HEALTH CENTER BUDGETING PROCESS: A CLOSER LOOK

Transcription

1 HEALTH CENTER BUDGETING PROCESS: A CLOSER LOOK MISSION: ACHIEVEMENT Operational Excellence Alabama Primary Health Care Association October 5, 2017 Presenter: Adrienne Hurtt

2 Introduction Adrienne Hurtt, CEO NEVAEH Healthcare Revenue Management Nevaeh Revenue Healthcare Management 2

3 Objectives Understand the purpose of budgets Understand budgeting principles and standards Understand budget objectives Understand favorable and zero based Identify key financial benchmarks Report key financial benchmarks Identify key performance indicators Discuss strategies to closely and accurately track your organization s performance Better understand how to incorporate clear, concise, and meaningful use of information to make operational decisions Nevaeh Revenue Healthcare Management 3

4 What is a Budget? A budget is a financial plan for future activities. The budgets used in business often include a sales or revenues budget detailed by products or services, production budgets, budgets for each department in the company, cash budget, capital expenditures budget, and others. Nevaeh Revenue Healthcare Management 4

5 Budgets Budgets help management decide which activities it will undertake and how the company's resources will be used. If the budgeted income statement and balance sheet coming out of the master budget are not acceptable, management can make the needed changes before the year actually begins. Budgets can also assist in controlling the actual costs, because managers realize that the costs of their activities will be compared to the budget. The differences between the actual amounts occurring and the budgeted amounts are known as variances. These variances can also signal some new problems that need management's attention. Nevaeh Revenue Healthcare Management 5

6 Budgeting for Non-Profits Budgeting for nonprofits can become complex when it involves several overlapping categories, such as grants, programs, function, and nature. Budgeting is also complicated when sources of support are not secured at the time the budget is prepared for the upcoming year. This could lead to the use of an account entitled Resource Development in order to balance the budget. Since resource development is often ongoing, budgets may require frequent modification. Good accounting software will also allow directors to compare budgeted amounts to actual amounts and make the necessary adjustments. Federal Grants Management for Health Centers Nevaeh Revenue Healthcare Management 6

7 Budgets HRSA Organization Department Provider/Productivity Nevaeh Revenue Healthcare Management 7

8 Benefit of Revenue Budget The main benefit of a revenue budget is that it requires looking into the future. The revenue budget should contain the assumptions made about the future and the details about the number of units to be sold, the expected... Nevaeh Revenue Healthcare Management 8

9 Budget Variances A favorable budget variance indicates that an actual result is better for the company (or other organization) than the amount that was budgeted. Here are three examples of favorable budget variances: 1. Actual revenues are more than the budgeted or planned revenues. 2. Actual expenses are less than the budget or plan. 3. Actual costs per visit/encounter are less than the amount budgeted for the period. Nevaeh Revenue Healthcare Management 9

10 Variance Types Accountants often use negative amounts to indicate an unfavorable variance. For instance, if actual revenues are less than the budgeted revenues, the variance (or difference) will be shown as a negative amount. The reason is that having less revenues than planned is not good. On the other hand, if actual expenses are less than the budgeted amount of expenses, the variance will be shown as a positive amount. The reason is that fewer actual expenses than budgeted is favorable (or good, positive). Nevaeh Revenue Healthcare Management 10

11 HRSA COMPLIANCE MANUAL Budgets

12 HRSA Compliance Manual ercompliancemanual.pdf Nevaeh Revenue Healthcare Management 12

13 HRSA Compliance - Requirements The health center must develop an annual budget that: 1. Identifies the projected costs of the Health Center Program project; 2. Identifies the projected costs to be supported by Health Center Program [award] funds, consistent with Federal Cost Principles and any other requirements or restrictions on the use of Federal funding; and 3. Includes all other non-federal revenue sources that will support the Health Center Program project, including: a) State, local, and other operational funding; and b) Fees, premiums, and third-party reimbursements which the health center may reasonably be expected to receive for its operation of the Health Center Program project. The health center must submit this budget annually by a date specified by HRSA for approval through the Federal award or designation process. Nevaeh Revenue Healthcare Management 13

14 Compliance - Requirement (cont.) a. The health center develops and submits to HRSA (for new or continued funding or designation from HRSA) an annual budget, also referred to as a total budget, 2,3 that reflects projected costs and revenues necessary to support the health center s proposed or HRSAapproved scope of project. b. In addition to the Health Center Program award, the health center s annual budget includes all other projected revenue sources that will support the Health Center Nevaeh Revenue Healthcare Management 14

