Innovative Approaches to Using Data to Demonstrate Value: Measuring - - PowerPoint PPT Presentation

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Innovative Approaches to Using Data to Demonstrate Value: Measuring - - PowerPoint PPT Presentation

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Innovative Approaches to Using Data to Demonstrate Value: Measuring & Reporting Clinical, Operational, Financial Improvement Jonathan Chapman Director, CHC Advisory Services AACHC/CVN Annual Conference 2019 Capital Link February 11,

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 2019 Capital Link 1 www.caplink.org

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, 2019

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 2019 Capital Link 2 www.caplink.org

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

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 2019 Capital Link 3 www.caplink.org

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
  • rganizations in planning for and financing operational growth and capital

needs

  • Industry vision and leadership in the development of strategies for
  • rganizational, facilities, operational and financial improvements
  • Metrics and analytical services for measuring health center impact,

evaluating financial and operating trends and promoting performance improvement

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 2019 Capital Link 4 www.caplink.org

Goal: Improved Access to High Quality Care AND Financial Sustainability

Improved Access & Financial Sustainability

Staffing

Productivity

Utilization Clinical Outcomes

Patient Satisfaction Financial Operations

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 2019 Capital Link 5 www.caplink.org

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

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Defining “Value”

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“Value?”

synonyms: worth, usefulness, advantage, benefit, gain, profit , good, help, merit, helpfulness, avail;More synonyms: principles, ethics, moral code, morals, standards, code of behavior"society's values are passed on to us as children" synonyms: evaluate, assess, estimate, appraise, price, put/set a price on"his estate was valued at $345,000" synonyms: think highly of, have a high opinion of, hold in high regard, rate highly, esteem, set (great) store by, put stock in, appreciate, respect; More

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. 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

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Defining Organizational Value

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Medical Value Equation

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Medical Value Equation

  • Healthy Outcomes
  • Patient and Provider Experiences
  • Timely, Comprehensive Service Options
  • Conscientious Budgeting and Operations
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Quadruple Aim

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Preparing for Value

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Transition to Value-Based System

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Value Based Transition

Transition to Value-Based System

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Transition to Value-Based System

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Transition to Value-Based System - HRSA

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Transition to Value-Based System - CMS

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Calculating Value

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What to Measure?

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How to Measure?

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Expectations?

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Key Performance Metrics

Metric Why This Is Important

1 Operating Margin Measuring stick of your business model; margins typically small but need to be positive 2 Bottom Line Margin 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

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Operating Margins - Medians

0.00% 1.00% 2.00% 3.00% 4.00% 5.00% 6.00% 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark

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Personnel-Related Expense as a Percent of Operating Revenue - Medians

68.00% 69.00% 70.00% 71.00% 72.00% 73.00% 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark

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Days Cash on Hand - Medians

10 20 30 40 50 60 70 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark

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Physician Visits per Physician FTE - Medians

2,000 2,500 3,000 3,500 4,000 2014 2015 2016 2017 Arizona FQHC US FQHC

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Mid-Level Visits per Mid-Level FTE - Medians

2,000 2,500 3,000 3,500 4,000 2014 2015 2016 2017 Arizona FQHC US FQHC

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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

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Total Patients per Provider FTE - Medians

500 550 600 650 700 750 800 850 900 950 2014 2015 2016 2017 Arizona - Total Patients per Provider FTE US - Total Patients per Provider FTE

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Total Unduplicated Patients per Total FTE - Medians

100 105 110 115 120 125 130 135 2014 2015 2016 2017 Arizona - Total Unduplicated Patients per Total FTE US - Total Unduplicated Patients per Total FTE

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Organizational Productivity per FTE - Medians

200 400 600 800 1000 2014 2015 2016 2017 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

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Operating Revenue & Expense per Patient - Medians

$700 $750 $800 $850 $900 $950 $1,000 2014 2015 2016 2017 Arizona - Operating Revenue per Patient Arizona - Operating Expense per Patient US - Operating Revenue Per Patient US - Operating Expense Per Patient

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AZ Operating Revenue & Expense per Patient - Percentiles

AZ FQHC Revenue / Patient AZ FQHC Expense / Patient

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Medical Services Cost per Patient - Medians

Arizona Median Arizona

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Percentage of Patients 18+ with BMI And Follow Up Documented – Percentiles

Arizona FQHC, UDS

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Conveying Value

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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
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Basic Visuals

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HRSA’s Emphasis

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HRSA’s Press Releases

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HRSA’s Messaging

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Previous Economic Impact Report

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Recent Value & Impact Report

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Recent Value & Impact Report

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Anticipated Value & Impact Report

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Anticipated Value & Impact Report

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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
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 2019 Capital Link 48 www.caplink.org

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
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Data & Value In Operational Planning Efforts

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Assumptions and Scenarios

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Financial Sensitivity: Medicaid Eligibility

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Financial Sensitivity: Medicaid Eligibility

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Financial Sensitivity: Medicaid Eligibility

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Financial Sensitivity: Medicaid Eligibility

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Financial Sensitivity: Reimbursement

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Financial Sensitivity: Reimbursement

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Financial Sensitivity: Reimbursement Initial Budget

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MEDICAL CORRECTION - Financial Sensitivity: Reimbursement

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Actual Payment Financial Sensitivity: Reimbursement

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PROJECTED MIGHT BE ACTUAL NOW CORRECTION Financial Sensitivity: Reimbursement

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Low Income Population

HPSA Score

LOW HIGH

Establishing Priorities

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MISSION FUNDING CAPACITY

Establishing Priorities

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Establishing Priorities

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Community Health Centers

Valuable e

Defining and Creating To All For All

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Visit us Online: www.caplink.org

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Jonathan Chapman Director of CHC Advisory Services 970-833-8513 jchapman@caplink.org