Board Meeting October 8, 2018 LOCATION PHONE NUMBER WEBSITE - PowerPoint PPT Presentation

Board Meeting October 8, 2018 LOCATION PHONE NUMBER WEBSITE FACEBOOK 21 Municipal Drive +1 636 933 2700 www.comtrea.org https://www.facebook.com/COMTREA/ Arnold, M O 63010

OUR MISSION To lead in providing quality, comprehensive healthcare that is affordable and accessible, and to support the dedicated professionals who make caring for the individuals we serve their number one priority.

AGENDA 7:30 AM – Meeting Open CEO Report Approval of Agenda and Minutes Action Items CLOSED SESSION Discussion Items Financials Adjournment Program Highlight

APPROVAL OF AGENDA MOTION: “ I, ______, move that the Board approve the, October 8, 2018 Meeting Agenda.”

APPROVAL OF MEETING MINUTES MOTION: “ I, ______, move that the Board approve the September 10, 2018 Meeting Minutes.”

CLOSED SESSION BOARD MEMBERS ONLY

CLOSED SESSION MOTION: “I , ____________, move that the Board enter into closed session.” (All others must agree by Voice Vote)

CLOSED SESSION - AGENDA MOTION: “ I, __________, move that the Board approve the October 8, 2018 Closed Session Agenda,”

CLOSED SESSION – MEETING MINUTES MOTION: “I, ___________, move that the Board approve the September 10, 2018 Closed Meeting Minutes.”

CLOSED SESSION – ADJOURNMENT MOTION: “I, ___________, move that the Board adjourn from closed session and enter back into Open Session.” (All others must agree by Voice Vote)

CASH ON HAND $ 1,399,180.63 ACCOUNT RECIEVABLES MOTION: $ 3,139,813.11 “ As a member of the Finance Committee, I _________, move that the Board approve the financials for the month of FINANCIAL REPORT August, 2018.”

COMTREA PROGRAM HIGHLIGHT Population Health presented by Patty Vanek, VP Population Health Wha hat is P t is Popula opulation He tion Health? alth? Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population.

CEO REPORT  FINANCIAL FOCUS UPDATE  Financial Alignment Plan  Growth Report  STATE ASSOCIATIONS  DIVISIONAL UPDATES  HRSA  VOLUNTEERS

FINANICAL ALIGNMENT PLAN September Updates – Performance Monitoring September Updates 9/27/2018 A. Performance Monitoring 1 MORS a. Monthly for Primary Care, Oral Health & Behavioral August financial review at MORs completed on 9/24/18 with Leadership of the three divisions. Primary Care: Results as Health expected with month Aug. production at 68%. Contribution margin/Income of $(11,365) was facilitated with the one time annual payment of $42,500 for Meaningful Use. The removal of this 1x payment to assess the true impact of operational/clinical/financial performance is a loss of $(53,865). Focus and expectations on scheduling, access and provider location flexibility based on patient needs. Oral Health: Positive contribution margin with $3,860 and attainment of FY Q.1 2019 goals to breakeven. September performance has forecast of continued improvement based on the Growth Report. The plan that Dr. Garland developed back in April is unfolding as written. Behavioral Health (Psychiatry): Strong performance and CM above budget. b. Quarterly for all programs Scheduled each quarter - 10/22/18 2 C-Team Review (Weekly Review) Ongoing. a. Laser focus on top 3 contributing factors (direct, Primary Care Continued Focus: (1) Focus on clinical need with monitoring of chronic care conditions; (2) scheduled indirect, no control) appointments at 3 or 6 mos. Intervals for prescription refills; and (3) scheduling. b. Coordinated intervention and accountability Oversight and accountability with the Primary Care Medical Director. Oral Health and Behavioral Plan delivering per plan. c. Tighter timeframe for low performance and change Continued per the A-B-C Alignment Plan. 3 Corrective Action Plans a. Essential components include 3-5 interventions, Continued weekly calls with Primary Care Operations Manager, Weekly distribution of the Growth Report, 1:1 monthly time referenced and measurable, and monthly meeting with CEO and Medical Director and CEO on-sight presence. written updates with weekly phone/in-person check- ins b. Primary Care Plan A-B-C 30-day updates provided at 9/24/18 MORs. i. Performance review time frame is Q.1 2019 FY (9/30/18) ii. Next Steps in process c. Oral Health Plan A-B-C 30-day updates provided at 9/24/18 MORs. i. Performance review time frame is Q.1 2019 FY (9/30/18) ii. Next Steps in process d. Weekly update and monthly updated report Current on reporting back to CEO and C-Team with updates to the Finance Subcommittee of the Board and Executive Subcommittee of the Board.

