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Assessing The Value of Web 2.0
on Knowledge Management
A HEALTH CARE REIMBURSEMENT STUDY
ICELW CONFERENCE JUNE 2013
Agenda
 About Me
 Research – KM and Web 2.0
 The Industry
 The Organization
 KM Challenges
 Web 2.0 / KM System
 Qualitative / Quantitative
Analysis
 Limitations
About Me
 Undergraduate in Management
 Work in Financial Services, Insurance, Healthcare
 MBA – Healthcare / Marketing
 MS – Industrial Relations (Economics)
 Adjunct Professor
 Traditional, Online, Hybrid
 DBA – Operations and Information
Management



Impact of Web 2.0 on KM
Mixed Methods Research
Expected 2015
Knowledge Management (KM)
 Strategies and practices used to identify,
create, represent, distribute, and enable
adoption of information and experiences
 Focus on objectives such as improved
performance, competitive advantages,
innovation, the sharing of lessons learned,
integration and continuous improvement.
 Overlap with organizational learning includes
a focus on knowledge as a strategic asset.
 Charlie’s Story…
Charlie’s Consulting Service
Hitting Valve With Mallet……………………………………………….... $
1.00
Knowing Where and How Hard………………………………………….$ 24,999.00
Total Due………………………………………………………………………... $25,000.00
SECI Model
Web 2.0
 Second Generation of the World Wide Web.
 Collaboration and Information Sharing Online.
 Web 1.0 Static => Web 2.0 Dynamic
 Open Communication, Web based Communities
 Communities Of Practice/Knowledge
 Wisdom of Crowds
 Blogs, Wikis, Social Networks
Industry Overview
 Health Care Funding
 Physician / Hospital Payments
 Third Party Payers
 Government (e.g. Medicare, Medicaid)
 Insurers (e.g. Commercial Payers)
 Self Pay
 Negotiated Contracts
 Participating Physicians
 Large (and Growing) Physician Practices
Payment Process
Physician
Renders
Service
Payment
Made to
Physician
Claim
Submitted
to Payer
Payer
Processes
Claim
Payment Failure Points
Physician
Renders
Service
Coding error
Output error
Failure
Payment
Made to
Physician
Processing error
Application error
Claim
Submitted
to Payer
Failure
Failure
Payer
Processes
Claim
Contract Error
Administrative error
Commercial Payers & Managed Medicare
The Organization - Consultant Services
 Understand Contractual Agreements
 Virtually always changing
 Administered incorrectly
 Review Billing and Payment Data
 Monthly cyclical process
 Identify Physician Underpayments
 Work with Payers to Make Physicians Whole
 Payment on Contingency basis
 Account Managers Compensated on Successful
Payment Recovery
The KM Challenge
 Know 10 – 12 Clients and 20 – 30 Payers




Different Contractual Agreements
Different Requirements
Multiple Projects in Flight
Monthly Data changes
 Understand the Impact of Regulatory and
Administrative Changes
 Contract Renewal Dates
 Important Milestones

Rate Increases
 Coding Changes
 Knowledge Sharing across Clients and
Payers
– Collaborate More Easily
 Work with Coworkers, Clients, and Vendors.
 Create, Follow and Contribute Discussions
 Make Announcements
 Share Documents,
 Coordinate Calendars
 Hold Web Meetings
 Manage Tasks,
 Build Web Databases
 Implemented and Developed Over 2008 -Present
Home Page
Contract Models
Ad Hoc Reports
Task Tracker
Issue Tracker
Discussions
Reimbursement and Coding Updates
Client Issues
Quantitative Analysis
 Identify Contributions to Database
 Measure Results in Performance
 Tracked Monthly Results
 42 Months worth of data
 Measure Correlation using SPSS
 Pearson Product-Moment Correlation
 -1 is a Reverse Correlation
 0 is Absolutely No Correlation
 +1 is a Positive Correlation
Client 1 / Payer 1 - Correlation
Client 2 / Payer 2 - Correlation
Qualitative Analysis
 Interviews with Individuals
 Increased Autonomy
 Convenient place to house information
 Good reference tool; less information to




remember
Ability to search
Downloadable information for
analysis
Easy to use
Consistent format data entry
Employee Engagement
 Increase in Employee Engagement
 Less dependence on asking the question
 More reliance on the data base
 More autonomy in work
 More continuity if people not
available
 Increase in documentation
 “How did we get buy without it?”
Study Limitations
 Small Company size
 Specific Industry / Specialized Work
 Early inconsistent use of WebOffice
 Early inconsistent tracking of Monthly
Financial & Operational Data
 Difficulty Coding Data Contributions

Timing and Quality
 Additional Study Opportunities
 Comparing Separate Organizations or Industries
Questions?
I hope to be back next year
with additional information!