2013- 2016 Strategic Plan

EXECUTIVE SUMMARY Overview The Show-Me Chapter of HFMA will continue our mission to promote education and professional development to our members. Our Chapter’s highest priority is service to our members and sustained excellence in performance. Our future goals of the Chapter incorporate a balanced approach in our service to our members and the development of Chapter goals through five foundational elements: 1. Education 2. Networking 3. Collaboration 4. Membership / Membership Satisfaction 5. Professional Development The plan applies specific goals and targets to each committee chair for attainment of those goals and implements a long-term focused campaign to assure progress is maintained. This strategic plan outlines the framework in which the Show-Me Chapter officers, Board of Directors and committee chairs will operate for the upcoming fiscal year and beyond. The strategic plan that follows this executive summary outlines our mission and vision as well as our core Chapter values and balanced approach to the future. CHAPTER FOUNDATION Chapter Mission Statement The mission of the Show-Me Chapter of HFMA is “to improve financial management through tools and solutions available to individuals to enhance their job performance and careers.” The vision of the Show-Me Chapter is “to be the resource for healthcare financial management in our service area.” The underlying core values support our mission and vision:  Service-The Chapter will provide value added service to our members.

 Teamwork- Working together is essential to our mission and success.

 Individuals-The Chapter believes individuals are important and should be treated with respect, dignity, and fairness.

 Financial Responsibility- The leaders and members of the Chapter will act in a financially responsible manner.

ENVIRONMENTAL ASSESSMENT

The Healthcare industry issues at the national, state and local levels have affected every aspect of the Show-Me Chapter. These factors have directly impacted member involvement in Chapter activities. The impact of these factors include: 2013- 2016 Strategic Plan

 The trend in membership growth has continued to remain fairly steady.

 The Chapter is seeing slight change in demographics of membership in the last two years. Namely, the baby boomer demographic has decreased where the Generation X has reflected the increase in percentage of members.

Ba by B oo Generation Generatio m Chapter Y n X er Traditionalist Blank 058 - Show Me State of Missouri 43 As of 5/31/12 Chapter 8% 31% % 1% 17% 058 - Show Me State of Missouri 49 As of 5/31/11 Chapter 8% 29% % 2% 12% 058 - Show Me State of Missouri 53 As of 5/31/10 Chapter 8% 27% % 2% 11%

40 As of 5/31/12 National HFMA Membership 7% 27% % 2% 23%

Generation Date of Birth Range Generation Y 1980-1994 Generation X 1965-1979 Baby Boomers 1946-1964 Traditionalist <1946

 The Chapter has experienced slight fluctuations in the location of membership. The counties making up the largest segment of membership and their trend over three years show decreases in Greene and Boon Counties and increases in St. Louis 2013- 2016 Strategic Plan

County. This geographic diversity between rural and urban membership creates challenges in educational programming. Other counties have minimal change over the period examined.

5/31/2013 5/31/2012 5/31/2011

Greene 52 Greene 56 Greene 55

Boone 34 Boone 42 Boone 38

St. Louis 15 St. Louis 13 St. Louis 13

Cole 11 Cole 10 Cole 10

Camden 10 Camden 9 Camden 9

Marion 10 Marion 10 Marion 8

Howell 9 Howell 8 Howell 11 Cape Girardea Cape Cape u 9 Girardeau 10 Girardeau 9

 The Chapter membership as a whole has remained consistent with average years in HFMA, average years in healthcare, average age and gender.

