Get the Most from your Membership with Data. Data Team National PACE Association

Transcription

1 Get the Most from your Membership with Data Data Team National PACE Association

2 Order of Presentation NPA Data Team Products NPA Data People Biannual Benchmark Report Staffing Ratio EHR Survey Financial Benchmark Reporting: Financial Ratio Benchmark Reporting & Per Member Per Month Report Medicaid Capitation and Census Survey

3 Products Offered by the NPA Data Team Medicaid Capitation and Census Survey Per Member Per Month Financial Benchmark Reporting Financial Ratio Benchmark Report Staffing Ratios Electronic Health Record Software Survey Biannual Benchmark Report If you are contributing data, you are seeing the reports and the results.

4 The People Behind these Products Data Team Ameeta Mistry Alan Gay Berry McCarthy Randi Kudner Livia Moulds

5 Biannual Benchmark Report Data in the following 4 categories is submitted quarterly by the PACE organizations from the EHR systems: Enrollment Admission Service Utilization HPMS/HOS- M/Participant Satisfaction NPA performs intense data quality checks on the submitted data Benchmarks calculated for the following categories: Participants Served Program Growth/Census Quality Utilization of Services Consumer Satisfaction

6 What is a Biannual Benchmark Report? ID Measure (A) Polarity (B) Rank in Peer Group (C) Your Result (D) Average Peer Group Results (E) 25th Percentile of Peer Group (F) Median of Peer Group (G) 75th Percentile of Peer Group Primary, Rehabilitative, and Specialist Care 217 Primary Care Encounters PMPM High 1 of Therapy Encounters PMPM Neutral 11 of Specialist Visits PMPM Low 33 of Reading the Report Going Across (A) Polarity indicates if a Low or High value is desirable for a Measure (B) Rank in Peer Group is the ranking of the PACE organization result in the Peer Group. Use this with Polarity. If Polarity is High, a high rank is desirable Compare (C) Your Result with the (D) Average Peer Group Results Take it one step further. By comparing Your Result to the (E) 25 th Percentile, (F) Median or (G) 75 th Percentile, you will be able to assess how far off you are from the average

7 How to Use Your Report ID Measure (A) Polarity (B) Rank in Peer Group (C) Your Result (D) Average Peer Group Results (E) 25th Percentile of Peer Group (F) Median of Peer Group (G) 75th Percentile of Peer Group Primary, Rehabilitative, and Specialist Care 217 Primary Care Encounters PMPM High 1 of Therapy Encounters PMPM Neutral 11 of Specialist Visits PMPM Low 33 of Can you see the connections? What is the takeaway? Awareness of percentile placement can be important if you want to improve your results You can track your progress over time with this Observed but not statistically proven correlation Low primary care encounters and high specialist visits

8 New Features Added to the Report Trending Graphs Added for the Following Measures o o o o o Growth by Age Group Growth of Census Groups ER Visits PMPA Acute Hospital Admissions PMPA Long Term NF Days PMPTA

9 Staffing Ratio What is it? o A biennial report showing the average number of FTEs and contracted personnel per 100 participants by discipline for each participating PO o Reporting is further segregated by 24 disciplines (clinical and administrative) and 5 census groups o Results are shared with POs who contribute their data which is collected via a survey conducted by NPA

10 Staffing Ratio Insights o POs in the census group have the highest staffing ratio (73%) as opposed to POs in the census group (42%) and POs in the census group (31%) o As PO census grows to the point of equilibrium in terms of staff to capitated revenue, the FTEs tend to start to fall off

11 Staffing Ratio Enhancements The Staffing Ratio is amongst the most popular benchmarks generated by NPA. In response to the demand by POs, new features will be added to the report that will be generated from the survey conducted in January 2017: 2016 Report All disciplines will now be included Staffing turnover rate will be generated

12 Electronic Health Record Survey Annual survey reporting the usage and satisfaction of EHR products in PACE Product Satisfaction EHR Usage Available Products

