President's Message

Flexibility Helps You "Enjoy The Ride" - Tim Beatty, FHFMA

Can you believe it, the summer is over and we survived another Hilton Head experience? It was a big change for me; it was my first year since 1992 attending the Hilton Head meeting without my family or Jeff Brown's family. Schedules have changed and children are either grown up or have other activities.

The summer provided a fast fun-filled experience without regard to my work schedule. It included baseball, swimming, yard work, and trips to Orlando (ANI) and Memphis. Also, intense heat combined with a severe drought in Georgia did not make outdoor activities pleasant.

With all that, the Hilton Head meeting was a huge success thanks to you. It also provided great memories for me including:

• Over 80 on-site registrations (Holy Cow!).
• Celebration of Lex's success last year.
• Catching waves on the Boogie Board.
• Talking sports with the college kids.
• Karoake singing (sorry for my lack of voice).
• Great education (Way to go Cynthia!)
• Pretty good food on Thursday night.
• YOU WERE THERE!

Now the fall is upon us and you know what that means; College Football, the best time of the year. Also, for me it means filing Cost Reports and helping with the Hospital's Strategic Plan. I am sure everyone is just as busy as I am. For HFMA, it means more workshops, the Savannah Institute, HFMA projects and great networking activities.

The fall meeting in Savannah will have excellent education and networking activities. Sports Night on Thursday night should be a blast. The Education committee has done a great job planning the meeting.

All in all, the Georgia Officers learned some great lessons this summer about being flexible to help HFMA meet your needs. With 80 on-sight registrations, we realize that your workload requires HFMA to move with you and not be stagnant with our organization. Also, since school starts earlier in Georgia, we will move the Hilton Head meeting back one week next year to meet your family needs. We also know our education content must change to meet your needs.(APC's, HIPAA, CPAR, E-commerce, etc.)

Special Thanks to our Scroll Committee and Jim Piper for publishing our 45th year anniversary issue. We hope you enjoy reminiscing about the past history of our Georgia Chapter accomplishments!

Don't hesitate to call myself or any Board member with your input to ensure Georgia HFMA is providing you with appropriate service. See you at Savannah in November!

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Employee Recognition & Rewards Program - Carrots Over Sticks

By Sam Thrower, MBA, MHA, CHE & Sharon Snow, MSN, MHA, Ph.D. of Thrower & Associates, Inc.

Patient financial service (PFS) operations, at the dawn of the new millennium, have become increasingly complex and difficult to manage. Consequently, and within limited operating budgets, many PFS directors and their management teams are feeling "pushed to the edge", and are struggling to regain a sense of job security. These struggles represent uphill battles to:

• Improve the quality of patient information documentation;
• Integrate and streamline procedures and processes for optimal workflow efficiency;
• Maintain strict compliance with various regulations;
• Increase front-end collections and overall cash flow;
• Reduce account receivable and bad debt levels; and
• Maintain excellent customer service, throughout all functional processes.

To help address such challenges, this article outlines an array of "best practices" and some key concepts for developing and implementing employee recognition & reward programs (ERRPs).

Establish A Basis For The ERRP

"Best Practices" begin with the management team creating meaningful workplaces. Every reasonable effort should be made to establish the environment, tools, resources and relationships that are most conducive to achieving optimal team performance (as described in last month's article, Designing Highly Effective Teams). PFS directors and their management teams should also begin by setting an example for departmental personnel, with role model behavior and execution of job responsibilities.

A solid foundation can be established for the development and ongoing management of an ERRP, by:

• Creating a high-level financial policy that outlines the necessary operating philosophy and critical performance standards that, while preserving the institution's mission, support optimization of PFS functions;
• Defining performance standards, monitoring tools, performance indicators and how each type measure should be utilized to control performance;
• Developing performance-based job descriptions for all PFS personnel;
• Maintaining comprehensive departmental policies and procedures that provide "current" instructions for completing the critical receivables management functions;
• Establishing an A/R task force to maintain a perpetual work plan for optimizing PFS operations at each collection control point (all PFS personnel should be encouraged to participate on a rotational basis, to solidify a strong sense of staff contribution and buy-in);
• Providing comprehensive management and staff training, regarding team building, collections approach, customer service and other revenue cycle functions; and
• Obtaining administrative "buy-in" (understanding, approval and active support) for the high-level financial policy, perpetual work plan and departmental policies and procedures.

