Advancing the Financial Strength of Los Angeles County Clinics: - PowerPoint PPT Presentation

Advancing the Financial Strength of Los Angeles County Clinics: Monitoring and Improving Health Center Performance Susan Petrie, MBA Chief Operating Officer, Capital Link AFS 102 Training Program December 5, 2019

Capital Link - Overview • Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and WV • Over $1.2 billion in financing for over 234 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  2019 Capital Link www.caplink.org 2

Advancing Financial Strength (AFS) Program Overview Program Developed with CCALAC • Tools, Trainings, Technical Assistance Goal: Improve Health Center Financial Sustainability and Increase Readiness for Growth. CMO/Clinical CFO/Finance Board CEO/COO Team Team Members  2019 Capital Link www.caplink.org 3

Goal: Financial Sustainability and Access to High Quality Care  2019 Capital Link www.caplink.org 4

Benchmarking/Dashboards

Performance Improvement  2019 Capital Link www.caplink.org 6

Benchmarking A standard or point of reference against which things may be compared or assessed.  2019 Capital Link www.caplink.org 7

Benchmarking/Best Practices What metrics should I track? What to compare performance to? What does it mean?  2019 Capital Link www.caplink.org 8

Capital Link’s Performance Benchmarking Toolkit http://caplink.org/california-clinics  2019 Capital Link www.caplink.org 9

Data Sources for Benchmarking

CA FQHCs Performance Trends http://caplink.org/ca-trends-2019  2019 Capital Link www.caplink.org 11

Capital Link’s Benchmarking Toolkit  2019 Capital Link www.caplink.org 12

Performance Trends: Key Metrics

Operating Margin 7.0% 6.3% 5.9% 6.0% 5.7% 5.6% 4.8% 5.0% 4.7% 4.5% 4.3% 4.0% 3.7% 3.6% 3.5% 3.1% 3.0% 2.0% 1.0% 0.0% 2015 2016 2017 2018 CCALAC Operating Median CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 14

Bottom-Line Margin 8.0% 7.3% 6.8% 6.8% 7.0% 5.9% 6.0% 5.5% 5.5% 5.4% 5.3% 5.1% 4.9% 5.0% 4.4% 4.1% 4.0% 3.0% 2.0% 1.0% 0.0% 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 15

Personnel-Related Expenses as a Percentage of Operating Expenses 73.0% 72.5% 72.1% 72.0% 71.8% 72.0% 71.5% 71.2% 70.9% 70.8% 71.0% 70.6% 70.2% 70.0% 69.3% 69.0% 68.0% 68.0% 67.0% 66.0% 65.0% 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 16

Days in Net Patients Receivables 60 54 48 50 44 43 41 41 40 39 38 38 38 40 37 30 20 10 0 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 17

Days Cash on Hand 120 97 100 94 92 81 79 80 71 71 67 63 59 60 53 43 40 20 0 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 18

Physician Visits per Physician FTE 3,400 3,300 3,200 3,100 3,000 2,900 2,800 2,700 2,600 2,500 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 19

Mid-Level Visits per Mid-Level FTE 3,600 3,400 3,200 3,000 2,800 2,600 2,400 2,200 2,000 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 20

Dental Visits per Dental Provider FTE 2,700 2,500 2,300 2,100 1,900 1,700 1,500 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 21

Median Growth Rates – Patients 14% 13% 12% 10% 8% 7% 7% 6% 5% 5% 5% 4% 4% 3% 3% 3% 3% 2% 1% 0% 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 22

Median Growth Rates – Visits 16% 14% 14% 12% 10% 10% 9% 9% 8% 7% 7% 7% 6% 6% 6% 5% 5% 5% 4% 2% 0% 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 23

CCALAC Growth Rates by Service Line 2015-2018 Median Health Center 25% 23% 20% 15% 12% 12% 10% 10% 5% 5% 5% 0% Medical Medical Visit Dental Patient Dental Visit Mental Health Mental Health Patient Growth Rate Growth Rate Growth Rate Patient Visit Growth Growth Rate Growth Rate Rate  2019 Capital Link www.caplink.org 24

CCALAC Median Health Center: Service Mix by Year 4% 3% 3% 4% 100% 4% 4% 4% 5% 8% 6% 10% 13% 80% 60% 77% 40% 79% 77% 75% 20% 0% 2015 2016 2017 2018 Enabling Visits as a Percentage of Total Visits Mental Health Visits as a Percentage of Total Visits Dental Visits as a Percentage of Total Visits Medical Visits as a Percentage of Total Visits  2019 Capital Link www.caplink.org 25

CCALAC Patients per Payer as a Percent of Total Patients (Median Health Center) CCALAC Medi-Cal CCALAC Self-Pay/Uninsured 160% 60% 140% 50% 5% 120% 85% 86% 86% 40% 87% 100% 5% 81% 82% 3% 80% 30% 3% 3% 2% 60% 45% 20% 35% 40% 29% 27% 64% 64% 65% 24% 24% 60% 55% 10% 47% 20% 0% 0% 2013 2014 2015 2016 2017 2018 2013 2014 2015 2016 2017 2018 Medicaid Collections as Percentage of Total Collections Self-Pay Collections as Percentage of Total Collections Medicaid Patients as Percentage of Total Patients Self-Pay Patients as Percentage of Total Patients  2019 Capital Link www.caplink.org 26

Evolving Business Models

Transition from FFS to Value-Based Reimbursement  2019 Capital Link www.caplink.org 28

Transition from FFS to Value-Based Reimbursement *Capital Link Performance Benchmarking Toolkit  2019 Capital Link www.caplink.org 29

Medical Patients per Medical Provider FTE 1,000 950 900 850 800 750 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 30

Medical Team Productivity: Medical Patients per Medical Staff FTE 320 310 300 290 280 270 260 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 31

Cost per Patient $1,200 $1,075 $1,049 $959 $1,000 $940 $917 $887 $875 $873 $868 $851 $837 $801 $800 $600 $400 $200 $0 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 32

Cost per Visit $300 $242 $239 $250 $233 $230 $220 $219 $218 $208 $204 $204 $201 $193 $200 $150 $100 $50 $0 2015 2016 2017 2018 CCALAC CA FQHCs Median NATIONAL Median  2019 Capital Link www.caplink.org 33

CCALAC Medical Support Staff by Medical Provider Median Health Center  2019 Capital Link www.caplink.org 34

How Does Your Health Center Compare?

Performance Evaluation Profile (PEP)  2019 Capital Link www.caplink.org 36

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Resources http://caplink.org/california-clinics  2019 Capital Link www.caplink.org 42

Benchmarking is an Ongoing Process!!

Questions? Contact Us Susan Petrie Tony Skapinsky—CA Office Chief Operating Officer Project Consultant Tel: 617-988-2248 Tel: 805-544-2355 spetrie@caplink.org tskapinsky@caplink.org Jose Fonseca—CA Office Jonathan Chapman Associate Project Consultant Chief Project Officer Tel: 805-819-8909 Tel: 225-241-6855 jfonseca@caplink.org jchapman@caplink.org  2019 Capital Link www.caplink.org 44