15 Demonstrating Compliance Program project, specifically: 1. Fees, premiums, and third-party reimbursements and payments that are generated from the delivery of services; 2. Revenues from state, local, or other Federal grants (for example, Ryan White, Healthy Start) or contracts; 3. Private support or income generated from contributions; and 4. Any other funding expected to be received for purposes of supporting the Health Center Program project. Nevaeh Revenue Healthcare Management 15

16 Demonstrating Compliance (cont.) c. The health center s annual budget identifies the portion of projected costs to be supported by the Federal Health Center Program award. Any proposed costs supported by the Federal award are consistent with the Federal Cost Principles and the terms and conditions of the award. d. If the health center organization conducts other lines of business (i.e. activities that are not part of the HRSAapproved scope of project), the costs of these other activities are not included in the annual budget for the Health Center Program project. Nevaeh Revenue Healthcare Management 16

17 Related Considerations The health center determines how to allocate projected costs between Health Center Program award funds consistent with Federal requirements, and other projected revenue sources within the annual budget. Nevaeh Revenue Healthcare Management 17

18 Fiscal Year Budget 2018 Historical Budget /Financial Performance Data 2018 Budget Review Proposed 2018 Audited Audited Audited Budget Revised Budget Budget Revenue Medicaid $ 4,120,000 $ 4,750,000 $ 5,082,500 Medicare $ 262,908 $ 311,415 $ 333,214 Commercial $ 365,898 $ 483,804 $ 517,670 Self Pay/Sliding Scale $ 304,968 $ 471,492 $ 504,496 Other Patient Revenue $ 8,251 $ 16,498 $ 17,653 Patient Revenue $ 3,199,995 $ 4,636,844 $ 4,976,199 $ 5,062,025 $ 6,033,209 $ 6,455,534 $ - HRSA $ 1,261,661 $ 1,447,792 $ 1,447,792 HRSA - BH $ - $ - HRSA- IT $ 242,530 $ - HRSA-HIIP $ 1,000,000 $ - HRSA-AIMS $ 150,000 ISDH-CHC $ 207,000 $ 207,000 $ 207,000 ISDH-IN Navigator $ 50,000 $ 100,000 $ 100,000 ISDH-TB $ 95,841 $ 95,841 $ 95,841 ISDH - Early Start $ 50,000 $ 15,807 $ 15,807 ISDH - BCCP $ 8,004 $ - $ - ISDH- HIV $ 181,872 FSSSA-ICE $ 200,000 CHIPRA $ 21,716 $ - $ - Walgreens/American Cancer Society $ 50,000 $ - $ - IU - SBIRT Grant $ 40,000 $ - $ - March of Dimes/Baby & Me $ 9,996 $ - $ 11,500 One Sight $ 450,000 $ 200,000 Grant Revenue $ 1,573,355 $ 1,999,457 $ 2,048,772 $ 2,036,748 $ 3,316,440 $ 2,609,812 $ - Covering Kids & Families $ 64,440 $ 64,440 $ 64,440 Contributions $ 34,079 $ 22,541 $ 58,259 $ 45,000 $ 45,900 $ 48,195 Pharmacy 340B $ 61,585 $ 62,817 $ 65,958 Rent Revenue $ 109,206 $ 94,255 $ 72,300 $ 74,400 $ 74,400 $ 78,120 Other $ 38,844 $ 83,243 $ 104,079 $ - Other Revenue $ 182,129 $ 200,039 $ 234,638 $ 245,425 $ 247,557 $ 256,713 TOTAL REVENUE $ 4,955,479 $ 6,836,340 $ 7,259,609 $ 7,344,198 $ 9,597,206 $ 9,322,059 Nevaeh Revenue Healthcare Management 18

