Board of Curators Health Affairs Committee June 11, 2018 Patrice “Patrick” Delafontaine, MD Hugh E. and Sarah D. Stephenson Dean, MU School of Medicine Professor of Medicine and Medical Pharmacology & Physiology OPEN – HEALTH AFF – INFO 2 – 1
UP Finance Summary – FYTD 2018 April (all years shown as of January 1) Percent Change Percent Change Actual April Budget April Actual April Budget FY18 vs. Actual FY17 vs. FYTD 2017 FYTD 2018 FYTD 2018 Actual FY18 Actual FY18 SOM Net Work RVUs (Physician) 1,943,042 1,937,600 1,935,258 0% 0% Net Work RVUs (Non-Physician) 317,834 336,810 328,057 -3% 3% Total Net Work RVUs 2,260,877 2,274,410 2,263,315 0% 0% Clinic Visits 532,223 538,789 563,585 5% 6% Total Net Charges $ 445,535,300 $ 446,731,600 $ 449,713,319 1% 1% RVU-Generating Collections $ 159,924,928 $ 162,259,864 $ 160,210,761 -1% 0% Non RVU Generating Collections less fees $ 4,675,936 $ 4,236,214 $ 4,791,974 13% 2% Meaningful Use/Quality Incentives $ 898,692 $ 397,754 $ 448,861 13% -50% Total SOM Collections $ 165,499,555 $ 166,893,832 $ 165,451,597 -1% 0% Total NonSOM Collections $ 4,474,563 $ 4,340,830 $ 5,881,598 35% 31% Total UP Collections $ 169,974,118 $ 171,234,662 $ 171,333,195 0% 1% PAF FTE (Physician) 451 400 469 17% 4% Clinical FTE (Physician) 282 N/A 287 N/A 2% Clinical FTE (Non-Physician) 130 N/A 150 N/A 15% WRVUs per CFTE (Physician) 6,895 N/A 6,748 N/A -2% RVUs per CFTE (Non-Physician) 2,445 N/A 2,191 N/A -10% Strong top line revenue against flat fixed fee schedule payor contracts OPEN – HEALTH AFF – INFO 2– 2
Clinical Challenges and Opportunities Budget to Actual • Revenue Cycle Conversion • Value Based Care and At-Risk Contracts – MU/Cerner Value-Based Care Retreat (04/20/18) – MPACT – Custom Network – Missouri Custom • Directed Payments (by Managed Medicaid) • Outreach and Clinical Footprint Development OPEN – HEALTH AFF – INFO 2– 3
UP 2018 Initiatives (all years shown as of January 1) • Extend Medicaid Support Funding to Managed Medicaid Eligibles • July 1 Approval - $2.5m per quarter additional payment • Tie Staffing & Productivity to Peer Institution Performance Benchmarks • Achieve Monthly Cash Collections Target of $16.5m • Support Year 1 OIG CIA Review & Plan for more efficient 2018 Review • Initiate Planning for Cerner Revenue Cycle Conversion • Project Design Phase – July 18, Projected Live Date March 2020 • Includes Capital Region Medical Center EMR & Revenue Cycle • Initiate External Documentation & Coding Review of ALL services • Coordinating with Compliance to ensure quality & reimbursement OPEN – HEALTH AFF – INFO 2 – 4
Unique Medicaid Patients (all years shown as of January 1) Transition to Managed Care Medicaid Accelerating – we accept all eligibles as 1 of 2 Designated Safety Net Hospitals in Missouri (UMKC-Truman is the other) ng top line revenue against flat fixed fee contracts CMS & MO Health Net Working to Provide Managed Medicaid Directed Payments Rewards Safety Net Medical Groups & Hospitals for Medicaid Access OPEN – HEALTH AFF – INFO 2 – 5