5/31/2013 5/31/2012 Average years in HFMA 11 11 Average years in healthcare 20 21 Average Age 48 48 Female 53.10% 53.00% Male 45.30% 45.60% . 2013- 2016 Strategic Plan

 The job function of the Chapter membership has consistently favored Director/Manager/Supervisor and CFO/Controller, followed by President/CEO/Executive Director. 5/31/2013 5/31/2012 President/CEO/Exec Director 16 6.20% 14 5.19% Partner, Principal or Owner 8 3.10% 9 3.33% CFO/Controller 56 21.71% 55 20.37% Other Chief officer excluding CFO 4 1.55% 2 0.74% Vice President 18 6.98% 17 6.30% Assistant/Associate VP 1 0.39% 2 0.74% Director/Manager/Supervisor 101 39.15% 112 41.48% Staff Specialist or Professional 41 15.89% 42 15.56% Professor 2 0.78% 4 1.48% Other Professionals 11 4.26% 13 4.81% 258 270

 The type of employer Chapter membership has consistently emphasized Hospital or Medical Centers and Health Systems. 5/31/2013 5/31/2012 Hospital or Medical Center 150 58.14% 169 62.59% Ambulatory Care Clinic 2 0.78% Other Provider or Clinical Service 2 0.78% 2 0.74% Skilled Nursing, Rehab or Subacute 3 1.16% 3 1.11% Medical Group or Specialty 7 2.71% 9 3.33% Health System Headquarters 27 10.47% 21 7.78% HMO Health Plan Insurance 3 1.16% 3 1.11% Accounting Firm 16 6.20% 13 4.81% Collection and AR Services 12 4.65% 10 3.70% Consulting Firm 14 5.43% 16 5.93% Professional Trade Association 4 1.55% 3 1.11% Educational Institution 3 1.16% 5 1.85% Physician Practice Management 1 0.39% 1 0.37% Other/Non Provider 14 5.43% 15 5.56% 258 270

 Nationally, HFMA members who are certified as CHFP/FHFMA was at 9.0% in the 2011-12 year (the last year data is available). The CHFP/FHFMA certification and CPA designation of the Show-Me membership has noted a 2013- 2016 Strategic Plan

flat trend in the last year – CHFP/FHFMA is at 23 members in each year, whereas CPA designations have increased by one. 5/31/2013 5/31/2012 CHFP 9 3.50% 6 2.20% FHFMA 14 5.40% 17 6.30% CPA 38 14.70% 37 13.70%

 The number of educational offerings and networking opportunities has decreased slightly over the past two years. The Show-Me Chapter was awarded a C. Henry Hottum Award for educational performance improvement in the 2012 and 2013 years and a Bronze award for educational hours increase in 2010, 2011 and 2012 and a Silver award for educational hours increase in the 2013 year. The chapter is experiencing a positive trend in the number of educational hours per member with less educational offerings. 5/31/201 5/31/2013 5/31/2012 5/31/2011 0

Education Offerings 29 36 34 30 4,007 3,551. 3,5 Education Hours 4837.8 .0 4 69.1 Education Hours per 1 Member 19.4 5.1 14.1 13.9

 The Chapter has experienced fluctuation in Membership Growth over the last four years. 5/31/201 5/31/2013 5/31/2012 5/31/2011 0 Membership Growth 4.40% -6.40% 6.40% -0.40%

HFMA SHOW ME MEMBERSHIP SATISFACTION SURVEY Members of the Show-Me Chapter participated in the membership satisfaction survey in the fall of 2012 which is conducted annually by the HFMA National Office. The results are based on a scoring system of 0=Dissatisfied, 1=Neutral, 2=Satisfied, 3=Moderately Satisfied, 4=Very Satisfied, 5=Extremely Satisfied. The 2013 survey results indicated that the membership was “very satisfied” or “extremely satisfied” at a rate of 59.0%. Because this was an increase of 5% over the prior year’s results, the chapter met its membership satisfaction survey goal. Membership satisfaction survey result2 for 2013-14 and forward must meet the 60% 2013- 2016 Strategic Plan threshold. Additionally, the membership satisfaction survey will become a larger weighting factor of the Chapter Balance Scorecard system prescribed by the National Office, from 15% to 20% in the 2013-14 year. The 2013 survey included responses from 56 total members for a response rate of 26%. This is somewhat in the middle of the chapter’s response rate over the last four years: HFMA Chapter Member Satisfaction Members "Very Satisfied" or "Extremely Satisfied" Survey Percentage '12-'13 '11-'12 '10-'11 '09-'10 '08-'09 '07-'08 Show-Me of Missouri Chapter 59.0% 54.0% 63.0% 46.0% 55.2% 55.2% Response Rate 26% 28% 22% 27% 34%