Once this foundation is in place, management and personnel should be able to make appropriate "front-line" decisions, while being held responsible and accountable for their actions. Management can then focus on establishing an ERRP that keeps the various PFS teams functioning as productive and efficient work groups in a cohesive manner toward achieving departmental and organizational goals. The On Purpose Team Model can assist management in being architects of effective ERRPs.

On Purpose Team Model

Characteristics Of Effective ERRPs

The On Purpose Team Model provides a framework of characteristics that effective ERRPs hold in common, including:

• A sense of common purpose or reason for existence;
• A high level of understanding and clarity regarding the individual roles of each team participant;
• Appropriate feedback regarding team behavior and role fulfillment, so that team members understand their level of contribution;
• A high degree of professional and personal commitment to the team and its goals; and
• Various means of appropriate collaboration (including honesty, choice, professional respect and a spirit of renewal).

Successful ERRPs are best described as those in which the team members are content with their jobs, dependable, highly resourceful and achieve or even exceed their defined goals and objectives. In addition to establishing appropriate infrastructure and guidelines for functional dynamics, PFS directors must clearly understand and carefully respond to "what their staff really want from their jobs". A simple staff survey can be helpful in prioritizing those factors that are most important to personnel (such as competitive wages and benefits, job security, promotional opportunities, interesting work, mentorship, recognition of achievements, etc.). Such a survey should be re-administered on an annual basis, since workforce dynamics and expectations have been undergoing significant and periodic changes, since about 1950.

Maintain A System For Quality & Performance Control

A highly effective and efficient PFS operation is always the product of individual performances on the job. The first step, therefore, calls for creating a commonly held vision among all personnel of how success will be achieved. Once the expectation for success is clearly conveyed, management should stress and reinforce to all personnel the necessary quality and performance standards, as well as the key indicators for objectively monitoring each standard.

The PFS director must establish accountability for the achievement of operational objectives and organizational goals, all the way down to the individual employee level. The ongoing quality and performance of PFS operations should then be monitored, evaluated and controlled, by means of a methodical, comprehensive and results-oriented management approach. A timely discovery and response must occur for any variance (positive or negative) between an established standard and an actual result, whether an indicator of quality or performance.

Quality and performance control efforts must focus on promoting continuous improvement, rather than adhering to absolute or static standards. Quality and performance reporting can best support an ERRP when a variety of reports are generated, including:

• Quality & performance audits (focused reviews that report accuracy or acceptability rates, regarding the critical operational activities performed);
• Exception reporting (documentation of processes that do not conform to required standards or specified parameters);
• Variance data (comparison of actual results to the expected standard); and
• Trend data (tables & graphs).

By tracking the key quality and performance indicators in this manner, management will in effect have a finger on the pulse of PFS operations, and will be optimally positioned to recognize individual performance and to reward behaviors that improve revenue cycle efficiency.

Implement The ERRP

Patient financial service personnel typically "look to" and rely on management and co-workers for constructive, consistent and timely job performance feedback. Aside from being constructive, consistent and timely, job performance feedback should always be disclosed in specific terms, with the rationale for employee recognition clearly explained. In the process, management should define how the employee's job performance affected other personnel and/or impacted PFS operations.

Management can most effectively promote employee teamwork, loyalty, morale and excellence in revenue cycle performance by an ERRP approach that:

• Stimulates ongoing employee motivation to be creative, innovative and successful on the job;
• Establishes effective lines of communication, including proper feedback;
• Conveys an ongoing sense that management sincerely cares about personnel;
• Takes into consideration the personal values and priorities of individuals;
• Specifies quality and performance expectations, and aligns such management expectations with PFS work force efforts; and
• Focuses on the value of superior personnel performance, creating a perception of significant (as opposed to marginal) achievement.

The management team should consider all these factors, when establishing the scope of processes and procedures that will be covered by the ERRP. A few other recommendations include:

• Focus primarily on team level (rather than individual effort) incentive-based reward programs;
• Meet with team members "on their turf" to express appreciation for work performance efforts; and
• Involve executive level management in activities that recognize/reward the team.