19 Fiscal Year Budget 2018 (cont.) Historical Budget /Financial Performance Data 2018 Budget Review Proposed 2018 Audited Audited Audited Budget Revised Budget Budget EXPENDITURES $ - Personnel $ 4,024,900 $ 5,375,625 $ 5,364,432 Contractual - Clinical $ 129,314 $ 131,900 $ 138,495 Professional $ 665,199 $ 925,431 $ 971,703 Occupancy $ 526,552 $ 437,142 $ 458,999 Lab Costs $ 18,672 $ 19,045 $ 19,998 Supplies - Clinical $ 156,372 $ 167,688 $ 176,072 Supplies - Office $ 49,320 $ 50,306 $ 52,822 Equipment $ 28,800 $ 29,376 $ 30,845 Maintenance & Repairs $ 46,800 $ 47,736 $ 50,123 Telecommunications $ 122,400 $ 131,604 $ 138,184 Conferences/Conventions/Meetings $ 30,800 $ 46,005 $ 48,305 Travel/Transportation $ 44,796 $ 45,692 $ 47,977 Dues & Licenses $ 69,150 $ 96,954 $ 101,802 Insurance $ 6,540 $ 12,573 $ 13,202 Advertising/Recruiting $ 12,457 $ 38,937 $ 40,884 Postage & Shipping $ 4,200 $ 4,284 $ 4,498 Printing and Publications $ 4,491 $ 4,580 $ 4,810 Security $ 132,000 $ 104,168 $ 109,376 Fundraising Expense $ 17,100 $ 17,522 $ 18,398 Bad Debts $ 72,000 $ 73,440 $ 77,112 Miscellaneous $ 21,600 $ 22,032 $ 53,134 Interest/Finance Charges $ 9,300 $ 9,486 $ 9,960 Depreciation $ 103,600 $ 105,600 $ 110,880 TOTAL EXPENDITURES $ 4,872,649 $ 5,981,765 $ 7,204,737 $ 6,296,362 $ 7,897,128 $ 8,042,010 Surplus (Deficit) Before Loan Paydown & Savings $ 82,830 $ 854,575 $ 54,872 $ 1,047,836 $ 1,700,079 $ 1,280,049 Loan Proceeds $ 1,092,000 Loan Payments $ 212,000 $ 252,000 $ 350,000 Capital Expenditures $ 270,000 $ 1,100,000 $ 1,300,000 Money Market Savings $ 489,000 $ 240,000 $ 480,000 Sub-Total $ 971,000 $ 1,592,000 $ 1,038,000 Net Surplus (Deficit) $ 76,836 $ 108,079 $ 242,049 Budget restructured to show surplus(deficit) before loan and Pay down. Budget Assumption: Based upon 7% Patient Revenue growth in 2018 Budget Assumption: Based upon 5% expense growth in 2018 Revenue does not include any factoring for VA project New Funding Source Bad Debt increased to reflect increase in needed timely adjustment activity Money Market Target per mo. for 12 months Nevaeh Revenue Healthcare Management 19

20 HRSA Budget Information Year 2 EHB Input 424 Estimated Funding Updated Original Federal 1,947,792 1,947,792 Applicant 5,000 State 410,845 5,000 Local 121,712 Other 249,731 Program Income 5,370,296 5,690,223 Total 8,100,376 7,648,015 8,100,376 - Section B Budget Categories Object Class Categories Federal Non-Federal Personnel 1,447,792 2,989,660 4,437,452 Fringe Benefits Travel 46,606 Equipment 29,964 Supplies 222,354 Contractual 826,611 Construction 500,000 Other 804,402 Total Direct Charges Indirect Charges Total 1,947,792 4,919,597 6,867,389 6,867,389 Section C- Non Federal Resources Applicant State Local Other Program Income Grant Program Function or Activity 410, , ,731 5,370,296 6,152,584 1,947,792 Total 8,100,376 8,100,376

21 Form 3 Resources Part 1 Payor Category Patients by Primary Medical Insurance (a) Billable Visits (b) Income Per Visit (c ) Projected Income (d) Prior FY Income (e) Medicaid 4,370,908 Medicare 278,919 Other Public Private 388,175 Self Pay 332,294 Total 20,000 50,000 5,370,296 5,370,296 Part 2 Other Federal - State Government 410,845 Local Government 121,712 Private Grants/Contracts Contributions 46,818 Other 202,913 Applicant Retained Earnings Total Other 782,288 Total Non-Federal Income 6,152,584 6,152,584 (Total + Total Other) Nevaeh Revenue Healthcare Management 21

