COO Report to the Board November 2018 Population Health Stated in - PowerPoint PPT Presentation

COO Report to the Board November 2018

Population Health Stated in $000's November, 2018 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 1,051 1,056 (5) (0.5)% 5,220 5,320 (101) (1.9)% Registry 133 122 11 9.1% 712 621 91 14.7% Employee benefits - - - 0.0% - - - 0.0% Contracted physician services - - - 0.0% - - - 0.0% Professional Services - - - 0.0% - - - 0.0% Purchased services 379 306 73 23.9% 1,270 1,529 (259) (16.9)% Pharmaceuticals - - - 0.0% - - - 0.0% Medical Supplies 0 - 0 100.0% 0 - 0 100.0% Materials and supplies 11 6 5 79.6% 43 36 7 17.9% Outside medical services 383 374 10 2.6% 1,881 1,907 (26) (1.4)% General & administrative expenses 14 23 (10) (42.1)% 64 117 (54) (45.9)% Repairs/maintenance/utilities - - - 0.0% - - - 0.0% Building/equipment leases & rentals - - - 0.0% 14 - 14 100.0% Depreciation 0 0 0 578.0% 1 0 1 578.0% Total operating expense 1,971 1,887 84 4.5% 9,204 9,531 (327) (3.4)% FTEs 109 117 (7) (6.2)% 108 116 (8) (6.7)% SYS Adjusted Patient Days 30,153 29,330 823 2.8% 155,163 150,221 4,942 3.3% FTEs / SYS Adj Occupied Bed 0.11 0.12 (0.01) (8.7)% 0.11 0.12 (0.01) (9.7)% Expense / SYS Adj Patient Day $ 65.38 $ 64.34 $ 1.03 1.6% $ 59.32 $ 63.45 $ (4.13) (6.5)% *Excludes Benefits Expenses ACTIONS • Continue recruitment for 1.0 FTE Interim Nurse Manager at Highland and 1.0 FTE at Alameda/ San Leandro for Care Management. A new Social Work manager for Highland started in November. • Two contractors for utilization management (Social Work and Registered Nurse) started in early December for a 90 day period to help with throughput in Highland. 2

Provider Delivery Stated in $000's November, 2018 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 3,271 4,096 (825) (20.1)% 16,861 20,546 (3,686) (17.9)% Registry 19 3 16 488.4% 21 16 5 28.7% Employee benefits - - - 0.0% - - - 0.0% Contracted physician services 6,678 6,290 388 6.2% 33,760 32,932 828 2.5% Professional Services - - - 0.0% - - - 0.0% Purchased services 214 402 (188) (46.7)% 1,200 2,011 (811) (40.3)% Pharmaceuticals - - - 0.0% - - - 0.0% Medical Supplies 0 0 0 62.9% 1 1 1 90.8% Materials and supplies 75 56 18 32.4% 388 321 67 20.9% Outside medical services - - - 0.0% - - - 0.0% General & administrative expenses 210 199 11 5.4% 992 995 (3) (0.3)% Repairs/maintenance/utilities 0 0 0 7.5% 0 1 (1) (78.5)% Building/equipment leases & rentals - - - 0.0% - - - 0.0% Depreciation 0 0 (0) (38.7)% 0 0 (0) (39.4)% Total operating expense 10,467 11,047 (580) (5.2)% 53,222 56,822 (3,600) (6.3)% FTEs 283 317 (34) (10.7)% 278 311 (33) (10.6)% Worked RVUs (wRVU) 84,932 79,341 5,591 7.0% 424,960 396,705 28,255 7.1% Expense / wRVU $ 123.24 $ 139.23 $ (15.99) (11.5)% $ 125.24 $ 143.24 $ (18.00) (12.6)% *Excludes Benefits Expenses ACTIONS • Finance is reviewing and reconciling existing contracts and invoices to confirm alignment with contract terms. • Bi weekly meetings between finance and CMO to review/ follow up on all pending action items 3

Ambulatory Care – Volumes November BUDGET # VAR % VAR YTD BUDGET # VAR % VAR PRIMARY CARE SUMMARY Highland 6,463 7,222 (759) (11)% 35,230 37,741 (2,511) (7)% AH Primary Care 34 90 (56) (62)% 172 250 (78) (31)% Eastmont 3,284 3,461 (177) (5)% 18,561 18,097 464 3 % Hayward 2,967 2,920 47 2 % 16,482 15,260 1,222 8 % Newark 2,184 2,394 (210) (9)% 11,244 12,171 (927) (8)% Fairmont 56 98 (42) (43)% 315 508 (193) (38)% Total primary care 14,988 16,185 (1,197) (7)% 82,004 84,027 (2,023) (2)% SPECIALTY CARE SUMMARY Highland 7,109 7,421 (312) (4)% 38,492 39,149 (657) (2)% Alameda 1,047 908 139 15 % 5,546 4,872 674 14 % Eastmont 1,093 1,536 (443) (29)% 6,774 8,274 (1,500) (18)% Total specialty care 9,249 9,865 (616) (6)% 50,812 52,295 (1,483) (3)% Total visits 24,237 26,050 (1,813) (7)% 132,816 136,322 (3,506) (3)% ACTIONS • Highland K6 updated residency templates to increase # of appointments; no impact yet. • Eastmont Wellness hired SAN provider in December; currently going through credentialing. • Outreach being conducted in Newark and Eastmont Primary Care is supporting a positive trend • Expansion of specialty care: breast / neurosurgery / rheumatology in Hayward; ENT in Alameda; Ortho in HGH K7 Perform detail analysis on clinic volume by site by physician to uncover reasons for continue lower clinic visit volume. • 4

