A Profitability and Cost Management Strategy for Healthcare Providers
Experts from Perficient and Oracle discussed how leveraging advanced analytics to manage population health, develop risk models, and examine clinical outcomes based on cost will enable Accountable Care and improve the quality of care.
Attendees learned how to link strategies to plans and then execute and monitor financial and operational results against goals as we explored:
• How to apply analytics to drive enterprise-wide performance improvement
• An innovative approach to link costing, patient analytics, and variance analysis to productivity management in an Accountable Care Organization
• An overview of Hyperion Profitability & Cost Management (PCM) solution differentiators, including micro costing
• How the PCM solution relates to the Oracle enterprise performance management and enterprise health analytics platforms
• A demonstration of multiple reports and dashboards such as patient-level P&L and revenue and cost margin by payer
Publicly tradedHeadquartered in St LouisGrown through mix of acquisition and organic growth - 22 offices in US Technology investments should be in the service of business goalsIncrease profitability and market share, but also be more agile to market conditions
More fast facts…$325 million in 2012. Strong balance sheetPride ourselves on 85% repeat business rateModel on National and Local Business levelAlso have multi-shore delivery capability w centers in China, India, Eastern Europe Able to bring the right consultants to the task while making the most of your capexspendcost-effective
Back office solutions such as ERP and SOA to run your businessEPM and BI solutions to manage your businessCRM and Portal solutions to market your business and stay engaged with your customers and colleagues
5 Key focus areas across healthcare – HIE, EPM, Compliance, SysOps, Portals1. Led by strategic visioning and project leadership via Perficient’s Enable Methodology; strong local presence.2. Supported by Oracle certified technical consultants during delivery phase w/ managed services & support on the backendCombined with the Healthcare Industry Vertical team, Perficient is uniquely qualified to deliver a wide range of services across an extensive array of technology solutions.Perficient has the capability to leverage our strong payer and provider claims analytics expertise with our experience Healthcare EPM experience to build out Profitability and Cost Management solutions. Prior to the release of HPCM this had to be coded by hand with custom Essbase solutions.We have certified delivery resources for the Oracle Enterprise Healthcare Analytics solutions including the Healthcare Data Model and pre-built integrations with major EMR vendors such as Cerner and Epic.
Specifically within EPM – Texas Childrens, Concentra, Christus HealthEPM solutions are designed to manage and optimize enterprise-wide performance enabling strategic, financial and operational management processes:Strategy Management Planning and ForecastingFinancial Close and ReportingProfitability ManagementAnalytical Solutions
Transition to William…Will show Oracle’s latest generation DSS that:Enables blending of operational and financial data for budgeting, service line profitability and analysisEnables organizations to understand the true cost and profitability drivers within their business and empowers users with the visibility and flexibility to improve resource alignment, increase margins and ensure profitability
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Oracle EHA platform will facilitate source extractions from different source systems using consulting assets (Source extraction from EPIC and other legacy systems) into the staging area.OHADI will be configured with the data governance policies and populate the 3rd normal form data warehouse. The data warehouse stores all the necessary clinical, financial and administrative entities at the granular level.This data will feed the EPM solution specific to Planning and the Cost Accounting functions and also the analysis required to understand what drives profitability. This integration will support the needs of the healthcare organization to obtain a clear picture of costs and its relationship to quality. They must be able to answer key questions:identify profitability by case, service line, etc.?Which activities and processes produce value and enhance quality?How do contractual payer prices compare to costs?How much capacity is being used?Are equipment investments justified?Further enhancements to cost accounting will result from better integration of encounter-specific data from various clinical and operational systems. By achieving this integration through Oracles EHA and EPM solutions, healthcare organizations can begin to develop predictive modeling capabilities to better understand cause-and-effect relationships, and proactively alter patient care practices based on the analysis of previous patients that were derived from high-cost and poor quality outcomes. The power of these capabilities is advanced even further