Board of Curators Health Affairs Committee June 11, 2018 Patrice - - PowerPoint PPT Presentation

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Board of Curators Health Affairs Committee June 11, 2018 Patrice - - PowerPoint PPT Presentation

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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

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SLIDE 1

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

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SLIDE 2

(all years shown as of January 1)

UP Finance Summary – FYTD 2018 April

Actual April FYTD 2017 Budget April FYTD 2018 Actual April FYTD 2018 Percent Change Budget FY18 vs. Actual FY18 Percent Change Actual FY17 vs. 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

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SLIDE 3

Budget to Actual

Clinical Challenges and Opportunities

  • 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

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SLIDE 4

(all years shown as of January 1)

UP 2018 Initiatives

  • 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

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SLIDE 5

(all years shown as of January 1)

Unique Medicaid Patients

CMS & MO Health Net Working to Provide Managed Medicaid Directed Payments Rewards Safety Net Medical Groups & Hospitals for Medicaid Access 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

OPEN – HEALTH AFF – INFO 2 – 5

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SLIDE 6

(all years shown as of January 1)

Medicaid Shift

$0 $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 $3,000,000 $3,500,000 $4,000,000

Jul, 2016 Aug, 2016 Sep, 2016 Oct, 2016 Nov, 2016 Dec, 2016 Jan, 2017 Feb, 2017 Mar, 2017 Apr, 2017 May, 2017 Jun, 2017 Jul, 2017 Aug, 2017 Sep, 2017 Oct, 2017 Nov, 2017 Dec, 2017 Jan, 2018 Feb, 2018

Medicaid and MC+ Shift

MC+ Net Payments Medicaid Net Payments Linear (MC+ Net Payments) Linear (Medicaid Net Payments)

OPEN – HEALTH AFF – INFO 2 – 6

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SLIDE 7

(all years shown as of January 1)

Merit-based Incentive Payment System (MIPS)

  • 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

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SLIDE 8

Average undergraduate cumulative GPA 3.74 Average undergraduate science GPA 3.68 3.8 GPA or higher 58% Male 47% Female 53% Age range 22 - 36 Missouri residents 85% Out-of-state residents 15% MCAT average 78% (508) MCAT Median 78% 70% MCAT or higher 79%

OPEN – HEALTH AFF – INFO 2 – 8

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SLIDE 9

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

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SLIDE 10

URM Matriculants 2018 21 (18.75%) 2017 13 (10%) 2016 9 (8%) 2015 6 (5%) In State Matriculants 2018 95 (84%) 2017 104 (81%) 2016 89 (85%) 2015 81 (77%) Multiple Accepts, but Matriculated to Mizzou 2018 38 (33%) 2017 34 (26%) 2016 33 (31%) 2015 30 (28%) Out of State Matriculants 2018 17 (15%) 2017 24 (18%) 2016 15 (14%) 2015 23 (22%)

(as of 5/25/2018)

OPEN – HEALTH AFF – INFO 2 – 10

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SLIDE 11

Shared Credit Research Expenditures YTD Research Expenditures NIH Research Expenditures

$19,283,390 $21,285,689 $22,775,301 $84,198,211 $83,121,568 $86,760,004

$- $10,000,000 $20,000,000 $30,000,000 $40,000,000 $50,000,000 $60,000,000 $70,000,000 $80,000,000 $90,000,000 $100,000,000

Research Expenditures SOM Research Expenditures Campus

22.9% 25.6% 26.3%

$12,306,115 $13,282,907 $14,361,631 $25,897,234 $27,090,445 $28,735,558

$- $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 $30,000,000 $35,000,000

FY16 YTD FY17 YTD FY18 YTD

NIH Research Expenditures SOM NIH Research Expenditures Campus

47.5% 49% 50% OPEN – HEALTH AFF – INFO 2 – 11

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Budget to Actual

Program Project Planning Grants

  • 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

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SLIDE 13

Questions

OPEN – HEALTH AFF – INFO 2 – 13