13 Electronic Health Record Survey EHR Usage in PACE Is your PO Currently Using an EMR? If you are not currently using an EMR, do you plan to adopt one in the coming year? 5% Yes No 20% 95% 80%

14 Electronic Health Record Survey EHR Products in PACE McKesson 3% Other 7% RTZ 12% 89% of PACE Organizations completed the 2016 Survey. This is a representative breakdown of those respondents. Allscripts 2% NextGen 6% Cognify 9% EPIC 12% Mediture 46% Centricity 3%

15 Electronic Health Record Survey Product Satisfaction Rating The report shows overall satisfaction as well as satisfaction by EHR vendor. Disappointed Very Disappointed Satisfied Very Satisfied Customer Service/Tech Support 6.25% 26.04% 48.96% 18.75% Price of Product 11.46% 22.92% 57.29% 8.33% DP2 Reporting 19.79% 45.83% 28.13% 6.25% Assistance in Day to Day Operations 7.29% 27.08% 55.21% 10.42% User Interface 7.29% 37.50% 47.92% 7.29% Applicability to PACE 10.42% 21.88% 48.96% 18.75% Overall Product Performance 6.25% 32.29% 46.88% 14.58% 100% 80% 60% 40% 20% 0% 20% 40% 60% 80% 100%

16 Financial Ratio Benchmark Reporting The Financial Ratios Benchmark Report contains 14 different accounting measures that fall into 4 major financial categories: Operating Margin Measures Liquidity Measures Capital Structure Measures Operational Measures Operating Margin EBITDA Margin Days Cash-on-Hand Current Ratio Debt Service Coverage Liabilities to Equity Operating expose as a % of Net Participant Revenue Excess Margin Quick Ratio Debt Service as a % of total Operating and Non- Operating Revenue Asset Turnover Return on Total Assets Days in Accounts Receivable Long-term Debt as a % of Total Capital

17 Financial Ratio Measures Operating Margin Measures Operating Margin EBITDA Margin Operating Margin - The Operating Margin indicates the percent of operating revenues available after operating expenses are met EBITDA Margin (earnings before interest, tax, depreciation and amortization) - The EBITDA Margin indicates the percentage of cash revenues remains after cash expenses are paid Excess Margin Return on Total Assets Excess Margin - The Total Excess Margin indicates total capacity to generate excess resources Return on Total Assets Net Income" is the same as the Total Excess of Revenues over Expenses

18 Financial Ratio Measures Liquidity Measures Days Cash-on-Hand Current Ratio Quick Ratio Days Cash-on-hand (unrestricted cash) - Measures an organization's ability to withstand fluctuations in operating results Current Ratio - This is a measure of an organization's liquidity, that specifically focuses on the organization's ability to meet current liabilities without drawing on long-term investments. Quick Ratio - A more rigorous test of liquidity than the current ratio Days in Accounts Receivable Days in Accounts Receivable - PACE providers should typically have low days receivable due to capitated revenue streams

19 Financial Ratio Measures Capital Structure Measures Debt Service Coverage Liabilities to Equity Debt Service as a % of total Operating and Non- Operating Revenue Long-term Debt as a % of Total Capital Debt Service Coverage - DSCR reflects a provider's ability to fund annual debt service with cash flow from annual net cash revenues Liabilities to Equity - Measures the extent to which a provider relies on long term and short term obligations versus retained earnings and invested or donated capital Debt Service as a % of Total Operating and Non-Operating revenue - Measures how much of Total Revenues, including nonoperating revenue, must be set aside to pay Debt Service Long-term Debt as a % of Total Capital - The Debt to Capitalization ratio measures what portion of Permanent Capital is financed by debt as opposed to equity.