when applied to the entire continuum of patient care.HYPERION EPMThe Oracle Enterprise Performance Management solution (EPM) consists of a range of applications that is built on a highly scalable architecture. This component based design, allows our customers, not only a choice in certified hardware and operating systems, to meet their performance requirements, but also enables an evolutionary path to deploy additional applications within the suite, when required by the business.The following two sections describe, at a summary level, the component based business applications and system architecture that Oracle EPM provides for its customers..Section I: Business User View of the Oracle Enterprise Performance Management SolutionThe end user experience for EPM applications is primarily web based. End users can leverage the leading web browsers (Internet explorer or Firefox) to use any of the applications that are part of EPM in a common user experience called the workspace. User training can be facilitated through a User Productivity Kit that enables real time training for users while in a particular EPM application. Users also have the option of leveraging Microsoft Office products such as Word, Excel or PowerPoint, as a user interface within EPM by deploying the included EPM Smart View add-in.Section 2From a technical perspective EPM is a highly scalable solution, both vertically and horizontally. Customers can scale their solution as they grow in user numbers as well as when they decide to add additional functionality over time. The tiers for this architecture are as follows: At the client tier a workstation that can support Windows in a variety of flavors (ex, Vista, Windows 7). At the Application Server Tier Oracle provides with its EPM applications its industry leading, Weblogic application server and HTTP server. Finally at the Database tier, EPM supports the leading RDBMS databases: Oracle, SQL, Db2 and the industry leading analytic engine, Essbase, in their respective supported OS and hardware platforms. Oracle provides a complete certification matrix of certified hardware for each tier, which is available at the following link: http://www.oracle.com/technetwork/middleware/bi-foundation/hyperion-supported-platforms-085957.htmlEPM Product SetDescriptionHyperion Financial ManagementOracle Hyperion Financial Management is a comprehensive, Web-based application that delivers global financial consolidation, reporting and analysis in a single, highly scalable software solution. Oracle Hyperion Financial Management utilizes today's most advanced technology, yet is built to be owned and maintained by the enterprise's finance team.Financial ReportingUsing Oracle Hyperion Financial Reporting, you’ll be able to produce boardroom-quality presentations that can be delivered in a variety of formats (including HTML, PDF, and Microsoft Office) and distributed either as live data or as static snapshots of data at specific points in time. Employing a standard Web browser, users will be able to interact with your data by changing report selections, page members, and navigation options. In short, all of your vital business information will be disseminated without burdening viewers with the mechanics of the process.Web AnalysisHyperion Web Analysis lets create dashboards and reports available via a web browser, or a company portal. The module is easy to use so your organization benefits from a fast adoption, and quick return on investment with a minimal amount of training.Smartview for OfficeOracle Hyperion Smart View for Office (Smart View) provides a common Microsoft Office interface designed specifically for Oracle's Enterprise Performance Management (EPM) and Business Intelligence (BI). Using Smart View, you can view, import, manipulate, distribute and share data in Microsoft Excel, Word and PowerPoint interfaces. It is a comprehensive tool for accessing and integrating EPM and BI content from Microsoft Office productsUPK- User Productivity KitOracle UPK provides a collaborative development environment to create system related assets - the "People to System" documentation - which are used throughout the project lifecycle. With the ability to produce multiple outputs through a single recording session, Oracle UPK reduces content development time and cost. Rapidly produce materials for all phases of the software lifecycle – from test scripts, system process documents, and interactive simulations, to job aids, instructor manuals, and in-application performance support. Oracle UPK is key to capturing knowledge, increasing productivity and reducing overall software implementation costs.Financial Data Quality Management (FDM)Oracle Hyperion Financial Data Quality Management is a packaged solution for finance users that helps develop standardized financial data management processes with its Web-based guided workflow user interface. Its data preparation server can ease integrating and validating financial data from any of your source systems. And to further reduce your data integration costs as well as data mapping complexities, Oracle Hyperion