New York Based Not-for-Profit Hospital

Situation

  • This New York-based hospital was a 300-bed not-for-profit hospital that was part of a larger New York-based hospital system
  • The hospital was experiencing increasing operating losses driven by declining revenues, operating inefficiencies and large medical malpractice claims
  • Operating losses were being funded by deferring medical malpractice premium payments to its insurance captive
  • The hospital was in default on its FHA loans and relations with the hospital’s parent were significantly stressed

Execution and Results

  • Implemented a Clinical Documentation Improvement Project to increase Case Mix Index and reduce denials
  • Significantly reduced the use of premium labor including overtime and nurse agency
  • Undertook a review of all clinical departments to drive revenue enhancement and expense reduction initiatives
  • Developed relations with area nursing homes and worked with FDNY to put additional EMS units on the street to increase admissions
  • Implemented a coding review project to identify lost revenue opportunities
  • Undertook a comprehensive review of the hospital’s Medical Enterprise/Faculty Practice Plan to identify underperforming physicians, and
  • Implemented a Patient Safety Initiative to reduce future medical malpractice claims
  • $30 million of revenue enhancing/expense reduction initiatives were identified
  • Cash from operations improved dramatically and an operating performance of 20% ahead of budget was achieved

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