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Building Skills for a Lean Culture inHealthcare – Part 1Building Leaders – Transforming Hospitals – Improving Care HTS3 2015 Page 1

Faith M Jones, MSN, RN, NEA-BCDirector of Care Coordination and Lean ConsultingFaith Jones began her healthcare career in the US Navy over 30 years ago. She hasworked in a variety of roles in clinical practice, education, management,administration, consulting, and healthcare compliance. Her knowledge andexperience spans various settings including ambulance, clinics, hospitals, home care,and long term care. In her leadership roles she has been responsible for operationalleadership for all clinical functions including multiple nursing specialties, pharmacy,laboratory, imaging, nutrition, therapies, as well as administrative functions related toquality management, case management, medical staff credentialing, staffeducation, and corporate compliance.Sara StantonVice President, Business DevelopmentSara Stanton is responsible for marketing and business growth for both new andexisting clients. She is a business development leader with over 15 years ofexperience in healthcare strategy, consulting, data analytics, and patientcommunications. Sara has worked with large provider organizations, communityhospitals, regional health systems, national ASCs and specialty providers, and thelargest IDN’s in the nation. This experience and exposure has given her a broadunderstanding of the American healthcare market and the initiatives, challenges,and mandates that hospital executives are facing. Stanton earned a BA inCommunication Studies from Baylor University. HTS3 2015 Page 2

Strategy – Solutions – Support45 Years of Delivering Superior Results HTS3 2015 Page 3

Strategy – Solutions – SupportOur CompanyOur TeamFormerly known as BrimHealthcare we have a45 year track record ofdelivering superiorclinical & operatingresults for our clients.Management TurnaroundStrategy Financial Operations CorporateCompliance BoardDevelopment HTS3 2015 Page 4Our Executive Teamhas experience inmanaging hospitalsfrom multi-billion healthcare systems tocommunity hospitalsConsulting RegulatoryCompliance andAccreditationPreparation Lean ProcessImprovement CHNAOur MissionWe believe that thecombination of People,Process & Technologytransforms healthcare &provides the requiredresultsPlacement ExecuitveRecruiting Interim ExecutivePlacements Mid-level andSpecialtyPlacementsTechnology Gaffey RevenueCycleManagement CrossTXPopulation HealthPlatform OptimumProductivity

Our MissionIncreasing Efficiency/Reducing Waste80% of Hospital Operating Expenses Fall into 4 CategoriesOpex CategoriesSalaries and WagesFringe BenefitsContract LaborTotal Labor ExpenseSupply ExpensePurchased ServicesPhysicians Fees%Revenue Cumulative41%10%2%53%14%9%4% GPO Services Cost Benchmarking Lean SC Consulting53%67%76%80%* Data from HealthTechS3 Comparative Financial Benchmark DatabaseManagement HTS3 2015 Page 5Consulting Executive Search ProductivityManagementSoftware Benchmarking Lean Projects GPO Services PPM Consulting Physician CompConsultingPlacementTechnology

Who we are and what drives us?PerformanceHealthTechS3 is an award winning healthcare services company. We are arenowned management company with award winning hospitals, health systemsand physician practices with CEOs of long tenure.ExpertiseHealthTechS3 only has consultants with deep experience; Consultants areformer hospital leaders and executives, clinical resources are best in theindustry.IntegrityHealthTechS3 is a trusted partner our hospitals. We are fair, honest, professional,and provide ongoing support.LongevityMarketValue HTS3 2015 Page 6HealthTechS3 has been around for 45 years and successfully navigated manyhospitals through an ever changing healthcare market.HealthTechS3 knows how to work with community hospitals and health systemsto best leverage their assets and resources to serve their market and maintainindependence.HealthTechS3 is flexible and affordable relative to many large nationalconsulting firms who focus on strategic work and ideas rather thanimplementation and impact.

