FINANCIAL VIABILITY AND LIABILITY

By establishing cooperative ventures and endorsed relationships with strategically selected organizations, MHA Solutions provides competitive pricing on specialized services that are essential to MHA members. 

MHA Solutions endorses several organizations offering value added programs and services to the MHA member hospitals.  Endorsement recommendations are tied directly back to the MHA Strategic Plan and the CEO responses on the MHA SatisfactionWorks survey.

Disproportionate Share/340B Consulting and Management Services DSH Management Solutions’ general Partner is RFG Associates, Inc., a data driven healthcare financial management firm with over 15 years of experience in the design and development of proprietary data warehouse systems that integrate information from Federal, State, hospital and physician sources in a HIPAA compliant platform overlaid with regulatory, table driven logic.  MDSS©, DMS’s proprietary software solution, can be leased and operated by hospitals or used by DMS in a consulting engagement.     DMS provides the expertise and services to qualify hospitals that are under the minimum threshold for DSH/340B revenue/cost reduction and increase the existing Federal DSH revenue for those facilities already receiving DSH reimbursement by an average of 15 – 20% for all Medicare cost reports that are open, or subject to re-opening. DMS provides advanced, proprietary software-driven solutions and consulting expertise that enables hospitals to enhance their DSH revenue streams by accessing previously untapped or inaccessible data sources, and qualify/re-qualify hospitals for 340B status through this same process and by programmatically integrating mandated Title XIX/XVIII benefit coverage into their proprietary MDSS© system.  Their unique approach enables hospitals to proactively manage their DSH/340B revenue/cost reduction streams – retrospectively, concurrently and prospectively. DISPROPORTIONATE SHARE (DSH) REVENUES Major opportunities for hospitals Retrospective Medicaid Appeal Package Development Hospitals can maximize the recovery of DSH receivables owed to them from prior years – funds that other consulting companies have overlooked, sub-optimized or not even considered. Concurrent DSH Management DSH Management tool enables hospital to monitor and proactively update and manage Medicaid and SSI member eligibility while identifying supplemental revenue opportunities.  NEW REVENUE OPPORTUNITES Previously untapped sources Retrospective Medicare/SSI Appeal Package Development DSH Management Solutions can identify past shortfalls in DSH ratio calculations and precisely calculate the significant nominal and interest component of the damages suffered by a hospital client. Prospective DSH Management By identifying a hospital client’s “market share” among region specific medical groups, the hospital can target these single or multi-specialty practices that have patient population with a high percentage of Medicare/SSI patients as potential medical group development opportunities. Claim Identification and Submission Services DSH can not only determine the hospital’s patient Medicaid eligibility status, but more specifically, those Title XIX and Title XVI members that have recently lost eligibility/entitlement.  If within the State specific Title XIX timely billing window parameters, DSH also offers EDI claim submission services prior to the billing window “closure” using HIPAA-compliant, secure, electronic data transmission system to ensure that no potential revenue streams are overlooked for this demographic subset. 340B MANAGEMENT SERVICES Qualification of facilities for the 340B Program DMS specializes in getting facilities that have never qualified for the 340B program and its attendant 15% annual cost reduction in outpatient pharmaceuticals expense, into that program, and keeping them there. Re-qualification of facilities for the 340B Program For facilities that were once qualified, but currently, or can reasonably anticipate will fall under the threshold in the future, DMS can quickly perform the consulting engagement to re-qualify that hospital for this program and pro-actively manage the month-to-month utilization trends to that there are no “surprises” during the next cost report filing. Contact: Robert Gricius President 888-550-2708, ext. 705 202-330-5269 (fax) Robertgricius@dshmgmtsys.com                                     www.dshmgmtsys.com

LHC Group is committed to partnering with community hospitals to improve the way that home care services are delivered in the communities we are fortunate to serve.  With a focus on putting the needs of the patients and caregivers first, our proven operating model is comprehensive and integrated with our hospital partners.  The LHC Group model starts with a commitment to delivering the appropriate level of care when and where it is clinically appropriate, as opposed to cost based operating models which focus on delivering a level of care when and where it is scheduled.  The results . . . a comprehensive home health program which allows the agency to: • Improve Outcomes: With a variety of specialized Disease Management programs, clinicians manage the clinical needs of our patients based upon standards of care. • Establish Greater Physician Relationships in the Community: With improved patient care, physicians look not only to homecare, but to the facility for future admissions. • Improve Resource Management: Our comprehensive software package enables staff to allocate direct patient care resources across a larger patient population in the aggregate and in a completely decentralized approach.  • Improve hospital length of stay/ER utilization: With our assortment of specialized disease management programs, our 24hr Phillips Lifeline Personal Emergency Response System (LHC-PERS), and a comprehensive management approach to homecare, our hospital partners often experience shortened lengths of stay for their inpatients, while improving overall outcomes as patients are less likely to experience readmissions and/or emergency room visits following discharge from the hospital. • Growth: With our professional clinically driven sales effort, Patient Care Representatives trained under our operating model, and an agency trained in providing exceptional customer service, we develop a five year plan with goals established for the agency according to the demographic profile of the service area. LHC Group has 36 partnerships in operation with community hospitals including locations in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Ohio, Tennessee, Texas and West Virginia. Contact: Dale Doise Senior V.P. Business Development 800-489-1307 337-233-1307 337-235-8037 (fax) Daryl.doise@lhcgroup.com www.lhcgroup.com