22 Fiscal Year Budget 2017 Q1 Performance Analysis & Review Historical Budget /Financial Performance Data 2017 Budget Review Budget to Extra Audited Audited Audited Budget Budget 4mo Actual 12 mo Extrapolation Variance Revised Budget Remaining Budget Revenue Medicaid $ 4,120,000 $ 5,325,718 $ 1,226,063 $ 3,678,189 $ 1,647,529 $ 4,750,000 $ 3,523,937 Medicare $ 262,908 $ 311,415 $ 62,886 $ 188,658 $ 122,757 $ 311,415 $ 248,529 Commercial $ 365,898 $ 422,093 $ 161,268 $ 483,804 -$ 61,711 $ 483,804 $ 322,536 Self Pay/Sliding Scale $ 304,968 $ 376,940 $ 157,164 $ 471,492 -$ 94,552 $ 471,492 $ 314,328 Other Patient Revenue $ 8,251 $ 8,498 $ 3,040 $ 9,120 -$ 622 $ 16,498 $ 13,458 Patient Revenue $ 5,062,025 $ 6,444,664 $ 1,610,421 $ 4,831,263 $ 1,613,401 $ 6,033,209 $ 4,422,788 $ 3,199,995 $ 4,636,844 $ 4,976,199 HRSA $ 1,261,661 $ 1,447,792 $ 516,247 $ 1,548,741 -$ 100,949 $ 1,447,792 $ 931,545 HRSA $ - $ - $ - $ - $ - $ - - BH HRSA- IT $ 242,530 HRSA-HIIP $ 1,000,000 $ - $ - $ 1,000,000 $ 1,000,000 $ 1,000,000 ISDH-CHC $ 207,000 $ 67,833 $ 203,499 $ 3,501 $ 207,000 $ 139,167 $ 207,000 ISDH-IN Navigator $ 50,000 $ 100,000 $ 39,403 $ 118,209 -$ 18,209 $ 100,000 $ 60,597 ISDH-TB $ 95,841 $ 95,841 $ 32,229 $ 96,687 -$ 846 $ 95,841 $ 63,612 ISDH - Early Start $ 50,000 $ 50,000 $ 15,807 $ 47,421 $ 2,579 $ 15,807 $ 15,807 ISDH - BCCP $ 8,004 $ 8,000 $ - $ - $ 8,000 $ - $ - CHIPRA $ 21,716 $ - $ - $ - $ - $ - $ - Walgreens/Amer $ 50,000 $ 50,000 $ 12,500 $ 37,500 $ 12,500 $ - $ 12,500 Can Soc IU - Sbirt Grant $ 40,000 $ - $ - $ - $ - $ - $ - March of Dimes/Baby $ 9,996 $ - $ - $ - $ - $ - $ - & Me One Sight $ 150,000 $ 450,000 $ 450,000 $ 300,000 Grant Revenue $ 1,573,355 $ 1,999,457 $ 2,048,772 $ 2,036,748 $ 2,958,633 $ 834,019 $ 2,052,057 $ 906,576 $ 3,316,440 $ 2,523,228 Covering Kids & Families $ 64,440 $ 64,440 $ 24,472 $ 73,416 $ 39,968 $ 64,440 $ 39,968 Contributions $ 45,000 $ 45,900 $ 5,965 $ 17,895 $ 28,005 $ 45,900 $ 39,935 $ 34,079 $ 22,541 $ 58,259 Pharmacy 340B $ 61,585 $ 62,817 $ 19,201 $ 57,603 $ 5,214 $ 62,817 $ 43,616 Rent Revenue $ 74,400 $ 74,400 $ 20,950 $ 62,850 $ 11,550 $ 74,400 $ 53,450 $ 109,206 $ 94,255 $ 72,300 Other $ 38,844 $ 83,243 $ 104,079 Other Revenue $ 182,129 $ 200,039 $ 234,638 $ 245,425 $ 247,557 $ 70,588 $ 211,764 $ 35,793 $ 247,557 $ 176,969 TOTAL REVENUE $ 4,955,479 $ 6,836,340 $ 7,259,609 $ 7,344,198 $ 9,650,854 $ 2,515,028 $ 7,095,084 $ 2,604,714 $ 9,597,206 $ 7,122,985 EXPENDITURES Personnel $ 4,024,900 $ 5,375,625 $ 1,566,183 $ 4,698,549 $ 677,076 $ 5,375,625 $ 3,809,442 Contractual - Clinical $ 129,314 $ 131,900 $ 1,800 $ 