Innovative Approaches to Using Data to Demonstrate Value: Measuring & Reporting Clinical, Operational, Financial Improvement

Transcription

1 Innovative Approaches to Using Data to Demonstrate Value: Measuring & Reporting Clinical, Operational, Financial Improvement Jonathan Chapman Director, CHC Advisory Services AACHC/CVN Annual Conference February 11,

2 Using Data to Demonstrate Value Value? Using existing data to better identify, address, and/or convey health center performance and value Demonstrate? Utilizing this data and value in operational and planning efforts 2

3 Capital Link Launched in 1995, nonprofit, HRSA national cooperative partner Offices in CA, CO, FL, MA, MO, and WV Over $1.1 billion in financing for over 230 capital projects - Direct assistance to health centers and complementary nonprofit organizations in planning for and financing operational growth and capital needs - Industry vision and leadership in the development of strategies for organizational, facilities, operational and financial improvements - Metrics and analytical services for measuring health center impact, evaluating financial and operating trends and promoting performance improvement 3

4 Goal: Improved Access to High Quality Care AND Financial Sustainability Staffing Financial Operations Productivity Improved Access & Financial Sustainability Patient Satisfaction Utilization Clinical Outcomes 4

5 Preparing for Value-Based Healthcare "Everyone's talking about it, no one really knows how to do it everyone thinks everyone else is doing it, so we all say we're doing it." Deb Gage, president and CEO of Medecision 5

6 Defining Value 6

7 Value? Noun 1. the regard that something is held to deserve; the importance, worth, or usefulness of something. 2. a person's principles or standards of behavior; one's judgment of what is important in life. synonyms: synonyms: synonyms: principles, ethics, moral think highly of, have a high opinion of, hold in worth, code, evaluate, morals, usefulness, assess, standards, estimate, advantage, code appraise, of benefit, price, gain, put/set profit high regard, rate highly, esteem, set (great) store, behavior"society's a good, price on"his help, merit, estate values helpfulness, was valued are passed avail;more at $345,000" on to us as by, put stock in, appreciate, respect; More children" Verb 1.estimate the monetary worth of (something). 2.consider (someone or something) to be important or beneficial; have a high opinion of. "Value" is what the customer is buying 7

8 Defining Organizational Value 8

9 Medical Value Equation 9

10 Medical Value Equation Healthy Outcomes Patient and Provider Experiences Timely, Comprehensive Service Options Conscientious Budgeting and Operations 10

11 Quadruple Aim 11

12 Preparing for Value 12

13 Transition to Value-Based System 13

14 Value Transition Based to Transition Value-Based System 14

15 Transition to Value-Based System 15

16 Transition to Value-Based System - HRSA 16

17 Transition to Value-Based System - CMS 17

18 Calculating Value 18

19 What to Measure? 19

20 How to Measure? 20

21 Expectations? 21

22 Key Performance Metrics Metric 1 Operating Margin 2 Bottom Line Margin Why This Is Important Measuring stick of your business model; margins typically small but need to be positive Is performance dependent upon large capital grants and/or other sources of non-operating revenue? 3 Personnel-Related Expense Consumes 70-75% of budget; key driver of financial performance 4 Days Net Patient A/R Financial management starts with collecting your money efficiently 5 Days Cash on Hand Is there enough liquidity to keep operations running smoothly? 6 Physician Productivity (visits) Productivity is the basis for revenue generation 7 Mid-Level Productivity (visits) Productivity is the basis for revenue generation 8 Dental Provider Productivity (visits) Productivity is the basis for revenue generation *Capital Link Performance Benchmarking Toolkit 22

23 Operating Margins - Medians 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% Arizona FQHC US FQHC Benchmark 23

24 Personnel-Related Expense as a Percent of Operating Revenue - Medians 73.00% 72.00% 71.00% 70.00% 69.00% 68.00% Arizona FQHC US FQHC Benchmark 24

25 Days Cash on Hand - Medians Arizona FQHC US FQHC Benchmark 25

26 Physician Visits per Physician FTE - Medians 4,000 3,500 3,000 2,500 2, Arizona FQHC US FQHC 26

27 Mid-Level Visits per Mid-Level FTE - Medians 4,000 3,500 3,000 2,500 2, Arizona FQHC US FQHC 27

28 Key Performance Metrics Metric Why This Is Important 9 Medical Provider Productivity (patients) Becomes more important in transition to team-based care 10 Medical Team Productivity Who are your teams? How do they perform? 11 Cost (Revenue) Per Visit How are your visit costs changing over time? 12 Cost (Revenue) per Patient With the move to PCMH, how are patient costs changing? 13 Medical Support Staff Ratio How strategic is the staffing of the medical teams? 14 Non-Clinical Staff Ratio Non-clinical employees are not revenue drivers 15 Visit/Patient Growth Rates Are visits growing faster than patients? Is demand growing? *Capital Link Performance Benchmarking Toolkit 28