Medicaid Shift (all years shown as of January 1) Medicaid and MC+ Shift $4,000,000 $3,500,000 $3,000,000 $2,500,000 $2,000,000 $1,500,000 $1,000,000 $500,000 $0 Jul, Aug, Sep, Oct, Nov, Dec, Jan, Feb, Mar, Apr, May, Jun, Jul, Aug, Sep, Oct, Nov, Dec, Jan, Feb, 2016 2016 2016 2016 2016 2016 2017 2017 2017 2017 2017 2017 2017 2017 2017 2017 2017 2017 2018 2018 MC+ Net Payments Medicaid Net Payments Linear (MC+ Net Payments) Linear (Medicaid Net Payments) OPEN – HEALTH AFF – INFO 2 – 6
Merit-based Incentive Payment System (MIPS) (all years shown as of January 1) • MIPS is 1 of 2 tracks of the Quality Payment Program (QPP) • MIPS has 4 categories: Total Score 100 points • Quality = 60% • Cost = 0% • Improvement Activities [IA] = 15% • Advancing Care Information [ACI] = 25% • UP Total MIPS Score 93.1 points* Category % Weight UP Points Quality 60% 53.1 Cost 0% NA IA 15% 15 ACI 25% 25 100% 93.1 * Does not include the readmission measure – calculated by CMS OPEN – HEALTH AFF – INFO 2 – 7
Average undergraduate cumulative GPA 3.74 Average undergraduate science GPA 3.68 3.8 GPA or higher 58% MCAT average 78% (508) MCAT Median 78% 70% MCAT or higher 79% Male 47% Female 53% Age range 22 - 36 Missouri residents 85% Out-of-state residents 15% OPEN – HEALTH AFF – INFO 2 – 8
Accepted = 112 Rural H.S. 10% Low SES 23% African American 12.5% Hispanic 5% American Indian 1% Other Minorities 16% OPEN – HEALTH AFF – INFO 2 – 9
(as of 5/25/2018) In State Matriculants Out of State Matriculants 2018 95 (84%) 2018 17 (15%) 2017 104 (81%) 2017 24 (18%) 2016 89 (85%) 2016 15 (14%) 2015 81 (77%) 2015 23 (22%) URM Matriculants Multiple Accepts, but Matriculated to Mizzou 2018 21 (18.75%) 2018 38 (33%) 2017 13 (10%) 2017 34 (26%) 2016 9 (8%) 2016 33 (31%) 2015 6 (5%) 2015 30 (28%) OPEN – HEALTH AFF – INFO 2 – 10
Shared Credit Research Expenditures YTD Research Expenditures NIH Research Expenditures $35,000,000 $100,000,000 $86,760,004 $90,000,000 $84,198,211 $83,121,568 $28,735,558 $30,000,000 $27,090,445 $80,000,000 $25,897,234 $25,000,000 $70,000,000 $60,000,000 $20,000,000 $50,000,000 $14,361,631 $15,000,000 $13,282,907 $40,000,000 50% $12,306,115 49% 47.5% $30,000,000 $22,775,301 $10,000,000 $21,285,689 $19,283,390 26.3% $20,000,000 25.6% 22.9% $5,000,000 $10,000,000 $- $- FY16 YTD FY17 YTD FY18 YTD NIH Research Expenditures SOM Research Expenditures SOM NIH Research Expenditures Campus Research Expenditures Campus OPEN – HEALTH AFF – INFO 2 – 11
Program Project Planning Grants Budget to Actual • 5 internal $75K SOM awards in March 2018, conditioned upon submission of a competitive multi-project application to NIH within 18 months (by October 2019) • Luis Martinez-Lemus, DVM, PhD , “Novel Targets Underlying Vascular Stiffening in Type 2 Diabetes” • Kerry S. McDonald, PhD , “Pathogenic Mechanisms & Genetic Therapy for Dystrophic Cardiomyopathy” • Debra Parker Oliver, PhD, MSW , “Informatics to Facilitate Caregiver Engagement in Advanced Cancer Care” • Kevin Staveley-O’Carroll, MD , “Immunotherapies to Cure Hepatocellular Carcinoma (HCC)” • Edward T. H. Yeh, MD , “Heart Failure with Preserved Ejection Fraction (HFpEF)” OPEN – HEALTH AFF – INFO 2 – 12
Questions OPEN – HEALTH AFF – INFO 2 – 13
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