5,400 $ 126,500 $ 131,900 $ 130,100 Professional $ 665,199 $ 778,503 $ 308,477 $ 925,431 -$ 146,928 $ 925,431 $ 616,954 Occupancy $ 526,552 $ 450,000 $ 145,714 $ 437,142 $ 12,858 $ 437,142 $ 291,428 Lab Costs $ 18,672 $ 19,045 $ 2,415 $ 7,245 $ 11,800 $ 19,045 $ 16,630 Supplies - Clinical $ 156,372 $ 167,688 $ 49,637 $ 148,911 $ 18,777 $ 167,688 $ 118,051 Supplies - Office $ 49,320 $ 50,306 $ 5,525 $ 16,575 $ 33,731 $ 50,306 $ 44,781 Equipment $ 28,800 $ 29,376 $ 7,086 $ 21,258 $ 8,118 $ 29,376 $ 22,290 Maintenance & Repairs $ 46,800 $ 47,736 $ 12,819 $ 38,457 $ 9,279 $ 47,736 $ 34,917 Telecommunications $ 122,400 $ 100,000 $ 43,868 $ 131,604 -$ 31,604 $ 131,604 $ 87,736 Conf/Conventions/Meetings $ 30,800 $ 31,416 $ 15,335 $ 46,005 -$ 14,589 $ 46,005 $ 30,670 Travel/Transportation $ 44,796 $ 45,692 $ 53,600 $ 160,800 -$ 115,108 $ 45,692 $ 7,908 Dues & Licenses $ 69,150 $ 97,155 $ 32,318 $ 96,954 $ 201 $ 96,954 $ 64,636 Insurance $ 6,540 $ 6,671 $ 4,191 $ 12,573 -$ 5,902 $ 12,573 $ 8,382 Advertising/Recruiting $ 12,457 $ 12,706 $ 12,979 $ 38,937 -$ 26,231 $ 38,937 $ 25,958 Postage & Shipping $ 4,200 $ 4,284 $ 2,101 $ 6,303 -$ 2,019 $ 4,284 $ 2,183 Printing and Publications $ 4,491 $ 4,580 $ 652 $ 1,956 $ 2,624 $ 4,580 $ 3,928 Security $ 132,000 $ 134,640 $ 40,382 $ 121,146 $ 13,494 $ 104,168 $ 63,786 Fundraising Expense $ 17,100 $ 17,522 $ 2,008 $ 6,024 $ 11,498 $ 17,522 $ 15,514 Bad Debts $ 72,000 $ 73,440 $ 9,989 $ 29,967 $ 43,473 $ 73,440 $ 63,451 Miscellaneous $ 21,600 $ 22,032 $ 3,468 $ 10,404 $ 11,628 $ 22,032 $ 18,564 Interest/Finance Charges $ 9,300 $ 9,486 $ 143 $ 429 $ 9,057 $ 9,486 $ 9,343 Depreciation $ 103,600 $ 105,600 $ 4,442 $ 13,326 $ 92,274 $ 105,600 $ 101,158 TOTAL EXPENDITURES $ 4,872,649 $ 5,981,765 $ 7,204,737 $ 6,296,362 $ 7,715,404 $ 2,325,132 $ 6,975,396 $ 740,008 $ 7,897,128 $ 5,587,812 $ - $ - $ - Surplus (Deficit) Before Loan Paydown & Savings $ 82,830 $ 854,575 $ 54,872 $ 1,047,836 $ 1,935,450 $ 189,896 $ 569,688 $ 1,864,706 $ 1,700,079 $ 1,535,174 $ - $ - $ 78,759 $ 173,241 Loan Payments $ 212,000 $ 252,000 $ 26,253 $ 252,000 $ 225,747 Capital Expenditures $ 270,000 $ 1,100,000 $ 20,462 $ 61,386 $ 1,038,614 $ 1,100,000 $ 1,079,538 Money Market Savings $ 489,000 $ 480,000 $ 80,000 $ 240,000 $ 240,000 $ 240,000 $ 160,000 Sub-Total $ 971,000 $ 1,832,000 $ 126,715 $ 380,145 $ 1,451,855 $ 1,592,000 $ 1,465,285 $ - $ - $ - $ - $ 189,543 $ 412,851 Net Surplus (Deficit) $ 76,836 $ 103,450 $ 63,181 $ 108,079 $ 69,889 Budget restructured to show surplus(deficit) before loan and Pay down. CKF and Outreach removed will show by grant/program.

