Divisional leaders also now use scorecards to track key cost drivers. If numbers stray from the monthly projection for two months, it's a trigger for the group to discuss it and create an action plan. To ensure nothing slips through the cracks, each metric on the scorecard has a sponsor, who compiles monthly and year-to-date results and develops plans for each initiative as appropriate.
The new process has helped managers and supervisors get a better understanding of ThedaCare's patient demand, allowing them to adjust capacity as appropriate.
"There are no surprises at the end of the month. And we're able to do a better job load-leveling our hours worked with the demand," Burmeister explains.
After a fairly smooth transition from the traditional budget to the quarterly process, ThedaCare continues to refine its approach. Although the rolling forecast is (and will always be) a work in progress, Burmeister and Olson agree that the change has proven successful for the organization. Among the positive results, the rolling forecast is accurate to less than 2% (plus or minus), and the organization has redeployed 20,000 hours of finance staff time to other projects and discussions.
"We absolutely would not go back [to the previous budget process]. This approach is more proactive than reactive… and the results just keep getting better," says Olson.
Going budget-free isn't for every hospital or health system. But it could be worth considering if your organization is bogged down in the details, yet the numbers still come up inaccurate at the end of the year.