Hospital Operations

Hospitals and healthcare systems are subject to ever increasing external and internal pressures in their pursuit of managing services and resources effectively and efficiently. Coker Group understands this complexity and works with our clients to realize sustainable improvements at the organizational, departmental, and services level. Coker Group's Hospital Strategies consulting practice provides timely and responsive solutions to its hospital clients in four general areas:

• Service Line Analysis
• Staffing / Productivity Benchmarking and Analysis
• Interim Management
• RAC Audit Readiness

Service Line Analysis

Coker performs a complete analysis of the hospital or health system's profitability margins, with a focus on delivering an objective determination of true contributions to the bottom line. Using a systematic approach and proven cost allocation methodology, Coker conducts analyses of all service lines and departments. This enables management to work on improving those services that are deemed as marginal while identifying and maximizing services that demonstrate a strong contribution to the bottom line. Coker assists clients in developing a specific implementation strategy that will produce improved performance and drive profitability.

Coker's Service Line Analysis encompasses the following:

• Perform an independent and objective review applying accounting allocation models to all hospital service lines (inpatient, outpatient, employed physician network, ancillary services, and non-core services)
• Conduct interviews with all levels of staff, management, and board members
• Compare and measure performance against industry standards and with other Coker clients
• Communicate and interact to attain buy-in by all parties to effect change and generate efficiencies
• Identify indicators and acknowledge ranking of service line performance as measured against each component and in comparison to industry

Staffing / Productivity Benchmarking and Analysis

Benchmarking of actual hospital staffing and productivity statistics is accomplished by using comparisons with several hospital indices and benchmarking metrics. The comparative protocols enable management to focus on staffing of departments (and services) that require closer scrutiny and monitoring that aligns productivity with experienced volumes. Applying established standards for productivity allows management to identify off-standard departments.

Coker's productivity analysis includes:

• Review and analysis of payroll-related indicators as to hours and productivity measurements
• Benchmarking that identifies dangerous trends in staffing when compared against appropriate metrics
• Monitoring protocols (reporting) that encourage the proper alignment of productivity with volume indicators and statistics
• Considering the re-engineering of essential workflow processes, with a goal of improving upon efficiencies and profitability
• Acknowledging attrition, overtime thresholds, and duplication of services, while enacting next steps to reduce payroll and benefits

Interim Management

Coker Group employs consultants with hospital CEO and CFO experience who are able to occupy, without delay, the vacated chairs of the hospital’s Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO).  Consultants are also available for interim positions of Controller and CIO.

During the sensitive period of identifying and attracting the replacement of key executives within the organization, Coker immediately steps in utilizing past work skill sets along with nationally recognized client site experiences.  With proven know-how in place, hospital administration is able to continue to concentrate on their assigned tasks.

Coker’s Executive Search practice will work hand in hand with Coker’s interim management consultant to provide a permanent placement for the vacated position.

RAC Audit Readiness

Coker's RAC Audit Readiness initiatives help hospitals proactively identify potential Medicare reimbursement vulnerabilities in both the inpatient and outpatient settings. This service is designed to correct the problems and mitigate the risks associated with future audits by RACs. Areas such as medically unnecessary admissions, discharges, documentation, coding, and billing are included in Coker's engagement.

Coker's RAC Audit Readiness analysis includes:

• Identify diagnoses focused upon in RAC audits
• Review coding and documentation to equip and prepare hospitals for RAC audit
• Understand appeal process for discoveries made during audits. Institute aggressive plan to appeal claims considered in error; modify processes for coding and/or documentation
• Develop proactive plans to react to audits and areas of exposure