23 Fiscal Year Budget 2017 Q1 Performance Analysis & Review Historical Budget /Financial Performance Data Projected Monthly Budget Remaining Audited Audited Audited Budget May June July August September October November December Total Revenue Medicaid $ 4,120,000 $ 414,581 $ 414,581 $ 414,581 $ 414,581 $ 621,870 $ 414,581 $ 414,581 $ 414,581 $ 3,523,936 Medicare $ 262,908 $ 31,066 $ 31,066 $ 31,066 $ 31,066 $ 31,066 $ 31,066 $ 31,066 $ 31,066 $ 248,529 Commercial $ 365,898 $ 40,317 $ 40,317 $ 40,317 $ 40,317 $ 40,317 $ 40,317 $ 40,317 $ 40,317 $ 322,536 Self Pay/Sliding Scale $ 304,968 $ 39,291 $ 39,291 $ 39,291 $ 39,291 $ 39,291 $ 39,291 $ 39,291 $ 39,291 $ 314,328 Other Patient Revenue $ 8,251 $ 1,682 $ 1,682 $ 1,682 $ 1,682 $ 1,682 $ 1,682 $ 1,682 $ 1,682 $ 13,458 Patient Revenue $5,062,025 $ 526,937 $ 526,937 $ 526,937 $ 526,937 $ 734,226 $ 526,937 $ 526,937 $ 526,937 $ 4,422,787 $3,199,995 $4,636,844 $4,976,199 HRSA $ 1,261,661 $ 116,443 $ 116,443 $ 116,443 $ 116,443 $ 116,443 $ 116,443 $ 116,443 $ 116,443 $ 931,545 HRSA $ - $ - $ - $ - $ - $ - $ - $ - $ - - BH HRSA- IT $ 242,530 HRSA-HIIP $ 125,000 $ 125,000 $ 125,000 $ 125,000 $ 125,000 $ 125,000 $ 125,000 $ 125,000 $ 1,000,000 ISDH-CHC $ 17,396 $ 17,396 $ 17,396 $ 17,396 $ 17,396 $ 17,396 $ 17,396 $ 17,396 $ 139,167 $ 207,000 ISDH-IN Navigator $ 50,000 $ 7,575 $ 7,575 $ 7,575 $ 7,575 $ 7,575 $ 7,575 $ 7,575 $ 7,575 $ 60,597 ISDH-TB $ 95,841 $ 7,952 $ 7,952 $ 7,952 $ 7,952 $ 7,952 $ 7,952 $ 7,952 $ 7,952 $ 63,612 ISDH - Early Start $ 50,000 $ 1,976 $ 1,976 $ 1,976 $ 1,976 $ 1,976 $ 1,976 $ 1,976 $ 1,976 $ 15,807 ISDH - BCCP $ 8,004 $ - $ - $ - $ - $ - $ - $ - $ - $ - CHIPRA $ 21,716 $ - $ - $ - $ - $ - $ - $ - $ - $ - Walgreens/Amer $ 50,000 $ 1,563 $ 1,563 $ 1,563 $ 1,563 $ 1,563 $ 1,563 $ 1,563 $ 1,563 $ 12,500 Can Soc IU - Sbirt Grant $ 40,000 $ - $ - $ - $ - $ - $ - $ - $ - $ - March of Dimes/Baby & Me $ 9,996 $ - $ - $ - $ - $ - $ - $ - $ - $ - One Sight $ 37,500 $ 37,500 $ 37,500 $ 37,500 $ 37,500 $ 37,500 $ 37,500 $ 37,500 $ 300,000 Grant Revenue $ 315,404 $ 315,404 $ 315,404 $ 315,404 $ 315,404 $ 315,404 $ 315,404 $ 315,404 $ 2,523,228 $1,573,355 $1,999,457 $2,048,772 $2,036,748 Covering Kids & Families $ 64,440 $ 4,996 $ 4,996 $ 4,996 $ 4,996 $ 4,996 $ 4,996 $ 4,996 $ 4,996 $ 39,968 Contributions $ 34,079 $ 22,541 $ 58,259 $ 45,000 $ 4,992 $ 4,992 $ 4,992 $ 4,992 $ 4,992 $ 4,992 $ 4,992 $ 4,992 $ 39,935 Pharmacy 340B $ 61,585 $ 5,452 $ 5,452 $ 5,452 $ 5,452 $ 5,452 $ 5,452 $ 5,452 $ 5,452 $ 43,616 Rent Revenue $ 109,206 $ 94,255 $ 72,300 $ 74,400 $ 6,681 $ 6,681 $ 6,681 $ 6,681 $ 6,681 $ 6,681 $ 6,681 $ 6,681 $ 53,450 Other $ 38,844 $ 83,243 $ 104,079 $ - $ - $ - $ - $ - $ - $ - $ - $ - Other Revenue $ 182,129 $ 200,039 $ 234,638 $ 22,121 $ 22,121 $ 22,121 $ 22,121 $ 22,121 $ 22,121 $ 22,121 $ 22,121 $ 176,969 $ 245,425 TOTAL REVENUE $ 4,955,479 $ 6,836,340 $ 7,259,609 $7,344,198 $ 864,462 $ 864,462 $ 864,462 $ 864,462 $ 1,071,751 $ 864,462 $ 864,462 $ 864,462 $ 7,122,984 EXPENDITURES Personnel $ 4,024,900 $ 462,777 $ 462,777 $ 462,777 $ 462,777 $ 570,000 $ 462,778 $ 462,778 $ 462,778 $ 3,809,442 Contractual - Clinical $ 129,314 $ 16,263 $ 16,263 $ 16,263 $ 16,263 $ 16,263 $ 16,263 $ 16,263 $ 