The uninsured and underinsured population continues to grow.  The fastest growing segment of the uninsured population is patients with annual household incomes greater that $50,000.  The under-insured population is being driven up by insurance plans and Consumer Driven Health Plans with high co-pays and deductibles generally exceeding $5,000 or more.  Recent statistics indicate that the insured patient’s responsibility is currently averaging 30% of overall costs.  nTelagent provides a Self-Pay Management System that is the premier upfront cash and overall collection management tool.  nTelagent ensures improvement in up-front cash flow, receivables and overall profitability by reducing bad debt and improving the revenue cycle process for self-pay patients. For self-pay patients, nTelagent’s system helps ensure that accounts are handled properly and consistently from the point of service, including the application of appropriate discounts and charity care based on the providers specific business rules and accounting policies. Using the provider’s specific business rules and accounting policies, the application establishes an economic profile of the patient via the assimilation of demographic data.  nTelagent allows the healthcare provider to have a proactive connection and dialogue with the patient before the patient leaves the facility. nTelagent’s Self-Pay Management System will enable your facility to: Improve upfront and overall collections Automate non-discriminatory self-pay and charity care policies Document self-pay and charity care activity Ensure tax-exempt compliance Improve employee training, automate policy and improve overall self-pay processes Contact: Jo Moore Director of Sales 205-591-2955 Jo.moore@ntelagent.com www.ntelagent.com

Precision Pricing Software Quest System 2000 (QS2) is a copyrighted, precision pricing and budgeting software system that operates at the end of the billing cycle.   Installed in hospitals since in 1990, Quest’s software allows hospitals to reduce how much they need to increase patient charges annually, while significantly increasing their cash flow. This precision pricing software system delivers more effective unit pricing, while meeting all current CMS, IRS, OIG and HIPAA requirements.  Through site of delivery analysis, the software, finds the “best” unit prices, which are realized through individually-developed, hospital-specific pricing indexes.  For inpatients, there is an index for each DRG; for outpatients, an index for each revenue code.  Each index is uniformly applied to each unit price and to each patient within the same DRG or revenue code. Through hospital-specific statistical analysis, the indexes are generated prospectively and applied to the unit charges at the time of billing, including the full scope of services delivered to the patient.  By reducing statistically over-priced items that result in contractual allowances, and increasing statistically under-priced items that increase overall cash flow, as the last step in the billing cycle, QS2 allows the hospital to charge less and bank more. QS2’s Financial Capabilities Generates additional net revenue Allows a hospital to provide immediate payer-specific price quotes Remains gross revenue neutral…while adding net revenue Does not affect standard Medicare or Medicaid reimbursements Reduces contractual allowances Requires no additional FTEs Requires no capital outlay Estimates verified within 48 hours of receipt of hospital’s actual data QS2’s Operational Capabilities Fully automated and electronic Operates from a dedicated server on the hospital’s campus Hospital’s internal data is secure from outside access No change to the hospital’s charge master Automatically reconciles general ledger after applying indexing QS2 refines the CDM validation of all other vendors No lost time in billing cycle Interfaces with your current HIS computer system paid for by Quest Uniform, fair, ethical and compliant pricing regardless of payer. Documented Compliance Validation 17-year history of approved CMS and client CPA annual audits. For an estimate of cash revenue improvement for your hospital, go to www.quest-health.net. Contact: Dallas Riley Senior VP, Business Development 931-432-2995 Dallasr1@charter.net www.quest-health.net

WellnessWorks’ unique approach to community outreach not only attracts the wellness and occupational health dollars, but emphasizes the local community hospital as a partner to employers in their communities. WellnessWorks partners with healthcare providers in integrating all Employee Health and Wellness services available through your health system, packaging it, and then delivering a comprehensive program back to employees, their employees, dependents, payer sources, case managers and their agents/brokers. WellnessWorks provides the expertise for the hospitals to market the program to employers as well as the customer service role to guide employee health and wellness services through their customer service center.  The simplicity of a single source for employers and employees for reporting, tracking and compliance will benefit the employer, the insurance carrier and the employee and their family members.  This is an important factor in the busy world we live in today.  In addition, WellnessWorks offers wellness promotion services, industrial health rehabilitation training and loss prevention services all with the intention of keeping the workforce healthy and the benefit dollar in the community. With workers’ compensation being one of the top payer sources in the country for healthcare providers and over 80% of employers providing general health insurance and disability plans to their employees, WellnessWorks has their target audience – employers.  WellnessWorks can “partner” with you to tailor your clinical delivery systems, sales efforts and community outreach services to satisfy specific employer needs through the myriad of services afforded through your health system and your associated physicians.  Our Comprehensive Employee Health, Wellness & Safety Program drives revenue into many service lines of your health system and local physicians’ offices in an effective and efficient manner.  This allows the health system to control costs while delivering high quality, outcome oriented services; thereby, increasing revenues. WellnessWorks recommends that you focus on the common denominator between workers’ compensation and group health plans putting together a truly comprehensive Employee Health, Wellness and Safety Program.  The healthcare provider who is truly able to “partner” with an employer and their employees to satisfy all of their specific healthcare needs becomes much more than a listing in a directory – they become the PROVIDER OF CHOICE. Contact: Brian Lackey Manager or Field Operations 888-977-3319 402-720-4360 brianl@wellnessworks.biz www.wellnessworks.biz