COO Report to the Board For Reporting Month - March 2020 May 08, - PowerPoint PPT Presentation

COO Report to the Board For Reporting Month - March 2020 May 08, 2020

Patient Revenue Enhancement Strategy: Update 2

Patient Revenue Enhancement Strategy: Update * Ambulatory revenue impact assumes that 25% of volume are non-billable visits Initiative Strategy/ Update Vol Var $ Var YTD Issues Trend YTD • Optometry: 2 UC Berkeley Optometry started one lane in (1,280) ($148,464) * Optometry students no longer at January w/ improvement in volumes Wellness Centers, which has additional • Are pursing additional FTE in FY 21 contracting. reduced clinical capacity. clinic days at EWC Primary Care • Tactics include overbooking, group visit, (15,328) ($1,816,590) * Physician recruitment at Clinic: 3% accepting walk in visit Eastmont Wellness has been • Peds/Adult med/Family Med adding extra slot challenging but continues. Volume each AM session effective 11/15 increase • Provider-level productivity improved and close to targets since December • Labor & Actively working with community clinics in (164) ($856,653) Will not meet established target efforts to increase CHCN referrals/ patients for the year. Looking at need to Deliveries: 200 • Lifelong – Other clinical rotations desired re-structure some clinics and new births (Medical specialties); Recommend urging services based on patient Obstetric referrals as part of MOU need/demand • Provided prenatal and lactation consultant capabilities • Provided updated FBC brochures/fact sheets • OP Women Provider templates to include 2 additional (7,797) ($1,156,470) * Plan to right-size clinical Services: 5% visits/ day- implemented August capacity in FY21 to meet • New templates with 2 additional visits/day and patient demand. Using volume open-access principles implemented February utilization data pre-COVID. increase 17th • Working with Alameda Alliance to outreach to members requiring Pap Smear/ Cervical screenings — 10k letters sent • LEAN office involved to help with daily huddles; provider engagement • SLH Med-Surg Continue to partner with the System Admission (692) ($1,236,935) With COVID-19 pandemic, 3 Transfer Center (ATC) to facilitate transfers from elective surgeries were cancelled Days: 5 Highland and census decreased. Will be additional ADC difficult to meet year-end

Patient Revenue Enhancement Strategy: Update Initiative Strategy/ Update Var $ Var YTD Issues Trend YTD HGH IOP Leverage operational resources between HGH and 3.10 $262,757 FMT campuses and decrease of 2 therapist FTE by Complete year end. One of the 2 FTEs has been transitioned out. BHS Contract: 1 Received confirmation from Alameda County that payment will be made in January, 2020. time payment Complete to BHCS EPIC Charge Charge capture will be realized in the last quarter of Working with Epic to improve FY 20. charge capture and revenue Capture: 2% Daily HB & PB calls tracking revenue capture activity collection. 93% of hospital billing improvement and addressing work queues real time. submitted within 3 days of Hiring EPIC consultant to assist in finding solution for service. charge issues in EPIC. 4

Population Health - Financials Stated in $000's March, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 1,213 1,398 184 13.2% 10,277 12,444 2,167 17.4% Registry 129 34 (96) (283.2)% 2,302 299 (2,003) (669.4)% Purchased services 190 327 137 42.0% 2,457 2,946 489 16.6% Medical Supplies 0 0 (0) (4359.0)% 2 0 (2) (2365.4)% Materials and supplies 44 9 (34) (364.3)% 345 85 (260) (307.3)% Outside medical services 1,046 351 (695) (197.7)% 4,844 3,162 (1,682) (53.2)% General & administrative expenses 32 17 (16) (93.7)% 585 149 (436) (292.4)% Total operating expense 2,655 2,136 (518) (24.3)% 20,818 19,088 (1,730) (9.1)% - - - - FTEs 116 132 15 11.5 % 118 132 13 10.1 % SYS Adjusted Patient Days 24,774 28,532 (3,758) (13.2)% 237,126 245,037 (7,911) (3.2)% FTEs / SYS Adj Occupied Bed 0.15 0.14 0.00 1.9% 0.14 0.15 (0.01) (7.1)% Expense / SYS Adj Patient Day $ 107.16 $ 74.88 $ 32.28 43.1% $ 87.79 $ 77.90 $ 9.90 12.7% ACTIONS • Catch up with past invoicing dating back to 2017 for Royal Ambulance increased costs in Outside Medical Services • Patient Financial Services has instituted changes in claims processing to help realize better UCSF payments associated with timely claims. 5

