Case Studies: Consulting Engagement
Case studies provide insight on how we stabilize, turnaround, and enhance healthcare organizations. Use the table of contents to navigate through the case studies in this section.
Table of Contents
A 420 bed urban public hospital.
Challenge
Financial hemorrhaging of nearly $100 million per year consisting of $35 million annual loss from operations and another $59 million in subsidies.
Results
The fiscal viability plan developed by Kurron projected to reduce the total five-year cumulative losses by over $200 million, with the last three years posting a positive gain from operations.
Solution
An intense, comprehensive operational assessment and fiscal viability plan.
Kurron was engaged to provide a comprehensive assessment and fiscal recovery plan for one of its hospitals.
Kurron conducted an intense operational assessment covering revenue enhancement opportunities, labor and productivity, non-labor expenses, business office processes and performance, DRG coding efficiencies, clinical case mix and length of stay studies, capital expenditure processes, contract service evaluations and program review.
Kurron also examined the corporate structure of the Hospital. Strategic recommendations were made regarding the integration of the Hospital with the nineteen area Department of Human Services neighborhood health centers, the creation of a 501(c)(3) public benefit corporation to allow greater competitive advantages, and the implementation of a faculty practice plan for hospital based physicians.
A 598 bed tertiary hospital.
Challenge
Construction plans were underway to replace an aging 1914 oversized hospital with a new $600 million 464 bed facility. Hospital management needed assistance in identifying revenue enhancements and expense reductions from improved physician productivity and appropriate staff sizing for the new building.
Results
Kurron developed a medical staff department-specific report with recommendations for improving productivity and profitability. Kurron's recommendations were adopted and implemented.
Solution
Kurron was engaged by the Hospital to determine appropriate physician staffing levels for a new 464 bed replacement hospital, a reduction of 134 beds. Kurron embarked upon a series of in-depth interviews with each department chairman; careful analysis of benchmarks for high quality care of similar organizations and the evaluation of existing consolidation opportunities. Kurron's resulting recommendations, which met the Hospital management's requirements of reducing financial losses while maintaining teaching program revenues and high quality patient care, called for the reorganization and downsizing of the salaried and teaching medical staff.
A 130 bed suburban hospital.
Challenge
Vacant Chief Executive Officer position; continuity issues; significant leadership void; and financial instability.
Results
Kurron stabilized the operation enabling the Hospital to recruit a new permanent Chief Executive Officer.
Solution
Interim chief executive officer services.
Kurron was engaged by the Board of Trustees to provide sound executive management while hospital leadership recruited a new full-time Chief Executive Officer.
Working with the Hospital's Board of Trustees, Kurron developed an eighteen month Management Action Plan addressing operational improvements and competitive repositioning initiatives. Kurron worked with other facilities in the region to formalize network affiliations.
Kurron also initiated the development of a physician hospital organization to better address future managed care opportunities collaboratively with the key attending physicians. During the six-month contract period, Kurron developed weekly cash flow schedules and planned vendor payouts as a means of reducing accounts payable without interruption.
In the first 90 days, the Hospital realized a 7% reduction in labor costs with the approval of the Hospital bargaining units to better match the work force with utilization requirements. This allowed the Hospital to avoid a year-end deficit and post a gain from operations.
A 130 bed specialty hospital.
Challenge
An incomplete management team; open Board of Trustees positions; lack of Board leadership, direction and accountability; high dependency on Medicaid; and very narrow market niche.
Results
Kurron developed a specific 21-point Action Plan for organizing a new Board of Trustees with restructured responsibilities and accountabilities. Kurron then assisted the Board of Trustees with the recruitment of a management team. The new hospital governance group and management are now positioning the Hospital for its current and future needs.
Solution
Kurron was engaged by the Hospital to conduct a strategic and organizational assessment of its preparedness for the future. Kurron provided the Hospital with a comprehensive evaluation of the organization's ability to accomplish both its stated mission and to reach its vision outlined in its strategic plan. Kurron focused on the role, responsibilities and accountabilities of the Board of Trustees and the Hospital's management team, as well as the consistency and appropriateness of the Hospital's policies, procedures and practices. Kurron facilitated a Board of Trustees retreat based on the organizational assessment and the 21- point Action Plan for the future.
A 150 bed acute care and 150 bed long- term care rural health care facility.
Challenge
Periodic need for additional financial management and consultative services to supplement and complement the resources of existing management.
Results
Kurron provided an interim Chief Financial Officer to set up accounting and financial reporting systems and assisted with the recruitment and selection of a permanent Chief Financial Officer.
After several years, the President and Chief Executive Officer of the Hospital called upon Kurron again, to develop a comprehensive program for revenue enhancement. The Hospital has implemented Kurron's recommendations.
Solution
Kurron provided an interim Chief Financial Officer who achieved productivity improvements, enhanced internal financial reporting formats, created a periodic cash flow projection process; negotiated a managed care contractual agreement and reorganized and downsized fiscal and patient accounting services. Kurron assisted with recruitment of a permanent Chief Financial Officer.
Kurron's follow-up engagement focused on methods of enhancing the organization's revenues through the improvement of systems and data management including accounts receivable, collections, reimbursement appeal opportunities and cash flow practices.