How multiple managed care, alternative payment arrangements help Shriners, per Bill Munley

Bill Munley serves as administrator at Tampa, Fla.-based Shriners Children’s in Greenville.

Mr. Munley will serve on the panel "The Big Priorities and Changing Role of Hospital Boards" at Becker's 10th Annual CEO + CFO Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the roundtable, which will take place in Chicago from Nov. 7-10, 2022.

To learn more about the conference and Mr. Munley's session, click here.

Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speakers had to say.

Question: What is the smartest thing you've done in the last year to set your system up for success?

I think overall the smartest thing we've done is entering into multiple managed care and commercial alternative payment arrangements. We've done this locally here at my hospital in Greenville, as well as system-wide for our 22 Shriners Children’s facilities across North America. These alternative payment arrangements include membership in clinically integrated networks. We are in three right now nationally, and we're talking seriously to a fourth. Furthermore, we’ve entered into some preferred provider organizations – PPOs – and other care guided arrangements. Additionally, we are members of some narrow networks where they encourage patients to utilize us. I think the grand slam is that we've entered into some managed care and commercial bundled payment arrangements for spine, hip and knee procedures; in fact, two are signed right now, and we are working on others.

We were able to do this because even through COVID-19, we stayed focused on our mission, which is to see more kids in more places. We also focused on the strategic plan, specifically our value-based care equation. This “value equation” is defined as quality and outcomes divided by cost related to patient experience. We have a phenomenal value equation, and third party payers recognized that and started sending patients our way.

As it was for everyone, COVID-19 was tough for us. Coming into 2022, our patient numbers were down 20 percent. But by staying the course, by the end of the year, we had helped patients from 34 states and 14 different countries. We never lost sight of our mission, our strategic plan and alternative payment arrangements.

Even during that tough year, we broke records for number of referrals, new patient visits, inpatient surgery and therapy visits. If there was one silver lining to the COVID-19 pandemic, it was the increased utilization of telehealth. As the comfort level for telehealth use increased, especially for people coming long distances, we could do a lot of initial visits virtually. We treat over 85 different orthopedic and neuromuscular conditions, and during those online visits we were able to evaluate if we were the right provider for the patient before they traveled to the hospital. If the appointment was a follow-up visit from surgery, we could now use telehealth as an alternative.

Because of our stringent COVID-19 precautions, we were still able to follow our mission of treating every appropriate patient regardless of ability to pay. Now, we are thriving.

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