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HOW SOFTWARE STITCHED TOGETHER 1,500 REMOTE SITES

NovaCare had a pretty big problem last year. Then the federal government stepped in to make things better.

That's when things got really bad. Not bad, exactly, but complicated. The Contract Rehabilitation division of NovaCare,

The company managed this vast network without benefit of branch offices. Approximately 80 managers worked out of their homes, slinging their offices over their shoulders when they went off to manage services at a rehab facility. They kept daily spreadsheet data and compared it with monthly close information from the central office in Philadelphia.

Periodically they'd hear whether they were meeting budgetary and operations goals. The system worked well enough, but the competition borne of the revolution in healthcare meant the system had to work even better. So when Congress passed the Balanced Budget Act, enacting an immensely more complex Medicare reporting and reimbursement system, NovaCare saw no choice but to overhaul its financial reporting and analysis system.

A flawless system had to be up and running. Soon.

NovaCare had little time to get its new act together. The system had to be effective for the upcoming budget year, and the changeover had to happen in the midst of the most turbulent times the industry had ever seen. In March 1998, management decided to make the change. The new Medicare rules went into effect on July 1, simultaneously with the new fiscal year and NovaCare's new budget season. A flawless system had to be up and running by then.

Under the new Medicare mandate, geriatric rehabilitation and the corresponding reimbursement were limited to minutes spent with the patient based upon the patient's Medicare classification. Therefore, NovaCare budgets and operations depended on how many minutes were spent with each patient, how much revenue was generated per minute, and how well each minute produced the desired care of a human being's health.

Because the new system was essentially a financial reporting system, the responsibility of reengineering came down on Amy Esposito, who at that time was the division vice president of finance.