CMS has served many nonprofit and government organizations:

EXAMPLES OF PAST PROJECTS

We helped a 600 Bed Hospital streamline its operations and improve its bottom line by:

· Analyzing detailed revenue and expense data to identify trends and problem areas for further study and action

· Designing and preparing financial reports showing the revenue generated by physicians and primary care practices against their compensation, payment, direct expenses, and overhead.

· Identifying potential new revenue sources and other revenue-enhancing ideas for primary care practices.

· Analyzing and recommending changes to patient registration, billing, and collections systems and procedures.

· Improving communications between health care providers and the Finance Department via regular financial reports, monthly meetings, and designated liaison staff.

For a major FQHC (Federally Qualified Health Center):

We helped this client develop a five-year Strategic Plan for their future:

· We brought together management, Board members, staff, and the community to develop their Strategic Plan by a process including interviews, questionnaires, focus groups, and a two-day Retreat.

· We designed all aspects of this Retreat including its location, a daily agenda, an analysis of the client's strategic plan priorities, and a workbook handed to all Retreat participants.

· Over 30 participants including management, program directors, and Board members attended the Retreat.

· Our professional trainer/meetings facilitator kept all Retreat participants engaged and active.

· We helped the Retreat participants develop a Mission Statement, identify key agency initiatives, develop action plans, and establish responsibilities and timetables for each initiative.

· Our final Strategic Plan report incorporated the Retreat results with our professional insight, ideas, and guidance based on experience with similar organizations.

For a 450 Bed Hospital:

We worked directly for the President, designing and directing a number of initiatives to improve revenue and reduce expenses. These initiatives included:

Revenue Cycle Analysis: We studied all phases of the Hospital's revenue cycle, from patient registration to collections.

Real Estate Analysis: We collected information on the Hospital's real estate holdings and presented an analysis of monthly revenue and expenses for all properties. This analysis was used in decisions as to which properties to sell.

Inventory of Hospital Recordkeeping Systems: We prepared a summary of how records were kept for various Hospital subsidiaries and affiliates. That information was useful in the successful closure of several such entities, and streamlining financial reporting for remaining entities.

Divestiture of Hospital-owned billing company: We successfully orchestrated the closing of a hospital-owned credentialing, billing and collections company, and outsourced these tasks to outside vendors at a considerable savings to the Hospital as well as improvements in the efficiency and timeliness of these vital tasks. Over a million dollars in old outstanding receivables were successfully collected within the first few months following the divestiture.

Self-Pay Receivables: We identified the extent of the Hospital's self-pay receivables, and spearheaded more aggressive attempts to collect these receivables. Our work led to the expansion of hours during the week when collections efforts take place to now include evenings and weekends. In addition, policies were changed to more carefully register patients and better identify their correct billing classification.

Profit and Loss Analyses

We prepared the first Profit and Loss analyses for several service units within the Hospital. These analyses were useful in assessing the strategic importance and financial impacts of each unit studied. Services reviewed included Home Care, Oncology, Cardiology, Outpatient Clinics, Wound Care, Pediatrics, Plastic Surgery and various other specialties.

Integrating Financial Management within a Decentralized Health System.

We worked with a $1-billion, 10,000-employee health system's Chief Financial Officer and top financial man-agers to envision, plan and develop an integrated financial management system, including:

1. Identifying finance department "customers," assessing their needs and reorganizing department operations and structures;
2. Reformulating financial policies and procedures, integrating computers and information systems at various levels, and developing system-wide annual budgeting timetables, procedures, instructions and monitoring systems;
3. Enhancing financial reporting and analysis systems; and
4. Providing related consultation, coaching and training to the top financial management team and departmental staff.

Conducting Due-Diligence Reviews for a University of Medicine.

We worked with the Senior Vice-President for Finance and the auditors of a $300-million university of medicine to plan and conduct a broad-ranging due-diligence review that identified key issues regarding IRS requirements and purchasing/payment authority, and provided recommendations and plans for avoiding IRS penalties and improving purchasing and payment controls.

Accounting for and Controlling Government Grants.