ManagementA Nationwide Client Base HealthTechS3 – currently provides hospital management,consulting, turnaround, supply chain management, andprofessional and physician recruitment services to:– More than 50 hospitals and health systemsnationwide– Community hospitals, Critical Access hospitals,district hospitals, non-profit hospitals– Most operate physician clinics– Net Revenue between 20M and 400M– Business Partner Illinois Critical Access HospitalNetwork (ICAHN)– Preferred vendor with California Critical AccessHospital Network and Texas Organization ofRural and Community Hospitals HTS3 2015 Page 7

ManagementClient Recognition and AwardsJanuary 2015Becker’s 50 Rural CEOs to Know Nicole Clapp, Grant Regional Health CenterJohn Gallagher, Sunnyside Community HospitalChandler Ralph, Adirondack HealthPhil Stuart, Tomah Memorial HospitalApril 2015HealthStrong Top 100 Hospitals(iVantage Health Analytics) Barrett Hospital & HealthcareCarlinville Area HospitalGrant Regional Health CenterHammond-Henry HospitalHillsboro Area HospitalTomah Memorial HospitalMay 2015Becker’s Top Hospitals for PhysicianCommunication(scored 92% or higher) Spooner Health System – score 94% Tri Valley Health System – score 93% Grant Regional Health Center - score 92% HTS3 2015 Page 8June 2015Becker’s 100 Great Community Hospitals Adirondack Health Grant Regional Health Center Hammond-Henry Hospital June 2015Top 100 Critical Access Hospitals(iVantage Health Analytics) Barrett Hospital & Healthcare Hillsboro Area Hospital Tomah Memorial HospitalJuly 2015Most Wired Hospitals – Small & Rural(published H&HN magazine) Hammond-Henry Hospital Sunnyside Community HospitalSeptember 2015Becker’s 50 CAH CEOs to Know Nicole Clapp, Grant Regional Health Center Florence Spyrow, Hammond-Henry Hospital Ken Westman, Barrett Memorial Hospital

Expert Led SolutionsConsultingStrategyGrowth StrategyMarket PositioningNetwork Collaboration andDevelopmentPhysician Relations andIntegrationTurnaround StrategyFinancial and OperationalRestructuringRisk AdvisoryCreditor ConsultancyTransaction AdvisoryMerger IntegrationDeal StructuringContract Analysis andNegotiationsACO Transition AnalysisPayment StrategyTransitionsFinancial ModelingCapital Sourcing HTS3 2015 Page ital ProgramsSupply ChainLabor ProductivityManaged CareNegotiationsRisk AdvisoryRevenue CycleBusiness OfficeConsolidationClinical Documentationand Coding ReviewsOperationsLean Workflow Analysis andRedesignPatient Access, Throughput,Level of CareCorporate ComplianceClinical & QualityQuality ImprovementQuality ProgramDevelopmentClinical Process RedesignCare and caseManagement ProcessBenchmarking andReportingRegulatoryCompliance andAccreditationPreparationSurvey ReadinessPlans of CorrectionPublic Reporting of Qualityand safety IndicatorsEvidence Bases carePopulation HealthManagementCare CoordinationTransitional CareManagementGovernance &LeadershipBoard AdvisoryEducationRetreatsHospital GovernanceManagementLicensing Advisory ServicesRegulatory StrategyDevelopmentAnnual Report Preparation

ConsultingIn 20 Months LEAN INSTRUCTOR NETWORK: 1HOSPITAL FACILITIES: 13ON-SITE INSTRUCTORS: 25LEAN COURSES: 28PARTICIPANTS/PROJECTS: 291Projected Annualized LeanProject Savings:Developing a Lean CultureReduced Process Variation& Non Value Added Tasks Happier workers Happier patients Increased capacity for work Lower operating costs 7.6 MILLION“I can't overstate the value [lean] is providing. It not only benefits our staffthat has developed professionally, but also community members the classis focused on improving the Triple Aim for our patients.” HTS3 2015 Page 10

Finding The Right LeaderPlacement45 Years of Excellence HTS3 has been recruiting SeniorExecutives for over 45 Years Our extensive understanding ofhospitals & healthcare helps usfind the right candidates for you.Peter Goodspeed leads our Executive Placement Services group.With over 30 years experience Peter understands the uniquechallenges of today’s hospitals. Whether finding a candidate for arural hospital or searching for a multi-hospital system, we focus onyour desired qualifications and specific needs. Services include: Interim Permanent Executive Search ProcessManagement HTS3 2015 Page 11ConsultingPlacementTechnology

Revenue Cycle - GAFFEYTechnologyProven & Trusted Technology 200 Hospitals & Health Systems37 States 14 Billion in Revenue Collected26 Years of InnovationUnmatched Service Industry Expertise Leadership - RCM expertsRun our own CBOWe use all of our technologyContinually innovatingTotal AR Mgmt.Best33%ProductivityTechnology& Transparency ImprovementPredictable ROIBest ResultsProprietary billing & Active monitoring efficiencycollections management Reduces cost of ownershipplatform Improves your productivity Creates Innovation Loopwww.GAFFEYHealth.com HTS3 2015 Page 12Complete BusinessAR1-4% IntelligenceIncrease inandNPRManagement33% betterproductivity85% clean clams rate20% cost reduction

TechnologyRevenue Cycle - GAFFEYTechnology Solutions that Target Key Areas of PainRevenue Attrition / Automation & Efficiency / Closed Loop LearningIncrease in Clean &Complete ClaimsLack of CollectionAutomationPoor Workflow &Task EfficiencyClaims ManagementAutoStatusAlphaCollectorUnder Payment &Revenue IntegrityCorrect PatientInformationIntegrated Reporting&Process InsightContract CalculatorIntegrated Eligibility HTS3 2015 Page 13AlphaAnalytics

TechnologyProductivity– OptimumThe Complete Solution.The Optimum Productivity Enhancer programprovides you with the tools and supportservices necessary to ensure your success inaddressing today’s productivity challenges.For over 40 years, our experiencedConsulting Staff have been assisting hospitalsin developing sustainable financialimprovement solutions.Optimize ProductivityPerformance.HealthTechS3 provides your managers,supervisors and C-suite theconfirmation needed to accuratelycalculate workload staffing andappropriately adjust staffing on atimely basis. HTS3 2015 Page 14

TechnologyPopulation Health : CrossTXCommunity Connect PlatformHealthTechS3 is a partner with CrossTX to bring a cloud based CareCoordination Platform, Community Connect, to both independent andaffiliated physician groups.This platform equips providers and care coordinators to plan, coordinate, track,and document all care giver relationships and episodes of care according tothe CMS reimbursement requirements. HTS3 2015 Page 15

TechnologyPopulation Health : CrossTXCommunity Connect PlatformThe estimated average approximate reimbursement is 42.60* per patient per month,which amounts to over 500 per year that your primary care providers are eligible to bepaid. With an average patient panel size of 3,2791 this can add substantial revenue toyour organization’s bottom line.Patient Panel Size1% of Panel on Medicare1Medicare Patients% of Medicare patients CCM Eligible2Number of CCM Eligible Patients3,27921.85%71668.6%491Annual Billing for CCM Patient 511.20Annual CCM Revenue Potential 250,999 HTS3 2015 Page 16

Building Skills for a Lean Culture inHealthcare – Part 1Building Leaders – Transforming Hospitals – Improving Care HTS3 2015 Page 17

The Right Tools for the Job Welcome 3 part series on building skills for a LeanCulture in Healthcare– Culture and Engagement - Today– Power of Observation – February 9th– The Patient Perspective – March 8th HTS3 2015 Page 18

Background of a Lean ebinars/ HTS3 2015 Page 19

Agenda Definition of CultureDescribing a CultureCulture ChangeSelf AssessmentsEngagement HTS3 2015 Page 20

CultureWhat is it?According to Merriam-WebsterDictionary (2015), culture is defined as“a way of thinking, behaving, orworking that exists in a place ororganization” HTS3 2015 Page 21

A Basic Tenet of LeanDeeply understanding how workcurrently happens is essentialbeforetrying to fix it!22 HTS3 2015 Page 22