FINANICAL ALIGNMENT PLAN September Updates B Data Review, Trends and Analysis 1 Enhanced Data Reporting a. Monthly Income Statement for revenue producing departments: Need for each Operations Manager to provide the total units of service (visits/encounters) to Amy for inclusion in the b. Units of Service (Visit) financials to obtain these additional performance indicators. Behavioral Health will be added to the Growth Report c. Revenue/Visit for October Reporting and this information will then be readily available. d. Cost/Visit 2 Monthly Financials - Inclusion of 12 Months Completed manually for August financial update with other priorities needing resources. Trending with move from manual to automated reporting. C Billing and Accounts Receivable 1 Claim Audits to review documentation Done monthly; no atypical trends identified. support for claims billed a. External: RMC with quarterly reports Training call with Psychiatry held on 9/21/18. b. Internal: Ongoing 2 A/R Billing Specialist (in the FY 2019 Budget) a. Identify what reports are available in the Re-organization of this role in process. EMR b. Dashboard design for reporting Timeframe to be scheduled. performance on key financial indicators 3 Credentialing Redesign a. Assess ROI for credentialing software The prior individual over Credentialing is no longer with COMTREA. We are in the process of hiring for this position and range of options and have an excellent candidate. b. Dashboard design to track credentialing To be developed. days for the top 5 payers

GROWTH REPORT – PRIMARY CARE SEPT # of Work Days 19.00 # DAYS 19 Net Rev Per Visit PC 162.00 Weekly GOALS MTD MONTH END FORECAST - PRIMARY CARE REVENUE & Net Patient Rev/Visit 110.00 101 BUDGET Schedule 86 Actual Actual THRU 9/28 PROJ PRIMARY CARE PROJ BUD VAR Schedul 10-Hr VISITS VISITS > ACT MTD GOAL % GOAL REV REV REV % VAR e 10-Hr Day Actual Day 8-Hr Day 87 Dr. Turner 0.38 38.4 9.6 32.7 8.2 6.5 87 124 70% 14,094 199 Dr. Helton 1.00 101.0 25.3 86.0 21.5 17.2 199 327 61% 32,238 172 Ashley Whitley 0.90 90.9 22.7 77.4 19.4 15.5 172 294 58% 27,864 288 Ashleigh McGrath 1.00 101.0 25.3 86.0 21.5 17.2 288 327 88% 46,656 141 Amanda Sherwood 0.75 75.8 18.9 64.5 16.1 12.9 141 245 58% 22,842 138 Dr. Hampton 0.50 50.5 12.6 43.0 10.8 8.6 138 163 84% 22,356 0 0.0 0.0 0.0 0.0 0.0 0 0 #DIV/0! 0 1,025 TOTALS 4.53 457.5 114.4 389.6 97.4 77.9 1,025 1,480 69% 166,050 249,227 -83,177 -33.37% Patient Revenue $112,750 85%

GROWTH REPORT – ORAL HEALTH / DENTIST Net Rev Per OH Visit 169.00 Weekly GOALS MONTH END FORECAST Net Patient Rev/Visit 150.00 75 Schedule 62 Actual Actual THRU 9/28 PROJ VISITS ORAL HEALTH VISITS FTE ACT MTD GOAL % GOAL PROJ REV Schedule 10 Hr Day Actual 10 Hr Day 8-Hr Day 0 Dr Suter 0.00 0.0 0.0 0.0 0.0 0.0 0 0 #DIV/0! 0 Dr. Garland 0.50 37.5 9.4 31.0 7.8 6.2 89 89 118 76% 15,041 Dr. Empkey 0.50 37.5 9.4 31.0 7.8 6.2 83 83 118 70% 14,027 Dr. Garrity 1.00 75.0 18.8 62.0 15.5 12.4 107 107 236 45% 18,083 Dr Blattel 0.25 18.8 4.7 15.5 3.9 3.1 33 33 59 56% 5,577 Dr. Landsford 1.00 75.0 18.8 62.0 15.5 12.4 133 133 236 56% 22,477 10 Dr. Mazuranic - PRN 0.00 0.0 0.0 0.0 0.0 0.0 10 0 #DIV/0! 1,690 Dr. Puisis 0.10 7.5 1.9 6.2 1.6 1.2 17 17 24 72% 2,873 6 Dr. Greaves - PRN 0.00 0.0 0.0 0.0 0.0 0.0 6 0 #DIV/0! 1,014 133 Dr. Emily 1.00 75.0 18.8 62.0 15.5 12.4 133 236 56% 22,477 137 Dr. Taylor 1.00 75.0 18.8 62.0 15.5 12.4 137 236 58% 23,153 114 Dr. Lorenz 0.75 56.3 14.1 46.5 11.6 9.3 114 177 65% 19,266 Dr. Darling 0.75 56.3 14.1 46.5 11.6 9.3 167 167 177 95% 28,223 Dr. Mazoli 0.75 56.3 14.1 46.5 11.6 9.3 130 130 177 74% 21,970 Dr. Shakhnovich 0.75 56.3 14.1 46.5 11.6 9.3 224 224 177 127% 37,856 169 Dr. Cook [8/13 1.0 FTE] 0.50 37.5 9.4 31.0 7.8 6.2 169 118 143% 28,561 1,552 TOTALS 8.85 663.8 165.9 548.7 137.2 109.7 1,552 2,085 74% 262,288 $232,800 Patient Revenue 83%