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ResApp Health Limitedcraneware.com Capital Markets Day: Craneware November 17, 2015 This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 1 craneware.com Craneware History & Update George Elliott This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 2 Trusted Partner to ¼ of US Hospitals craneware.com Customers During the last 15 years, approximately one quarter of all registered US hospitals have chosen Craneware to assist them on their journey to improve financial performance and revenue integrity. Customers range from small community hospitals to large healthcare networks. This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 3 Today’s Presenters craneware.com Russ Rudish, Non-Executive Director Russ Rudish has more than 30 years' experience in serving the Healthcare industry, both in the United States and internationally. Russ holds a directorship in Rudish Health Solutions, LLC, a healthcare consulting firm. Russ is also a principal in Healthcare IT Leaders and Run Consultants, both of which provide IT staff augmentation services. Between 2006 and 2014, Russ served as partner and Global Sector Leader for Healthcare at Deloitte Touche Tohmatsu, where he led the $2 billion global consulting, audit, tax and financial advisory business, developing the firm's Global health care strategy. He is an active speaker and contributor to thought leadership on today's most pressing Healthcare business issues. Russ holds a directorship in Rudish Health Solutions LLC. He previously held a partnership in Deloitte LLC, from 2006 Colleen Blye, Non-Executive Director Colleen Blye is the Executive Vice President and Chief Financial Officer for Catholic Health Systems of Long Island ("CHS"), an integrated healthcare delivery system which includes six hospitals, three nursing homes, a regional home care and hospice group and a community-based agency for persons with special needs. Colleen joined CHS in 2010 from Catholic Health Initiatives (CHI), where she served as Executive Vice President and Chief Financial Officer since 2005. She was with CHI for over twenty years, serving in various roles of increasing responsibility. Ms. Blye started her career in Finance with Ernst and Young in Philadelphia, PA. She has been a certified public accountant since 1984 and is a member of the American Institute of Certified Public Accountants, and the Pennsylvania Institute of Public Accountants. She is also a member of the Healthcare Financial Management Association Mark Montgomery, Chief Marketing Officer As Chief Marketing Officer, Mark Montgomery provides strategic and operational leadership for corporate development, product management and marketing that drive to Craneware’s long-term goals. Prior to joining Craneware in 2013, Montgomery led several teams for Experian Healthcare’s client services organization, encompassing reimbursement, client support and central operations. Montgomery joined Experian in 2011 with the acquisition of Medical Present Value, Inc. (MPV). Prior to joining MPV in 2009, Montgomery spent eight years with McKesson and 17 years with Lanier Healthcare in a variety of strategic sales, marketing and operations roles. Montgomery earned his bachelor’s degree in broadcast communications from Tennessee Temple University and a master's degree in business administration from the University of Georgia. This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 4 craneware.com Healthcare Consulting Strategies for a Consolidating Market Russ Rudish This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 5 Industry Impacts to the IT/Consultancy Market craneware.com Regulatory Evolution Alliances & Acquisitions Renewed Focus Toward Innovation Consultancy as a Strategic Partner The industry continues to be led by regulatory influences: 1960s—Medicare & Medicaid 1980s—Prospective Payment System 2000s—Medicare Advantage 2010s—Affordable Care Act Health providers are aggressively seeking strategic partners that: Expand current services offerings Expand to new markets within the traditional and non-traditional service areas Seek alliance/acquisition of physicians and other healthcare professionals Quality care delivery Optimal margin performance and growth Compliance with regulatory and commercial payor polices Innovation in care delivery and patient engagement Expanded revenue and cost management execution People/Process/Technology Channel partners: Group Purchasing Organizations Channel partners: Consulting Services firms HIS deployment Cyber Security Population Health readiness This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 6 craneware.com The CFO Role: Managing Emerging Risks in a Value Based Market Colleen Blye This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 7 craneware.com VALUE = {1} Quality Payment {2} {1} Composite of patient outcomes, safety, and experiences {2} Cost to all purchasers of purchasing care This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 8 Revenue Cycle • Fee-for-service • Connect charges to units of service provided “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue” craneware.com Value Cycle • Value-based and other alternative payment models • Connect costs to units of service and charges “The process and culture by which healthcare providers pursue quality patient outcomes and optimal financial performance through the management of clinical, operational and financial assets.” Patient Access Service Charge Capture Coding Claim Denial Mgmt. Clinical Data Operational Data Financial Data This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 9 Risks Will Increasingly Affect Your Margins Population Health/Assumption of Risks Example: Medicare's Comprehensive Care Joint Replacement (CCJR) Program • • Responsible for all aspects of care for a given population for life Balancing care/payment to ensure financial viability for the provider craneware.com Alternative Reimbursement Models = Less Predictable Cash Flow Example: payments tied to clinical outcome and quality • • • Bundled Risk/quality contingency Full risk: fixed payment for preventative and curative services Consumerism and Patient Engagement Example: growing patient engagement and patient responsibility • • • • Clinical awareness and education Self pay: High deductible / patient responsibility Pricing transparency Uninsured & self-pay Self insured: Companies are contracting directly with providers for outcomes-based care delivery with transparent pricing This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 10 Keys to Success craneware.com Meeting the Challenge: • For the patient: Competitive pricing that delivers optimal clinical outcomes • For the provider: balancing quality patient outcomes with optimal financial performance Information driven through Data Analytics • Create the ability to measure clinical outcomes, quality and cost data accurately in real-time Care Management Infrastructure • Meeting consumer expectations • Delivering optimal clinical outcomes • Creating the appropriate care network This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 11 craneware.com Healthcare Trends Mark Montgomery This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 12 An evolving healthcare marketplace is rapidly driving shifts to new financial performance metrics focused on value. craneware.com Revenue Cycle Management Value Cycle Management Capitation Fee for Service FFS/Value Based Population Health Previous Recent Now Today/ Tomorrow This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 13 Your Population Right Patient craneware.com 11 Right Payment 11 11 Right Outcome 11 The Value Cycle Right Place Right Diagnosis Right Cost Right Treatment This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 14 craneware.com Craneware Moving Ahead This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 15 Craneware in the value cycle, today and in the future craneware.com Your Population Right Patient 11 Right Payment 11 11 The Value Cycle Right Outcome 11 Right Place Right Diagnosis Right Cost Right Treatment Our Domain Our Future This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 16 craneware.com Craneware Patient Engagement Strategy This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 17 Patient Responsibility for Payment is Escalating craneware.com This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 18 Higher Deductibles are the Reality craneware.com This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 19 craneware.com This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 20 craneware.com Questions This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipients, and may not be shared with vendors outside of Craneware. 21
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