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Critical Access Hospital (CAH) &
Rural Health Clinic (RHC)
Finance
Benefit: For Medicare patients only. Enhanced reimbursement model, otherwise no different that a Prospective Payment System (PPS) Hospital
Eligible hospitals must meet the following conditions to obtain CAH designation:
Required Services
Benefit: For Medicare and Medicaid patients
Purpose: intended to increase access to primary care services for patients in rural communities
RHC Requirements:
Types of RHCs:
RHC visits may take place:
Atchison Hospital
& Clinics
Revenue Mix
by Payor
Inpatient
17.4% of Total Patient Revenue
Outpatient/Phys Office
Outpatient: 70% of Total Patient Revenue
Phys Office: 12.6% of Total Patient Revenue
Inpatient- Medicare (45% of overall total revenue)
Inpatient- Medicaid (11% of overall total revenue)
Inpatient- Blue Cross Blue Shield & other commercial
(BCBS 24%, Other Commercial 15% of overall total revenue)
Inpatient- Self Pay (5% of overall total revenue)
Outpatient Departments- Medicare
Outpatient Surgery, Outpatient Depts, ER
Estimates
Expenses are Actual
Medicare
Medicaid
Commercial Insurance
Self-Pay
Summary
Financials Revenue= an average/estimated overall rate,
resulting in a significant variance at times
Revenue Cycle
Lack of Financial Information Systems/Electronic Medical Records interoperability resulting in:
Projecting:
169 days in March
Discharged Not Final Bill (DNFB) After 3-Day Hold: $749,357.92
Total AR Balance = $13,556,507.37 (charges)
90-Day Average Daily Revenue = $290,527.45
Inpatient
Ancillary Stats
Strategic Plan
Create a Sustainable
Regional Rural Health System
Strategic Plan: Create a Sustainable Regional Rural Health System with Strategic Growth & Partnership/Collaboration.
Orthopedics, Cardiology)
Atchison Hospital)
Reimbursement Reductions
are Inevitable
Most CAH
are unprepared
FY 2019 Results
As of Fiscal YTD Jan 2020
Projected Reimbursement Cuts
Margin Goal
Hospital/Clinic Acquisitions
Primary Care-
RHC
Specialty Care
Timely Access
Customer Experience
Cardiology,
Other....
Timely Access
Customer Experience
Community Perception
Unavailable Specialists
Inpatient/ Swing Bed
Specialists
Radiology
Population Health
Surgery
ER
Home Health
&
Hospice
Laboratory
OB/Maternal
ER
Specialty Care
6%
Ortho, Procedure (TIF)
Primary Care- RHC
94%
Includes Outpatient clinic, radiology, laboratory, surgery, rehab
Strategic Plan involves NorthEast Kansas
Outpatient KHA Data for NorthEast Kansas
Future Plans for Market Data
Strategic Growth
of a
Regional Rural Health System
STRATEGIC PLAN
CURRENT
Consists of:
CURRENT
STRATEGIC PLAN
Goal: Care in Home for patient comfort & reduce expensive hospital utilization
Current
Strategic Plan
Current
Strategic Plan
New Service Line
Long-term Goal
Details
2017 $826,900
2018 $1,008,040
2019 $3,785,935 – Meditech- $3,373,577, Non-Meditech-$412,358
$500,000 each year from Riverbend Foundation
Non-Clinical Space Needs
1) Home Health & Hospice Offices
2) Move offices out of Clinic Space
3) Accounts Payable Dept (4)
4) Quality Director
5) Education Coordinator
6) Marketing Specialist
7) Billing Department (6-10)
8) Parking Spaces
Clinical Growth Priorities
1) Surgery/Infusions expansion (move HIM)
2) Add Materials Management building
3) Rural Health Clinic Expansion
4) Ortho/AHS Suite
5) Purchase Mosaic Clinic ($320,000)
6) OB Storage to Patient Room Conversion
7) Capital Equipment Needs
Construction Recommendation
**Requesting Board of Directors to approve ($1.85 million):
1) Purchase of Mosaic Clinic at Atchison Hospital for up to $350,000.
2) Change Construction Plans to Option 1 ($1.3 million) and RHC space improvement($200,000)
Continuous Stage
Merger Benefits
Partnership
&
Collaboration
2) Partnership/Collaboration