We reviewed the University's handling of government grants and worked with the finance department to:

1. Create uniform purchasing and accounting policies, systems and procedures, and consolidate hundreds of private departmental accounts;
2. Enable the University to identify millions of dollars of federal grant indirect cost allowances open to audit and carry over unspent grant funds; and
3. Train managers and staff in accounting for and controlling government funds.

Integrating Physicians' Clinical Practices into the University.

Working closely with the Finance Department, department chairs, Corporation Counsel and others, we:

1. Identified strategic options and made recommendations for integrating separately incorporated physician practices into the University structure;
2. Planned and implemented due-diligence reviews of selected departments' outside clinical practices, analyzed selected practices' fiscal performance and made recommendations for improvement; and
3. Provided guidance to a steering committee that helped oversee actual practice integration.

Conducting Various Financial and Management Studies.

Working closely with the Finance Department, Dean of the Medical School, and Department Chairs and Administrators, we:

1. Studied business management functions and staffing for the Department of Medicine and developed recommendations and a plan for improvement;
2. Performed a special analysis of the Department of Medicine's Division of Pulmonary Medicine, Critical Care and Allergy Division;
3. Reviewed clinical productivity and revenues for the Department of Ophthalmology;
4. Studied programs and funding for the Department of Mental Health Sciences and made recommendations for reorganizing financial management;
5. Reviewed and reorganized management and reporting systems for $10-million in outside funds;
6. Created a comprehensive table of organization plan, working with a task force that included the heads of Personnel and Information Services; and
7. Reviewed staffing of the Office of the Dean of the Medical School, prepared a reorganization plan for the Dean and drafted new position descriptions for all Associate and Assistant Deans.

Developing and Reviewing Departmental Budgets.

We worked closely with the Finance Department, Department Chairs and Department Administrators to:

1. Create a mechanism for departments to present clinical revenue assumptions, rates, volumes, etc., tied to departmental budget requests;
2. Develop prototypes for new departmental budget formats;
3. Prepare monthly reviews of clinical department revenues and current budgets; and
4. Modify departmental budgets based on changes in revenue estimates.

Conducting a Detailed Economic Analysis of Hospital Physician Practices.

Working with three Vice-Presidents (Medical Services/Education, Administration/Finance and Patient Services) of this $200-million, 600-bed teaching affiliate of a major university medical school, we designed and conducted a detailed economic analysis of physician practices to provide reliable information for senior management doing strategic planning for a merger.

Designing and Installing an Integrated, University-Wide Budgeting System.

We worked closely with the Director of Budgeting, Dean of the Medical School, other Deans and selected Department Chairs to:

1. Create an integrated package of academic budgeting policies, procedures, calendar, instruction manual and forms for planning, identifying and controlling all departmental income and expenses;
2. Study faculty income from University-affiliated sources, complete initial faculty-effort reporting survey, design and implement initial budget review and analyze clinical cost-center budget requests, all for the Dean of the Medical School;
3. Design procedures and a computerized template to help identify reductions in Medical School budget requests;
4. Develop monthly departmental budget reporting, monitoring and correction systems and materials;
5. Identify follow-up projects, work-plans and project-control mechanisms for the Medical School to prepare for the annual budget hearings; and
6. Develop a plan for coordinated administrative reviews by the three Deans of University schools (undergraduate, graduate and medical school).

Some Other Engagements:

1. Conducted a profit-and-loss study of specialist practices for a $200-million community hospital;
2. Helped an acute-care hospital plan and develop a cooperative, community-based primary care net-work;
3. Established fiscal systems and procedures for creating community based clinics in cooperation with local hospitals;
4. Worked with board, management and staff of two community mental health agencies to review 20 key organizational and management areas, prepare separate organizational improvement reports and design a Three-Year Action-Plan to guide joint planning and decision making in working toward a possible merger;
5. Conducted a two-day team-building retreat for the President, three Senior Vice-Presidents and the Corporate Counsel of a $300-million, 5,000-employee university hospital, and designed a follow-up team-building process for them;
6. Provided team-building for middle-management teams and operating room physicians and nurses;
7. Management and train-the-trainers programs to improve service quality and productivity (emergency room, hospital, health system);
8. Trained nurse-managers and hospital educators, and provided training in understanding and working effectively within hospital cultures; and
9. Supported individual managers through coaching and individualized development activities.