16,263 $ 130,100 Professional $ 665,199 $ 77,119 $ 77,119 $ 77,119 $ 77,119 $ 77,119 $ 77,119 $ 77,119 $ 77,119 $ 616,954 Occupancy $ 526,552 $ 36,429 $ 36,429 $ 36,429 $ 36,429 $ 36,429 $ 36,429 $ 36,429 $ 36,429 $ 291,428 Lab Costs $ 18,672 $ 2,079 $ 2,079 $ 2,079 $ 2,079 $ 2,079 $ 2,079 $ 2,079 $ 2,079 $ 16,630 Supplies - Clinical $ 156,372 $ 14,756 $ 14,756 $ 14,756 $ 14,756 $ 14,756 $ 14,756 $ 14,756 $ 14,756 $ 118,051 Supplies - Office $ 49,320 $ 5,598 $ 5,598 $ 5,598 $ 5,598 $ 5,598 $ 5,598 $ 5,598 $ 5,598 $ 44,781 Equipment $ 28,800 $ 2,786 $ 2,786 $ 2,786 $ 2,786 $ 2,786 $ 2,786 $ 2,786 $ 2,786 $ 22,290 Maintenance & Repairs $ 46,800 $ 4,365 $ 4,365 $ 4,365 $ 4,365 $ 4,365 $ 4,365 $ 4,365 $ 4,365 $ 34,917 Telecommunications $ 122,400 $ 10,967 $ 10,967 $ 10,967 $ 10,967 $ 10,967 $ 10,967 $ 10,967 $ 10,967 $ 87,736 Conf/Conventions/Meetings $ 30,800 $ 3,834 $ 3,834 $ 3,834 $ 3,834 $ 3,834 $ 3,834 $ 3,834 $ 3,834 $ 30,670 Travel/Transportation $ 44,796 $ 989 $ 989 $ 989 $ 989 $ 989 $ 989 $ 989 $ 989 $ 7,908 Dues & Licenses $ 69,150 $ 8,080 $ 8,080 $ 8,080 $ 8,080 $ 8,080 $ 8,080 $ 8,080 $ 8,080 $ 64,636 Insurance $ 6,540 $ 1,048 $ 1,048 $ 1,048 $ 1,048 $ 1,048 $ 1,048 $ 1,048 $ 1,048 $ 8,382 Advertising/Recruiting $ 12,457 $ 3,245 $ 3,245 $ 3,245 $ 3,245 $ 3,245 $ 3,245 $ 3,245 $ 3,245 $ 25,958 Postage & Shipping $ 4,200 $ 273 $ 273 $ 273 $ 273 $ 273 $ 273 $ 273 $ 273 $ 2,183 Printing and Publications $ 4,491 $ 491 $ 491 $ 491 $ 491 $ 491 $ 491 $ 491 $ 491 $ 3,928 Security $ 132,000 $ 7,973 $ 7,973 $ 7,973 $ 7,973 $ 7,973 $ 7,973 $ 7,973 $ 7,973 $ 63,786 Fundraising Expense $ 17,100 $ 1,939 $ 1,939 $ 1,939 $ 1,939 $ 1,939 $ 1,939 $ 1,939 $ 1,939 $ 15,514 Bad Debts $ 72,000 $ 7,931 $ 7,931 $ 7,931 $ 7,931 $ 7,931 $ 7,931 $ 7,931 $ 7,931 $ 63,451 Miscellaneous $ 21,600 $ 2,321 $ 2,321 $ 2,321 $ 2,321 $ 2,321 $ 2,321 $ 2,321 $ 2,321 $ 18,564 Interest/Finance Charges $ 9,300 $ 1,168 $ 1,168 $ 1,168 $ 1,168 $ 1,168 $ 1,168 $ 1,168 $ 1,168 $ 9,343 Depreciation $ 103,600 $ 12,645 $ 12,645 $ 12,645 $ 12,645 $ 12,645 $ 12,645 $ 12,645 $ 12,645 $ 101,158 TOTAL EXPENDITURES $ 4,872,649 $ 5,981,765 $ 7,204,737 $6,296,362 $ 685,073 $ 685,073 $ 685,073 $ 685,073 $ 792,296 $ 685,074 $ 685,074 $ 685,074 $ 5,587,812 $ - Surplus (Deficit) Before Loan Paydown & Savings $ 82,830 $ 854,575 $ 54,872 $ 1,047,836 $ 179,389 $ 179,389 $ 179,389 $ 179,389 $ 279,455 $ 179,388 $ 179,389 $ 179,389 $ 1,535,174 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 28,218 $ 28,218 $ 28,218 $ 28,218 $ 28,218 $ 28,218 $ 28,218 $ 28,218 $ 225,747 Loan Payments $ 212,000 Capital Expenditures $ 270,000 $ 134,942 $ 134,942 $ 134,942 $ 134,942 $ 134,942 $ 134,942 $ 134,942 $ 134,942 $ 1,079,538 Money Market Savings $ 489,000 $ 20,000 $ 20,000 $ 20,000 $ 20,000 $ 20,000 $ 20,000 $ 20,000 $ 20,000 $ 160,000 Sub-Total $ 971,000 $ 183,161 $ 183,161 $ 183,161 $ 183,161 $ 183,161 $ 183,161 $ 183,161 $ 183,161 $ 1,465,285 $ - $ - Net Surplus (Deficit) $ 76,836 -$ 3,772 -$ 3,772 -$ 3,772 -$ 3,772 $ 96,294 -$ 3,773 -$ 3,772 -$ 3,772 $ 69,889 Budget restructured to show surplus(deficit) before loan and Pay down. CKF and Outreach removed will show by grant/program. Nevaeh Revenue Healthcare Management 23