Celebrate Successes

"Celebrating successes" should then be orchestrated in a manner that further reinforces quality and performance standards. In fact, management should publicly acknowledge employees' achievements on a quarterly basis with praise and support (if not otherwise rewarded), when targeted goals are attained or performance expectations are met/exceeded. The celebration of successes, regardless of how significant each success may be, provides an effective means for expressing management's appreciation for staff accomplishments.

Celebrating successes can certainly be a cost-effective means for enhancing a wage and salary program, since the celebration does not necessarily have to involve monetary rewards. Anything valued by personnel can become a reward, such as:

• Public acknowledgement;
• Flex-time;
• Earned time-off;
• Participation on a selected committee;
• Special events or activities;
• honorary parking privileges;
• Office or work station amenities.

The most meaningful celebrations, however, are quite often the result of good timing and proper sentiment, rather than the monetary value of a gift.

Summary

Leland Kaiser (1991) challenges us as health care leaders. He states, "We are the architects of our future health care system. We are creators of new realities. Intuition is our major design tool. Innovation results in social and organizational change. Highly intuitive leaders promote change by sensing what could be." Kaiser's comments can certainly be applied to designing employee recognition & reward programs that promote employee teamwork, loyalty, self-esteem, renewed performance incentive and performance optimization.

This article is written in follow-up to the presentation, "Recognition & Reward: Carrots Over Sticks" delivered at the Georgia HFMA Summer Institute on August 10, 2000. The recommendations of this article can be easily applied/adapted to the operating parameters, constraints and performance improvement opportunities of various type healthcare organizations.

REFERENCES

Thrower, Sam & Sharon Snow. "Designing Highly Effective Teams - PFS Work Group Performance Optimization." The Georgia Scroll (Summer, 2000): 27-28.

Thrower, Sam & Sharon Snow. "Managing An Effective Team Approach For Patient Financial Service Operations." Connections (April/May, 2000): 8-9.

Ulschak, Francis. & Sharon Snow. Team Architecture, The Manager's Guide To Designing Effective Work Teams. Ann Arbor: Health Administration Press, 1995.

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Chapter Chatter...

Larry Bradley has left Grady Health Systems to join NCO.

Ann Finland is the new CFO at Baptist in Atlanta

Teresa Singley has joined Newnan Hospital in Newnan, Georgia.

Jim Brown has returned to Sumter Regional Hospital as the Business Office Director.

Steve Rowell is the new PFS Director at St. Francis Hospital.

Pat Hamby is serving on the HFMA National Nominating Committee.

Ginger Elliott Anspaugh is the Chairperson for the Professional Development Council of the National Advisory Councils (NAC).

Ray Snead is the Chairperson for the Board of Examiners. Ray has also accepted the appointment of President and CEO of Healthcare Receivables Professional.

Ron Anspaugh is a member of the National Strategic Planning.

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Past Presidents Recall Special Memories...

"Winning the Shelton and knowing that the Georgia Chapter was the best in the country during my year. You did make a difference!" - Lex Klamke, 1999-2000

"My favorite memory as a President of the Georgia chapter is of all the wonderful people I had the opportunity to meet and to interact with both in the Georgia chapter and many other chapters around the country. HFMA is a big part of my extended family and all the friends I have made through HFMA are very special to me." - Ginger Anspaugh, 1996-1997

"It has to be when Dick Clark called to say we had won the Shelton. I had a great time calling the 4 past presidents and inviting them to Chicago to accept the award in 1995!" - Larry Sims, CHFP, 1994-1995

"Winning the Shelton! Another was when Bonnie Phipps was sworn in as National HFMA President!" - Clint Harkins, 1991-1992

"I really enjoyed acting as "tour guide" at the many meetings. Great crew to work with!" - Bob Crump, 1988-1989

"My favorite memory is Jim Lowry as Program Chairman for Glenn Black agreeing to keep the cocktail hour going for three hours during a hurricane at Jekyl Island and then talking the vendor into paying for it. He always has had a silver tongue!" - Bonnie Phipps, 1986-1987

Ann recalls the night before Medicare went into effect, the government changed everything! - Ann Longshore, 1972-1973, 1971-1972

"We were a young chapter then. We spent a lot of time focused on education. There were not many people in the workforce who knew a lot about healthcare accounting. We held a lot of basic courses for accountants. National adopted our chapter's workshop on Hospital Budgeting as a model." - Bob Jones, 1960-1961