When compared to the results from the prior year, membership indicates that the chapter is making improvements in most all facets of the chapter’s offerings. The largest improvement is noted in the location of the chapter programs, speakers and the overall education programs. The one area in which the chapter decreased, though only less than 1% point, was in Newsletter. Ranking of Very Satisfied & Extremely Satisfied Show Me Chapter

2013 2012 Variance 62. 51. 11. Education Programs Overall 30 00 30 58. 49. 9. Education Topics 50 00 50 60. 48. 11. Speakers 40 90 50 50. 38. 12. Location of Chapter Programs 90 80 10 60. 49. 11. Coverage of State / Local Issues 00 00 00 59. 60. (0.8 Newsletter 60 40 0) 2013- 2016 Strategic Plan

51. 46. 5. Networking Opportunities 90 00 90 47. 42. 5. Chapter Website 80 60 20 58. 53. 4. Chapter Overall 50 80 70

When the Show Me membership satisfaction survey results were compared to the results from all chapter results, the chapter lacked in all areas. The largest areas for improvement were the Chapter Website, Networking Opportunities and the Chapter Overall. 2013 Ranking of Very Satisfied & Extremely Satisfied Show All Me Chapters Variance 62. 63. (0.8 Education Programs Overall 30 10 0) 58. 61. (3.1 Education Topics 50 60 0) 60. 65. (4.6 Speakers 40 00 0) 50. 57. (6.4 Location of Chapter Programs 90 30 0) 60. 63. (3.4 Coverage of State / Local Issues 00 40 0) 59. 62. (3.2 Newsletter 60 80 0) 51. 59. (7.7 Networking Opportunities 90 60 0) 47. 56. (9.1 Chapter Website 80 90 0) 58. 66. (7.6 Chapter Overall 50 10 0)

INTERNAL ASSESSMENT SWOT Analysis A SWOT analysis was performed as part of the internal environment assessment of the Officers and Board of Directors in 2012. The survey was not renewed in 2013 and it will be a goal of the 2013- 2016 Strategic Plan

Chapter to update the internal assessment of the Officers and Board of Directors every two years. The following points of the 2012 SWOT analysis were noted and have been consistent with historical surveys:

Strengths  Leadership Team  Provider Influence on the Chapter  Quality Education  New member involvement – work early to get new members on committees/volunteers

Weaknesses  Membership decline  Young members not active  Geography of chapter affecting location of events

Opportunities  Sponsorship  Collaboration with colleges and universities  Increase Member involvement – continue to focus on more quality volunteers  Education – work with other organization to provide education (MHA, CPA Society, etc)  Social Media

Threats  Economy – loss of members  Mergers/Consolidations of member employers  Competition for member education dollars

EXTERNAL ASSESSMENT Government Regulations  Healthcare financial professionals are required to possess and maintain a broad understanding of regulatory and operational issues affecting all sectors of healthcare. Within an increasing demand and complexities of these issues, a burden is placed on healthcare professionals to lead their organizations to compliance with related mandates. Healthcare professional organizations, 2013- 2016 Strategic Plan

