Transcript Pulling IT All Together

Pulling IT All Together
Madonna McDermott RN, MS, MPA – Director, Student Health Service
Victoria Svoboda, MS – Associate Dean of Students
Learning Objectives
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2.
3.
Identify key stakeholders to involve in the
exploration and implementation process as
it relates to mandatory insurance and third
party billing.
Discuss strategies that best match your
institution reflecting on mission, cost and
resource availability.
Describe technology strategies to streamline
communication and implementation
processes for mandatory health insurance
and third party billing.
University of St. Thomas
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Largest private
institution in MN
Catholic affiliation
Urban setting
10,984 students
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6,076 undergraduate
4,908 graduate
2,400 residential
No medical school
Brief History at UST
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1998: Discontinued mandatory insurance
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2004: ACHA Consultation
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Hard waiver–manual process through Business Office
Retained insurance requirements for athletes and
international students
<2000 visits to Student Health Service
Institutional fit
Staffing / Space
Funding structure
ACHA Standards
2004-2006: Times of transition
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New senior administration, Law School, Office for Mission
↑ undergraduates (1000 FR in 2003, 1300 in 2006)
↑# of residential students (added 500+ beds)
>7500 visits to Student Health Service
Assumptions
Not experts in anything but our own
experience
 Lessons learned may be helpful to
others on their own journey
 Theoretical framework provides
structure to our experience
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Pulling IT All Together
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Eight Stage Process of Creating Major
Change (Dr. John Kotter)
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2.
3.
4.
5.
6.
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8.
Establishing a Sense of Urgency
Creating the Guiding Coalition
Developing a Vision and Strategy
Communicating the Change Vision
Empowering Broad-Based Action
Generating Short-Term Wins
Consolidating Gains and Producing More Change
Anchoring New Approaches in the Organization
1. A Sense of Urgency (K)
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This first step is essential.
Failure to create a sense of urgency is a
major cause for organizational change to fail.
Must motivate people out of comfort zone.
Without motivation, the effort goes nowhere.
This requires strong leadership.
Make the status quo seem more dangerous
than launching into the unknown.
1. A Sense of Urgency (UST)
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Supports the
mission of your
university
Increasing costs of
higher education
Increasing
competition
Important
marketing tool
Changing political
environment
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Good stewards of
scarce resources
Promise of new
revenue for your
institution
Increasing health
care costs
Increasing number
of students
requiring medical
care (share stories)
2. The Guiding Coalition (K)
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Key Stakeholders
Must find them at all levels (VPs/Deans,
support staff, IT, etc.).
 Include supporters and critics/skeptics.
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Assessment & Environmental Scanning
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National and local data regarding
mandatory insurance, third party billing
and other funding structures
2. The Guiding Coalition (UST)
Stakeholders
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Mandatory Insurance:
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SHS Team,
Dean of Students,
VP of Student Affairs,
Academic Deans,
Registrar,
Business Office,
Advisors
(financial/academic),
Students and their families
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Third-Party Billing:
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all of the above +
Controllers Office
CFO
Purchasing Office
Catholic Social Teaching
invited us to pay attention to
issues of access and
representation.
2. The Guiding Coalition (UST)
Assessment & Scanning
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Benchmarks:
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External Experts:
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ACHA Standards and benchmarking data
Dialogue with and visits to other institutions
ACHA Consultants,
Multiple external consultants,
Training on coding
Internal Resources:
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Background/history of AAL,
Surveys of students to determine insurance rates,
Interviews with those who were here when we last did hard
waivers to learn from their experience,
Business analysts in IT, etc.
3. Vision and Strategy (K)
Every successful transformation effort
must have a vision …
A picture of what the future will look like
 A vision that is easy to communicate
 A vision that is transparent
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3. Vision and Strategy (UST)
Mandatory Student Health Insurance
Undergraduates with 12 or more credits
 Graduate students with 9 or more credits
 Identified “owner of process”
 Already required of NCAA athletics and
international students
 History of previous requirement
 Describe proposed process
 Key communication strategies identified
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3. Vision and Strategy (UST)
Third Party Billing - Preparation
Do you as a leader have the knowledge
and skill set to launch this change
process?