Ambulatory Care – Financials Stated in $000's November, 2018 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 3,966 4,470 (504) (11.3)% 20,151 22,058 (1,908) (8.6)% Registry 64 82 (18) (22.0)% 323 453 (130) (28.7)% Employee benefits - - - 0.0% - - - 0.0% Contracted physician services - 3 (3) (100.0)% - 15 (15) (100.0)% Professional Services - - - 0.0% - - - 0.0% Purchased services 152 194 (42) (21.8)% 913 972 (60) (6.1)% Pharmaceuticals 57 108 (51) (46.9)% 428 553 (126) (22.7)% Medical Supplies 256 248 7 3.0% 1,321 1,370 (49) (3.6)% Materials and supplies 59 60 (1) (1.9)% 336 301 35 11.5% Outside medical services - - - 0.0% - - - 0.0% General & administrative expenses 3 18 (15) (82.9)% 32 89 (57) (64.6)% Repairs/maintenance/utilities 32 38 (5) (14.6)% 212 188 24 12.9% Building/equipment leases & rentals 186 195 (9) (4.6)% 930 975 (46) (4.7)% Depreciation 79 81 (2) (2.8)% 417 405 12 2.9% Total operating expense 4,854 5,497 (643) (11.7)% 25,061 27,380 (2,319) (8.5)% FTEs 474 556 (82) (14.7)% 474 538 (64) (12.0)% Clinic Visits 24,237 26,050 (1,813) (7.0)% 132,816 136,322 (3,506) (2.6)% FTES / Clinic Visit 1.96 2.13 (0.18) (8.3)% 1.78 1.97 (0.19) (9.6)% Expense / Clinic Visit $ 200.28 $ 211.02 $ (10.74) (5.1)% $ 188.69 $ 200.85 $ (12.16) (6.1)% *Excludes Benefits Expenses ACTIONS • Overages in labor costs resulting from Modified Duty and Leave of Absence to be managed by holding vacant positions as well as managing non-payroll spend when appropriate. • Orthopedics & Podiatry considering consolidation of Podiatry across AHS campuses to improve operational performance and service effectiveness • Leadership team is finalizing interventions to support success in a number of additional pay-for-performance 5 metrics for PRIME, QIP and HPAC contract.

Acute Care – Volumes November BUDGET # VAR % VAR YTD BUDGET # VAR % VAR ACTIONS DISCHARGES 1,190 1,246 (56) (4)% 6,245 6,157 88 1 % Improving operations by reducing • ALAMEDA 207 188 19 10 % 1,018 940 78 8 % avoidable days with aggressive HIGHLAND 791 852 (61) (7)% 4,186 4,160 26 1 % patient placement is ongoing. SAN LEANDRO 192 206 (14) (7)% 1,041 1,057 (16) (2)% AVERAGE DAILY CENSUS 211.0 207.4 3.6 2 % 212.2 197.5 14.7 7 % • Increasing use of Interventional ALAMEDA 31.0 30.5 0.5 2 % 31.1 27.9 3.2 11 % Short Stay Unit for Cardiac HIGHLAND 155.5 141.2 14.3 10 % 153.2 140.5 12.7 9 % related Observation days SAN LEANDRO 24.5 35.7 (11.2) (31)% 27.9 29.1 (1.2) (4)% assigned to Medicine team is in Average Length of Stay 5.3 5.0 0.3 6 % 5.2 4.9 0.3 6 % process at Highland. ALAMEDA 4.5 4.9 (0.4) (8)% 4.7 4.5 0.2 4 % HIGHLAND 5.9 5.0 0.9 18 % 5.6 5.2 0.4 8 % • Capturing Inpatient Room & SAN LEANDRO 3.8 5.2 (1.4) (27)% 4.1 4.2 (0.1) (2)% Board charges for ED Boarders Occupancy 84% 83% 1 % 85% 79% 6 % with Admit Orders is in progress SURGERIES 716 735 (19) (3)% 3,756 3,848 (92) (2)% at Highland. ALAMEDA 166 169 (3) (2)% 924 912 12 1 % HIGHLAND 456 455 1 0 % 2,244 2,275 (31) (1)% • Formed multidisciplinary teams SAN LEANDRO 94 111 (17) (15)% 588 661 (73) (11)% including nurses, physician, and EMERGENCY VISITS 8,232 9,190 (958) (10)% 43,404 47,997 (4,593) (10)% managers to maximize efforts ALAMEDA 1,381 1,292 89 7 % 6,811 6,572 239 4 % and communication to address HIGHLAND 4,644 5,183 (539) (10)% 24,709 27,457 (2,748) (10)% SAN LEANDRO 2,207 2,715 (508) (19)% 11,884 13,968 (2,084) (15)% the throughput issues. IP ER 811 974 (163) (17)% 4,245 4,768 (523) (11)% • Congruent and collaborative ALAMEDA 152 159 (7) (4)% 693 771 (78) (10)% HIGHLAND 497 624 (127) (20)% 2,651 3,031 (380) (13)% system process being established SAN LEANDRO 162 191 (29) (15)% 901 966 (65) (7)% to optimize department billing OP ER 7,421 8,216 (795) (10)% 39,159 43,229 (4,070) (9)% ALAMEDA 1,229 1,133 96 8 % 6,118 5,801 317 5 % Standard work process to • HIGHLAND 4,147 4,559 (412) (9)% 22,058 24,426 (2,368) (10)% validate midnight census 6 SAN LEANDRO 2,045 2,524 (479) (19)% 10,983 13,002 (2,019) (16)% effectvie Feb 2019 DELIVERIES 103 116 (13) (11)% 570 584 (14) (2)%