crucial patient education
materials and communications.
One high-volume “customer” is
Methodist Children’s Hospital and
Women’s Services. The department’s
materials include:
• Physician office brochures.
Methodist provides community
doctors with informational
brochures that end up in the hands
of patients. Representatives of
Methodist’s pediatric and women
services visits more than 150
doctor’s offices a month, helping
set up brochure racks where
needed. Xerox®
Centralized Print
Services helps replenish these racks
• Pediatric Directory. Centralized
Print Services produces this colorful
40-page directory of Methodist’s
pediatric providers and specialists
that includes photos and contact
information. The directory is
updated once a year by Xerox®
Centralized Print Services.