like HFMA Show-Me, are likewise challenged to meet the increased demand of their membership for up-to-date education and tools.  With Healthcare Reform changes taking place, it will continue to be increasingly important to stay in tune with the changes as they occur and to provide updates and education to members on these changes. Membership  An increased need for broadened educational offerings will include a demand for more programs on general management and leadership skill development, other non-financial topics and topics that may reflect the relevance of the many components of the organization that contribute to successful financial performance.  The chapter must be responsive to the diverse programming needs of hospital-based members who work in various settings: urban, rural, teaching, home care, physician practice management, revenue cycle, etc.  The shift to cost-based reimbursement from prospective payment reimbursement has caused a gap between the Critical Access Hospitals and PPS Hospitals. The chapter must provide additional uniquely targeted programming for both categories.  The geographical diversity of the Show-Me Chapter highlights the need for programming opportunities throughout the state to meet the needs of membership. The Chapter must be proactive in utilizing web-based programming and “taking the programs to the people.” Technology  Technology allows for cost-effective programming to our members’ facilities. Web-based and / or teleconferencing formats enable members to share programming opportunities with others at a low cost without added costs of travel time and expenses. The technology also allows for additional educational opportunities to our remotely located members, members with limited time and multiple attendees from facilities. Competition for Education Hours  The same technology available to Show Me Chapter is also highly competitive in that others can and do provide education to our members, as our members are more accessible to other regional and national organizations via the internet and videoconferencing.  Additionally, other providers of quality education compete for our members’ time and attention. These include other professional organizations, vendors or internal (system) departments. To continue to compete with these other offerings, HFMA Show-Me must remain relevant, competitively priced and consider offering Continuing Professional Education (CPE) hours which satisfy Certified Public Accounting continuous learning requirements. Economy 2013- 2016 Strategic Plan

 The current economy continues to threaten the financial wellbeing of healthcare organizations and the results include cutbacks in travel, education and memberships. National HFMA  National HFMA provides the Show-Me Chapter a clear direction of the vision it has for the organization. As a chapter, Show-Me evaluates the national platform and prioritizes these initiatives with the greatest benefit to our members in which we will invest our Chapter resources.  The National HFMA office also provides web-based and on-site learning opportunities which the Show-Me Chapter will continue to leverage to provide education to membership. CRITICAL GOALS AND STRATEGIES The HFMA Show-Me Chapter will focus our resources and efforts in the following areas: Provide Quality Education / Networking Education offerings must meet the needs of membership and the goals of hours per member for Chapter requirements. Education offerings will specifically be:  Affordable, timely education using multiple delivery methods  Relevant to day-to-day and strategic operations of healthcare finance operations  Clear education tracks with recognized authorities in their respective fields  Collaborative efforts with other organizations including other professional organizations and other HFMA Chapters The Chapter shall adopt a goal to obtain a C. Henry Hottum award for the 2014 and 2016 years (6% increase in prior year) as well as set a goal for to obtain a Gold award for education hours per member (<=20.1 – <26.3 hours per member). Hours per Increase from Year Member PY 2013 19.40 2014 20.56 6.00% 2015 21.80 6.00% 2016 23.11 6.00%

To reach this goal, the chapter shall  Promote as many educational offerings as possible at the beginning of the year on the Show-Me Chapter’s website and through a postcard mailing to members.  Add structure the Programs Committee with members in specific areas of expertise. These subcommittees shall identify needs within their areas and provide possible topics and speakers to the Programs Committee for consideration. These subcommittees will specifically consist of: o Accounting/Finance o Revenue, Reimbursement, Managed Care 2013- 2016 Strategic Plan

o Revenue Cycle o Information Technology o Critical Access Hospitals  Offer education sessions to non HFMA audiences along with HFMA members. These specifically will include o Affordable Care Act (ACA) “road shows” strategically held throughout the state at provider locations to area employers and area providers o Ethics Conference to Certified Public Accountants in December to meet ethics CPEs  Offer “high content / low commitment” education that will consist of one-day sessions or an afternoon of education followed up with networking opportunities  Offer CPE for live education offerings in accordance with the Missouri State Board of Accountancy  Expand the use of webinars to reduce education costs for members. Aside from live broadcasts, recorded broadcasts of webinars will be promoted and hours of education accumulated.  Embrace social media, namely LinkedIn, as a means of communicating educational events to followers. Other platforms (e.g. Facebook, google+, Twitter, YouTube may be considered as well.) Promote Membership The Chapter has experienced fluctuations over the last few years in membership retention. It is thought this is due to changes in the healthcare landscape (e.g. systemization of independent providers, economic constraints) The trend of retention has shown: '11-'12 '10-'11 '09-'10 '08-'09 '07-'08 Average Show-Me Membership Retention 86.4% 93.3% 87.9% 87.9% 93.4% 89.8%

Show-Me Chapter will set a goal to retain at least 92% of chapter membership from the prior year.