 What type of assistance do you need?
 Internal vs. external consultant?
 Does your current insurance plan meet
your students needs?
 What is your time frame?
 What start up costs will you need?
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3. Vision and Strategy (UST)
Third Party Billing - Logistics
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Software selection
Negotiate (payer)
insurance contracts
Provider credentialing
Billing and accounting
policies and procedures
Physician/NP/PA
reimbursement
(Provider fee schedule)
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Laboratory services
reimbursement (Lab fee
schedule)
Proposed clinic fees and
general payer allowed
amounts
Draft tools such as
charge ticket, consents,
etc.
4. Communicating the Change (K)
Be as transparent as possible.
 Clearly articulate the what, why, who,
how. Tailor this message to each
audience.
 Include all stakeholders in developing
your plans.
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4. Communicating the Change (UST)
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Build process into existing systems
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Campus Media (daily bulletin, student newspaper,
parent newsletter, faculty newsletter)
Direct Mail (letters to all students)
Email (to those who utilized SHS in past 12
months; to those needing to complete verification
process on a weekly basis)
Personal Contacts (to students not responding to
emails; to colleagues to build support)
Meetings (visits to AAL, President’s Council,
University Council, Grad Records & Registration)
Misc. (enclosure in student bills, postcards,
posters at SHS/on campus, web sites)
5. Broad-Based Action (K)
Remove obstacles
 Make change easy
 Use of technology
 Communicating with those who are
resistant
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5. Broad-Based Action (UST)
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Make change easy / remove obstacles
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Simplify reporting
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Began with registration holds, now billing for insurance.
Included appeal process.
Secured grants for uninsured/underinsured.
Bill by semester instead of year, ensuring it is included in financial
aid.
A = auditing
B = billing
C = communication
Make technology work for you:
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Banner: Student Records, mailings, status for insurance
Lyris: Listserv manager for sending communications
Nuesoft: Added billing module to existing medical software
Appworx: Generates queries and develops reports from Banner;
runs chains to lift holds, change status, etc.
Cognos/Report Net: View holds and error reports
6. Short-Term Wins
Kotter: Promote, make visible the wins
 UST:
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Identify short-term wins through data
analysis and surveys
 Communicate results
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 Patient
satisfaction
 Revenue
 Compliancy
 Additional services
7. Consolidating Gains and
Producing More Change
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Kotter:
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Hire, promote, develop people who can
implement change.
Be careful of declaring victory too soon.
Change implementation takes years.
UST:
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Partnered with talent across campus, increased
staffing in SHS.
Phased processes with IRT to ensure continuous
service.
Eliminated duplication within the organization.
Used new revenue to expand services, improve
facilities.
8. Anchoring New Approaches
in the Organization
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Kotter:
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Make change stick by developing social norms
and shared values.
Develop next generation of leaders.
UST:
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Moved from “it can’t be done,” to “the way we do
things around here.”
Can demonstrate how the new processes have
helped (students, SHS, the institution).
Embed our work in existing systems such as
enrollment, orientation, etc.
Lessons Learned
1.
2.
3.
4.
5.
6.
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Stakeholders must include both your champions
and your critics
Document everything and create a shared space
(virtual and physical)
Language translation
(Medical/IT/Immigration/Financial)
Never lose sight of your goal (Don’t prioritize
process over people)
Discuss strategies that best match your institution
reflecting on mission, cost and resource availability.
Use technology resources (people & systems)
Appreciative inquiry
References/Resources
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Kotter, J.P. (1996). Leading change.
Cambridge, MA: Harvard Business Press.
Collins, J.C. (2005). Good to great and the
social sectors. A monograph to accompany
Good to great: Why some companies make
the leap—and others don’t.
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Madonna McDermott - [email protected]
Victoria Svoboda - [email protected]
Dawn Lunde - [email protected]
Christine Duprey - [email protected]
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