Financial Data Quality Management includes prepackaged adapters for Oracle Hyperion Financial Management, Oracle Hyperion Planning, Oracle Hyperion Strategic Finance, Oracle's Hyperion Enterprise, Oracle Essbase, and Oracle E-Business Suite.Financial Close ManagementOracle Hyperion Financial Close Management centralizes management of all period-end close activities, replacing traditional, manually maintained checklists with dynamic dashboards that give users the ability to immediately view and act on information. Supported close-cycle processes include ledger and subledger close, data loading and mapping, financial consolidation, 10K/10Q creation, reconciliations, tax/treasury–in fact, any task associated with the extended financial close.Disclosure Management Oracle Hyperion Disclosure Management enables organizations to centralize and effectively manage the development of XBRL tagged submissions now required by many regulatory bodies.Oracle Hyperion Disclosure Management enables customers to graphically perform XBRL tagging at several levels – within Microsoft Office, within EPM System reports or in the data source metadata. The solution lets customers modify or extend taxonomies before the mapping process as well as set up multiple taxomonies. Final XBRL instance documents can be created and validated before submission.Oracle Hyperion Disclosure Management's common foundation and tight integration with other Oracle performance management applications reduces the total cost of ownership by providing a single point of maintenance—a feature that point solutions and non-integrated EPM suites cannot match.EssbaseOracle Essbase is the industry-leading multi-dimensional online analytical processing (OLAP) server, providing a rich environment for effectively developing custom analytic and enterprise performance management applications. By leveraging its self-managed, rapid application development capabilities, business users can quickly model complex business scenarios. For example, line-of-business personnel can simply and rapidly develop and manage analytic applications that can forecast likely business performance levels and deliver "what-if" analyses for varying conditions. Oracle Essbase supports extremely fast query response times for vast numbers of users, large data sets, and complex business models.Data Relationship ManagementOracle Hyperion Data Relationship Management provides the industry's first data model-agnostic master data management solution built to enable financial and analytical master data management in dynamic, fast-changing business environments.
Financial View of the Healthcare SystemMarried with outcome and quality data at the bottomReview volume and quality data. Look at Service Lines
Orthopedics jumps out as having a real issue the last few months
Look at cost pool analysis for that service line and procedures.
Analysis of the direct costs can go to physician specific analysis. Lower dashboard has surgeons charging to that CPT and we can easily see that Surgeon 12 has the most significant costs. Let’s look at his device of choice and see if he has made changes the last few months to drive costs up.
No. He is still using the same device.
This is a “Patient” P&L with Fully Loaded Costs. Truth is – analyzing one patient is not realistic. Clinical and operational decisions will not hinge on the profitability of one patient. On the other hand – analyzing patient populations based upon attributes and groupings DOES significantly influence the decision making process.
The heart of HPCM, showing where cost came from. Understand the methodology, trusting the data… Executives are confident in their decisions made from results and analysis.
A Profitability and Cost Management Strategy for Healthcare Providers
A Profitability and Cost Management Strategy for Healthcare Providers March 2013
Our SpeakersWilliam Bercik, Director of Healthcare, OracleWilliam has over 25 years’ experience in the healthcare industryand specialized in enterprise applications and technology solutionssince 1992. Mr. Bercik provides specialist product expertise anddevelops and executes solution strategies for the healthcaremarket. Prior to joining Oracle, Mr. Bercik was a former ChiefFinancial Officer of a 350 bed acute care hospital. .Tony Coffman, Director Oracle EPM, PerficientTony has over 7 years of ERP/BI experience in addition to his 9+years of Oracle EPM expertise within Healthcare, Oil & Gas andManufacturing. Tony’s areas of focus are in ProgramManagement/Strategy, Hyperion Planning, HyperionHFM, Hyperion Essbase/BI, and Master Data Management. 2
About PerficientPerficient is a leading information technology consulting firm serving clientsthroughout North America.We help clients implement business-driven technology solutions that integratebusiness processes, improve worker productivity, increase customer loyalty and createa more agile enterprise to better respond to new business opportunities. 3