20 Financial Ratio Measures Operational Measures Operating expose as a % of Net Participant Revenue Asset Turnover Operating expense as a % of Net Participant Revenue - This measure is comparable to the "Medical Loss Ratio" used by many HMO's as an indicator of financial and operational efficiency/strength Asset Turnover - The asset turnover ratio is a measure of how efficiently and effectively an organization uses its assets to generate revenues

21 Financial Ratio Reporting The asset turnover ratio is a measure of how efficiently and effectively an organization uses its assets to generate revenues. 250% PACE Financial Ratios Asset Turnover Ratio Total Revenue Total Assets Comment: * The higher the asset turnover ratio, the more efficiently an organization's assets have been used. * A change in the asset turnover ratio could indicate a decrease in revenues - OR - an increase in the organizations assets (which may be a positive change) * Results may differ based on developmental stage of the organization and the nature of its sponsorship. Mature organizations have more physical assets but should also have higher net income. Developmental stage organizations would have different 200% 150% 100% 50% 0% Median All 151% 148.0% 173.0% Median % 108.4% 223.5% Median % 175.3% 151.4% Your Results 55.0% 55.3% 52.9%

22 PMPM Financial Benchmark Reporting The PMPM Financial Benchmark Report contains: 18 Care Expenses 4 Revenue Categories 6 Business Expenses PMPM Report

23 PMPM Financial Benchmark Reporting Revenue PACE Medicare PACE Medicaid PACE Other Income - Other

24 PMPM Financial Benchmark Reporting Care Expense PACE Center Primary Care PACE Center Based Adult Day Care PACE Center Contracted, Off-site Primary Care Contracted, Off-site Adult Day Care Social Services Therapy Home Care Meals Transportation Outpatient Specialist Pharmacy DME/Medical Supplies Lab and Diagnostics Nursing Home Hospital Sub-Acute Rehabilitation Assisted Living/Residential Care Administrative Marketing Insurance Depreciation Facility Other Expense Business Expense

25 PMPM Financial Benchmark Measures $ $ $ $ $ $ $0.00 Outpatient Specialist PMPM Minimum 1st Quartile Your Result Median 3rd Quartile Maximum $ PMPM % of Total Revenue 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% Outpatient Specialists: Audiology Dentistry Optometry Outpatient Dialysis Pathology Podiatry Psychiatry Psychology Radiology Surgery

26 PMPM Financial Benchmark Measures $ $ $ $ $ $ $ $ $ $0.00 Transportation Expenses PMPM Minimum Your Result 1st Quartile Median 3rd Quartile Maximum $ PMPM % of Total Revenue 14% 12% 10% 8% 6% 4% 2% 0% Transportation: Outsourced transportation: ambulance for non-inpatient Transportation Staff: drivers, assistants, other Van Fleet: van leasing, repairs, maintenance, gas and oil

27 Medicaid Capitation and Census Survey Annual survey conducted by NPA; commencing every year in January. Medicaid Capitation Rate Medicaid Only Dual Eligible Census Values Across all payer sources for each PACE Organization

28 Medicaid Capitation and Census Survey PACE Medicaid Only Rates, $7,000 $6,000 $5,633 $5,785 $5,821 $5,000 $4,810 $4,809 $4,809 $4,582 $4,621 $4,652 $4,809 $4,809 $4,809 $4,000 $3,000 $2,000 $1,000 $0 MEAN MEDIAN

29 Medicaid Capitation and Census Survey PACE Census as of January 1, ,000 40,000 38,284 35,000 31,654 34,413 30,000 25,000 22,788 25,443 28,255 20,000 15,000 10,000 5,000 0 CENSUS

30 Medicaid Capitation and Census Survey 140 Number of PACE Organizations: 6-Year Trend, # OF PACE ORGANIZATIONS

31 Wrap Up These reports have been created with the intention of providing value to your healthcare operations Your participation ensures that we are able to provide robust results With the Common Data Set we will be able to expand our offerings We are investing in technology that will us to move to the next level of analytics where we will be providing insights as opposed to just reporting numbers