29 Total Patients per Provider FTE - Medians Arizona - Total Patients per Provider FTE US - Total Patients per Provider FTE 29

30 Total Unduplicated Patients per Total FTE - Medians Arizona - Total Unduplicated Patients per Total FTE US - Total Unduplicated Patients per Total FTE 30

31 Organizational Productivity per FTE - Medians Arizona - Total Unduplicated Patients per Total FTE Arizona - Total Patients per Provider FTE US - Total Unduplicated Patients per Total FTE US - Total Patients per Provider FTE 31

32 Operating Revenue & Expense per Patient - Medians $1,000 $950 $900 $850 $800 $750 $ Arizona - Operating Revenue per Patient Arizona - Operating Expense per Patient US - Operating Revenue Per Patient US - Operating Expense Per Patient 32

33 AZ Operating Revenue & Expense per Patient - Percentiles AZ FQHC Revenue / Patient AZ FQHC Expense / Patient 33

34 Medical Services Cost per Patient - Medians Arizona Arizona Median 34

35 Percentage of Patients 18+ with BMI And Follow Up Documented Percentiles Arizona FQHC, UDS 35

36 Conveying Value 36

37 Conveying Organizational Value Dashboards Recognize Representation, Audience, etc Celebrate through Organizational Alignment and Actions Create and/or Acknowledge Traditions Engagement Social Media, Virtual Meetings, Visual, Share All Successes Connect Meetings, Talk, Deliberate Encouragement Have Fun with It Puns, Anniversaries, Contests Lead by Example Establish a Champion Accountable to Oversee/Coordinate 37

38 Basic Visuals 38

39 HRSA s Emphasis 39

40 HRSA s Press Releases 40

41 HRSA s Messaging 41

42 Previous Economic Impact Report 42

43 Recent Value & Impact Report 43

44 Recent Value & Impact Report 44

45 Anticipated Value & Impact Report 45

46 Anticipated Value & Impact Report 46

47 Sample PCA Publications and Websites About the Organization and FQHC Model Defined Overview of Board, Leadership, Staff, and Membership Service Area Geographic and Service Mix (Quality) Description and Characteristics of Patients Outcomes Economic Impact and Value of FQHCs to Communities Partners Collaborations and Communication (SDOH) Innovations - HCCN, Workforce, HIT, ACO, IPA, etc Programs - Education, Policy, Training, Emergency Preparedness, etc Financial Transparency and Sustainability Both PCA and Health Centers 47

48 Examples of Value and Engagement AACHC Awards Arizona Health Centers in the News - Hepatitis C: The Silent Epidemic - Take a Book, Leave a Book Little Free Libraries - Healthy Arizona Worksites Program GOLD Award - CHC Talks to Chamber about Community Health Services - Donate and Receive a Dollar-for-Dollar Arizona Charitable Tax Credit 48

49 Data & Value In Operational Planning Efforts 49

50 Assumptions and Scenarios 50

51 Financial Sensitivity: Medicaid Eligibility 51

52 Financial Sensitivity: Medicaid Eligibility 52

53 Financial Sensitivity: Medicaid Eligibility 53

54 Financial Sensitivity: Medicaid Eligibility 54

55 Financial Sensitivity: Reimbursement 55

56 Financial Sensitivity: Reimbursement 56

57 Financial Sensitivity: Reimbursement Initial Budget 57

58 MEDICAL CORRECTION - Financial Sensitivity: Reimbursement 58

59 Financial Sensitivity: Reimbursement Actual Payment 59

60 PROJECTED MIGHT BE ACTUAL NOW CORRECTION Financial Sensitivity: Reimbursement 60

61 Low Income Population Establishing Priorities HIGH LOW HPSA Score 61

62 Establishing Priorities MISSION FUNDING CAPACITY 62

63 Establishing Priorities 63

64 Community Health Centers Defining and Creating Valuable e To All For All 64

65 Jonathan Chapman Director of CHC Advisory Services Visit us Online: Learn more about our products and services Download our free publications and resources Register for upcoming webinars Sign up for our e-newsletter, Capital Ink Subscribe to our blog at capitallinksblog.blogspot.com 65