24 PROGRAM BUDGET

25 ICE- Project Period 1 April 1, June 30, 2017 BIP April May June July Total Budget Remaining Budget Staff 1,194 2,880 3,895 7,969 12,000 4, CFR 2,000 2,000 2,000 6,000 8,000 2,000 Consumer Advisory 10,508 10,508 12,000 1,492 Meetings ,500 3,450 Travel ,500 2,042 Other ,000 1,681 3,194 5,058 17,052 25,304 40,000 14,696 TANF April May June July Total Budget Remaining Budget Administration $7500 5,106 2, ,500 7,500 - Assessements 225 $ ,525 5,100 10,625 10,625 - Consumer ea 15 Non-medical Wellness Groups ,299 1, Non-medical Education Classes - 1,771 1,771 Parent/Marriage Classes ,299 1, Patient Tech (patient reminders)-actual ,771 1,771 - Non-Medical Transportation- Actual - 1,771 1,771 Healthcare Navigation- Actual 1, ,771 1,771 - Recovery Supports Non-clinical coaching $53-3,551 3,551 Non-medical support to implement Physician Recommendation $53-3,551 3,551 Peer Recovery Mentoring/Coaching $60-3,551 3,551 Transitional Housing Supports Rent Asst- Actual Cost ,656 1,768 Utility Asst- Actual Cost 1,835 1,835 2, Household Asst- Actual Cost ,656 2,043 Food Asst- Actual Cost ,628 2,061 13,233 9,159 5,777 28,168 50,000 21,832 Invoice Total 16,427 14,216 22,829 Nevaeh Revenue Healthcare Management 25

26 ICE- Project Period 2 July 1, June 30, 2018 TANF July Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Total Budget Remaining Budget Administration $30,000 Assessements - 30,000 30, sets of $ ,450 99,450 Consumer per group/class up to $ Non-medical Wellness Groups - 3,896 3, Non-medical Education Classes - 3,896 3, Parent/Marriage Classes Patient Tech (patient reminders)- Actual - 3,896 3,896-3,919 3,919 Non-Medical Transportation- Actual - 3,919 3,919 Healthcare Navigation- Actual - 3,919 3,919 Recovery Supports Budget: $23,548 - Non-clinical coaching $53-7,844 7,844 Non-medical support to implement Physician Recommendation $53-7,844 7,844 Peer Recovery Mentoring/Coaching $60-7,860 7,860 Transitional Housing Supports: $23, Rent Asst- Actual Cost up to $ ,879 5,879 Utility Asst- Actual Cost up to $ ,879 5,879 Household Asst- Actual Cost to $ ,879 5,879 Food Asst- Actual Cost up to $ ,918 5, , ,000 Nevaeh Revenue Healthcare Management 26

27 CASE STUDY

28 Health Center Zebra Health Center Zebra has been struggling to meet a positive bottom line in it s monthly financial statements to the management team and BOD. The finance department has been asked to review revenue and expenses and determine where the problem lies. The CFO must report the projected months ahead to determine if the fiscal year will end on a cash positive position. Nevaeh Revenue Healthcare Management 28

29 Steps Plan Study Act Do Nevaeh Revenue Healthcare Management 29

30 LET S DISCUSS IT Nevaeh Healthcare Revenue Management

31 Contact Information Adrienne Hurtt Nevaeh Revenue Healthcare Management 31