Perficient Profile• Founded in 1997• Public, NASDAQ: PRFT• 2012 revenue of $327 million• Major market locations throughout North America • Atlanta, Austin, Charlotte, Chicago, Cincinnati, Cleveland, Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Los Angeles, Minneapolis, New Orleans, Philadelphia, San Francisco, Northern California, Southern California, St. Louis and Toronto• Global delivery centers in China, Europe and India• ~2,000 colleagues• Dedicated solution practices• ~85% repeat business rate• Alliance partnerships with major technology vendors• Multiple vendor/industry technology and growth awards 4
Market Position Key Differentiators As compared to local boutiques:Project size, Breadth of Expertise • Bring solutions expertise & capital • Deep technology expertise • Disciplined project execution • Scale to handle large projects As compared to large integrators: • Highly experienced consultants • Local and national delivery model Depth of Expertise, Efficiency & Value, • Collaborative, not take-over Client Importance • Better value 5
Our Solutions ExpertiseBusiness Solutions Technology Solutions• Business Intelligence • Business Integration/SOA• Business Process Management • Cloud Services• Customer Experience and CRM • Commerce• Enterprise Performance Management • Content Management• Enterprise Resource Planning • Custom Application Development• Experience Design (XD) • Education• Management Consulting • Information Management • Mobile Platforms • Platform Integration • Portal & Social 6
Healthcare SolutionsAs a leading provider of services in the healthcare industry, Perficient has delivered both strategic consulting and advanced technology solutionsto many of the top provider, payor, life science and government healthcare organizations.Perficient Technology Solutions • Top tier partners of IBM, Microsoft and Oracle • Healthcare Analytics / Business Intelligence • Enterprise Performance Management solutions • Master Data Management solutions • Portal design and development • Multi-Sourcing solutionsPerficient Consulting Services • Business value assessment/financial sustainability modeling • Requirements analysis/product selection • Architecture planning and platform selection • Custom solution design and development • Implementation services • Usability testing and user-centered design • Consumer readiness assessments (PEMM) • ICD-10/5010 conversion • Technology enabled process improvement • Business integration • Process/workflow design • Enterprise Application Integration (EAI) 7
Oracle EPM11+ Year RelationshipWorking closely with Oracle product management to provide feedback forsoftware enhancementsOracle Platinum Partner/Authorized ResellerCertified on the latest Oracle product platforms and technologies, as wellas implementation and migration best practices.Oracle Certified Education PartnerCertified to deliver the official Oracle course curriculum to customers viaonsite training classes. Perficient owns and operates one of the nationalOracle training facilities listed on the Oracle websiteOracle BI/EPM Specialized PartnerCertified by Oracle to deliver and sell the Oracle BI and EPM applications. 9
Case Study 1 CHALLENGE • Budget cycle lasting 6-8 months • Consolidated financial statements required 24-48 hrs• Ranked #6 Pediatric Hospital by USNWR • Operating target negotiations began after• 1.7B Revenue, 6500+ Employees the budget was finalized• Leader in Neonatology, Pediatric Cardiology, Oncology EPM SOLUTION• “Integrated Delivery System” includes: • Phase I – Core Planning application for •Texas Children’s Health Plan IDS, replacING Peoplesoft EPM / Excel. •Texas Children’s Pediatric Associates Implemented top-down revenue, margin •Texas Children’s Health Centers targets. Deployed enterprise-wide, •Texas Children’s Women’s Specialists driver-based budgeting for revenue, salary, opex. Calendar year forecast updated monthly and self-service management reporting. • Phase II – Planning application for TCPA. Driver-based revenue model. 11
Case Study 1 EFFICIENCY METRIC BEFORE AFTER GAINSVariance Budget vs. Target First Pass First Pass 77%(First Pass) $90M $20MPrep Time (Operating Targets) 12 Hrs 2 Hrs 83%Consolidate Data 24 Hrs 15 Min 99%Budget Season 8 Months 4 Months 50%Cost Avoidance (3 Staff) $225K $0 100% 12
Case Study 2 CHALLENGE • Multiple GL systems including Oracle EBS, Lawson, Yardi, MAS 200, McKesson, Peachtree, and Great Plains. Meditech EMR. • Offline databases and XL models for IC elims, account reconciliation, and ETL • Hyperion Enterprise reaching end-of-lifeChristus Health is a Catholic, not-for-profithealth system comprised of almost 350 SOLUTIONservices and facilities including more than • Replace Enterprise/Ledgerlink with Hyperion50 hospitals and long-term care facilities. • Financial Management and Financial Data QualityRanked among the top ten Catholic health Managementsystems in the United States by size, the • Created financial reporting packages/SVChristus Health system in North Americaincludes facilities in eight US states andMexico. BENEFITS • Common, rationalized financial master data • Automated business logic and performance metrics via HFM rules • Robust web-based architecture for reporting and analysis 13