"My favorite memory were the joint meetings with Tennessee and Georgia. I made a lot of life long friendships!" - Dan Barker, 1957-1958

"When I was President, I was recognizing Glenn Black for his contributions. I gave him a set of French cuff links. He opened the cuff links and discovered there were someone else's initials engraved on them. He quickly pointed the mistake out to all of us. I responded, "We know, but we got a great deal!' ". - Jim Lowery, 1982-1983

"I have to say that creating the Sr. Rose Margaret Schweers (Georgia President 65-66) Most Valuable Member Award and seeing her personally award the first recipients at the end of my Presidential year was the most memorable occasion, the happiest event I have had the privilege of participating in." - Lee Evins, 1998-1999

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Where they are now?

1999-2000, Lex Klamke - Assistant Administrator, CFO, Newnan Hospital

1998-1999, Lee Evins - Executive Director of Patient Financial Services, WellStar

1997-1998, Pat Hamby - VP, Regulations, McKesson HBOC

1996-1997, Joanne Kimmons - Consultant

1994-1995, Larry Sims - Vice-President, Financial Services, Colquitt Regional Medical Center

1993-1994, James Piper - Director, Managed Care, South Fulton Medical Center

1991-1992, Clint Harkins - Attorney, Harkins and Henry

1989-1990, Bobbie Jarrett - Consultant, Bobbie Jarrett & Associates

1988-1989, Bob Crump - CFO, Piedmont Hospital

1986-1987, Bonnie Phipps - President and CEO, PROMINA Managed Care Organization and PROMINA Health Plan, Inc.

1987-1988, Dennis Crum - Senior Vice-President and CEO, St. Mary's Heath System, Inc.

1984-1985, Norma Ramey - President, Collection Choice Corporation

1983-1984, Larry Bradley - Senior Director of Operations, NCO Financial Services

1982-1983, Jim Lowery - President, Coquitt Regional Medical Center

1980-1981, Glenn Black - Senior Vice-President & CFO, Promina Health Systems

1976-1977, David Blankenship - President, Blankenship & Associates

1973-1975, Tom Satterfield - Instructor, Georgia State University

1972-1973, 1971-1972, Ann Longshore - Retired 

1965-1966, Sister Rose Margaret Schweers - Hospital Historian, St. Joseph Hospital

1960-1961, Bob Jones - Retired

1957-1958, Dan Barker - Retired

GEORGIA SALUTES OUR OWN WHO SERVED AS NATIONAL HFMA CHAIRMAN

1997-1998 - Ronald Anspaugh, FHFMA

1992-1993 - Bonnie Phipps, FHFMA, CPA

1988-1989 - Glenn Black, FHFMA 

1979-1980 - Tom Satterfield, FHFMA

1970-1971 - Charles Anderson, FHFMA, CPA

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Founder Points - Add Them Up! 

By Richard L. Childs, FHFMA

In the last issue of the Scroll, I shared the history of the Founders Points Award Series. To recap, there are four Awards - The Follmer Bronze, The Reeves Silver, The Muncie Gold and The Medal of Honor. The first three Awards require an accumulation of 100 Founders points for each level. The Medal of Honor requires the first three Awards and three continued years of involved service and nomination by the Board of Directors of the local Chapter.

Just how do we accumulate those points? National HFMA has developed a point system that promotes continued active participation in Local Chapter and National HFMA activities. The point system has a maximum of 40 Founders Points to be given in any one fiscal year. Points earned are reported by the Chapter's Founders Contact to HFMA National by August 10 of each year for the previous fiscal year ending May 31. National HFMA and the Local Chapter track most of the points for each member; however, it is ultimately the responsibility of the individual member to report points to the Chapter's Founders Contact.

The Georgia Chapter of HFMA depends on YOU! You make the difference in the success of our Chapter. Being an active participant in HFMA is great for professional development and networking with our peers. Keep an eye on the Georgia HFMA WEB Page ( www.GeorgiaHFMA.org ) for information on The Founders Award Point System.

If you have any questions concerning your total points, or you feel that you have not received points that you may have earned, please contact Rick Childs via e-mail to review your points.  Childs_Richard@Piedmont.Promina.org.

The following chart outlines the categories and the points awarded for each activity: