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Revenue Cycle Employee Engagement During Mergers,

Acquisitions and Consolidations

Jennifer CollierVice President, Revenue Cycle

CHRISTUS® Trinity Mother Frances Health System

CHRISTUS® NETX

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Welcome to Healthcare…

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Health Services Sector =

More than 1000 deals per year since 2016

2018:

• Volume was up 14.4% over 2017

• While volume was high, value was down over 2017, totaling $121.5 billion in 2018

2019:

• Volume ended similar to 2017

• Excluding mega deals in 2018 and 2019, total value increased by 77% and Q4 represented largest quarter in 5 years

• Hospitals, Long Term Care and Managed Care = the sectors with growth in volume and value

Source: Healthcare Finance and PricewaterhouseCooper 3

Healthcare Mergers and Acquisition Activity

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Managing Employee Engagement From Both Sides of the Fence

Responsibility falls to both organizations involved in the merger/consolidation/acquisition

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You may be….

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• The larger organization acquiring a smaller one• A small organization being acquired• Part of an organization going through the process of

centralizing their business offices• Part of a merger of equal partners• Part of the full outsourcing of revenue cycle

…. And More

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The Do’s and Don’tsThings to consider and evaluate

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Assumptions

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• Don’t make assumptions about their revenue cycle performance

• This goes both ways

• Don’t assume one organization’s way is the only way

• But don’t get caught up in terminal uniqueness

• Don’t assume this merger/acquisition/consolidation will be exactly the same as the last one

• Sometimes senior leadership has different plans based on different situations

• Don’t assume this will be a negative thing!

• But don’t assume they will know all your questions without you asking

• Don’t assume people won’t be onboard with change

• This includes assumptions about leadership’s commitment

• But also don’t assume everyone will be happy about the change

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Communication

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• Remember how this announcement will impact your staff

• Leaders vs front line• Walk in their shoes to help craft communications

• Communicate clearly and often • Answer crucial questions

• Even if you don’t think it’s crucial, do the staff think it is?

• Give employees a forum to ask/submit questions

But what if you can’t release the answers yet?

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So where do communications go wrong?

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Communication

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Real world examples of communications gone wrong:

• Announcements hitting the press or LinkedIn before announced to staff • Front line staff receiving communications before leadership• Information distributed from HR not matching information communicated

from leadership • Offer letters being delivered late and with incorrect info• Assessment of current state meetings with front line staff without notifying

their leadership• Posting future communications on your intranet before being announced

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Communication –Other Don’ts

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• Don’t make promises you can’t keep

• Don’t blame change on “the C suite”, “them”, “the other organization”, etc

• Don’t tell people why they should be happy with what they are getting

• Instead engage them in real discussion, acknowledge concerns and provide solutions when possible or explanations when not

• Don’t commit to deadlines you can’t keep

• Especially if the change involves letting staff know about reorganization changes, job changes, pay changes, benefit changes etc.

• Pad your deadlines if needed – better to announce earlier than expected

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Communications – More Do’s

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• If you don’t know the information or can’t share it yet, be honest.

• Don’t make something up to appease the crowd

• If you promise to follow-up on a question, then follow-up.

• Be open to suggestions from both sides on how to make a smooth transition.

• Front line staff often have great ideas and appreciate being included when possible!

• Arm your leaders at all levels with good information

• Make and follow a detailed plan for all communications

• Don’t rush to get out information

• But don’t wait too long either!

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Turnover During Transition

How do you ensure the good ones stay?

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PHI

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First:Follow the

do’s and don’t’sof communication!

Communication is one of the most effective ways to engage and

retain employees!

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Considerations

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Do you need a retention plan with bonuses?

• Not only for executives

• Other leaders and Front Line Staff

• Effective with both especially if you will have legacy run out AR

• Phased approach and scaled to level of position

• Lets employees focus on the best transition and not whether they have job security or should consider changing jobs?

• Creates buy-in to transition’s success

• The earlier the better

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You may be looking at the big picture –

The long term finish line….

But your team members are worried about how this impacts them personally

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Considerations

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Beyond the obvious pay and insurance benefits, how might this change impact your employees personally:

• Is for-profit vs non-profit status changing?

• Could impact loan forgiveness programs and retirement plans

• Will this change bring about care directives based on religious doctrines?

• Example: Non-catholic hospital being acquired by Catholic health system may need to change services offered. Scheduling and registration staff often take the brunt of unhappy patients who may be caught in the middle.

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Considerations

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Beyond the obvious pay and insurance benefits, how might this change impact your employees personally:

• Will payroll deduction options change?

• Associated credit union loans, payment plans, cafeteria charges, etc.

• What about employees in the middle of a degree plan and a tuition reimbursement program?

• What about commitments previous organization made with regards to supporting employees’ involvement in community or professional organizations?

• Example: Local community boards or HFMA

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Considerations

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Beyond the obvious pay and insurance benefits, how might this change impact your employees personally:

• Will you honor tenure?

• This is a big one! It’s best if you can answer this one early.

• PTO changes:• Buyout versus rollover – hot button topic and can be

confusing to those who have never been through a merger

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Considerations

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Beyond the obvious pay and insurance benefits, how might this change impact your employees personally:

• What employee policies differ between the organizations?

• Flex Time

• Attendance Policies

• Remote Employees

• Parking Rules

• Time off policies

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Merging Different Cultures

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Considerations

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“Many integration issues aren’t operational but cultural”

- 10 Lessons From Leaders Who Have Merged or Acquired Hospitals (Beckers Hospital Review)

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Celebrations and TraditionsImportant when merging cultures

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Celebrations and Traditions

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This may not seem important to you but employees often feel passionate about their office culture and traditions:

✓ Casual / Jeans Days ✓ Annual Holiday Traditions✓ Celebration Cakes ✓ Employee Recognition ✓ Decorating Contests

This can vary between different physical locations even within the same organization.

✓ How do you balance standardization with physical location differences? ✓ Big Bang versus Phased

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Wrap Up Reminder!

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In Summary:

• Communicate often and honestly

• Don’t make assumptions

• Consider things from your employees’ perspective –

even if trivial to you

• Engage both sides – both sides can learn from each other

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Contact Info:

Jennifer Collier Vice President, Revenue Cycle

CHRISTUS® Trinity Mother Frances Health System and

CHRISTUS® NETX

903.606.7765Jennifer.Collier2@bshsi.org Questions?

Thank you

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