The chapter shall set a goal of increasing chapter membership above the CBSC goal of .4% growth by 2.5% per year to be recognized as a Gold award performance in chapter growth. Specifically, the goal for membership growth shall be:

Increase Year Membership Goal from PY 2013 261 2014 269 2.50% 2015 276 2.50% 2013- 2016 Strategic Plan

2016 284 2.50%

To reach these goals, the chapter shall target Provider, Sponsor and Student memberships. For Providers, the chapter will:  Target future members of the Show-Me Chapter by promoting education offerings to non members. This will be accomplished through promotion to the “nonmember list” obtained from HFMA National Office as well as through promotion to non member facilities. Education offerings such as “road shows” or webinars which are offered without charge, will cease in October 2013 to promote membership in the chapter. Live educational offerings which have a nonmember registration rate, will continue to be promoted throughout the year. For Sponsors, the chapter will:  Promote involvement in the chapter by bundling sponsorship opportunities and benefits with a chapter membership. These sponsor members will be further given the opportunity to participate in Chapter committees and /or offer educational topics for the chapter members. For Students, the chapter will:  Recognizing that student members are the future leaders of HFMA, Show-Me shall continue to promote HFMA at a campus level by speaking presenting at least twice during the academic year. These presentations will include the classroom setting (e.g. Masters of Healthcare Administration course) and / or to professional organizations (e.g. Accounting Society – Beta Alpha Psi) These presentations may include University of Missouri and Missouri State University as in the 2012-13 year. It is noted that the Student members do not go towards meeting the Chapter’s membership goals, but the hours of education for Student Members do count to education hours per member. As a continued means of involvement in HFMA Show Me Chapter, quantifiable goals of involvement will be set and monitored by means of the Committee Matrix. The goal will be to increase chapter involvement to 15% in 2013-14 and then by 2% thereafter. General recruitment for volunteers will be used as well as identified specific members may be asked to serve the chapter. This goal will be adjusted in accordance with the membership growth goal: Members Increase Year Involved Percent from PY 2013 29 11.11% 2014 40 15.00% 2.50% 2015 47 17.00% 2.50% 2016 54 19.00% 2.50% 2013- 2016 Strategic Plan

The Show-Me Chapter website, quarterly newsletter, as well as Social Media will be used to report Membership participation, involvement and activities if appropriate (such as job changes, promotions, etc.) Membership Satisfaction The goal for member satisfaction reported as “Very Satisfied” or “Extremely Satisfied” will be 65% in the 2013-14 year. The goal is to increase the satisfaction by 2 percentage points for the 2014-15 and 2015-16 years. Specific means to attain the goal are:  Revamp the chapter website to better meet the members’ needs and communicate chapter events and news.  Promote networking at all live events, giving members a means to feel a part of the chapter  Promote the Satisfaction Survey personally (through personal interaction or a phone call) to no less than 50 Show Me members beginning in September, explaining the importance of the survey and attaining the highest level of satisfaction from members. Also promote the survey via e-mail to all members by October 15 in anticipation of the survey reaching members by late October. Professional Development To meet the CBSC goal, the Show-Me chapter must attain one additional CHFP/FHFMA in the 2012-13 year. To obtain a Gold award for Chapter certified members, seven members of the Chapter must pass the certification exam, which will be the Chapter’s goal for the 2013-14 year. This goal will be met by:  Promoting web-based course review of the CHFP exam course at least once in the 2013-14 year.  Extend life-time membership status to retired Show-Me members who are FHFMA certified. As previously mentioned, Show-Me Chapter will offer CPEs for Missouri CPAs at live events if the education sessions qualify under the Missouri State Board of Accountancy policies.