Provider Delivery - Financials Stated in $000's March, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 4,226 4,386 160 3.6% 34,727 37,955 3,228 8.5% Registry 20 1 (19) (1691.5)% 224 10 (215) (2177.9)% Employee benefits 341 379 37 9.9% 2,823 3,186 363 11.4% Contracted physician services 6,090 6,353 263 4.1% 56,614 57,180 566 1.0% Purchased services 278 429 151 35.2% 2,330 3,860 1,529 39.6% Materials and supplies 108 77 (31) (40.0)% 670 696 26 3.7% General & administrative expenses 132 242 111 45.7% 1,894 2,179 285 13.1% Total operating expense 11,195 11,868 672 5.7% 99,285 105,068 5,784 5.5% - - - - FTEs 287 315 28 8.9 % 278 311 34 10.8 % Worked RVUs (wRVU) 75,386 83,573 (8,187) (9.8)% 714,126 752,158 (38,032) (5.1)% wRUVs/ Physician FTE 263 265 (291) (1) 2,572 2,415 (1,128) (0) Expense / wRVU $ 148.51 $ 142.00 $ 6.51 4.6% $ 139.03 $ 139.69 $ (0.66) (0.5)% ACTION • Provider Delivery remains favorable to budget as many newly hired MDs have start dates in FY21. Continue working to optimize professional billing and charge capture to reflect accurate wRVU. 6

Ambulatory Care – Volumes ACTIONS • Ambulatory leadership is pushing the adoption of telephone and video visits to provide patient care during COVID, and are looking at provider utilization and access on a weekly basis. 7

Ambulatory Care – Financials Stated in $000's March, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 4,160 4,491 331 7.4% 37,486 38,984 1,497 3.8% Registry 62 10 (52) (510.5)% 978 90 (888) (992.4)% Purchased services 77 114 36 32.0% 1,019 1,024 5 0.5% Pharmaceuticals 147 106 (41) (38.2)% 870 911 41 4.5% Medical Supplies 246 269 23 8.5% 1,871 2,338 467 20.0% Materials and supplies 44 72 28 38.3% 431 648 218 33.6% General & administrative expenses 4 17 13 74.5% 66 154 88 57.2% Repairs/maintenance/utilities 24 33 8 25.7% 236 306 70 22.8% Building/equipment leases & rentals 192 195 3 1.4% 2,143 1,752 (391) (22.3)% Depreciation 66 81 15 18.3% 603 729 126 17.3% Total operating expense 5,027 5,391 364 6.8% 45,731 46,963 1,232 2.6% - - - - FTEs 479 537 59 10.9% 493 523 30 5.7% Clinic Visits 21,737 28,212 (6,475) (23.0)% 220,157 240,226 (20,069) (8.4)% FTES / Clinic Visit 2.20 1.91 0.30 15.6% 2.02 1.96 0.06 2.9% Expense / Clinic Visit $ 231.26 $ 191.10 $ 40.16 21.0% $ 207.72 $ 195.49 $ 12.23 6.3% ACTIONS • Active recruitment of Primary Care providers for EWC. (Currently, 4 provider vacancies with their equivalent support staff.) • Registry use to backfill a Practice Manager on leave. 8

Acute Care – Volumes March BUDGET # VAR % VAR YTD BUDGET # VAR % VAR PYTD % Var DISCHARGES 1,188 1,299 (111) (9)% 11,370 11,746 (376) (3)% 11,142 2 % ALAMEDA 216 219 (3) (1)% 1,960 1,748 212 12 % 1,978 (1)% HIGHLAND 755 842 (87) (10)% 7,373 7,977 (604) (8)% 7,209 2 % SAN LEANDRO 217 238 (21) (9)% 2,037 2,021 16 1 % 1,955 4 % AVERAGE DAILY CENSUS 185.9 233.9 (48.0) (21)% 204.2 216.5 (12.3) (6)% 220.6 (16)% ALAMEDA 28.0 38.4 (10.4) (27)% 31.0 32.2 (1.2) (4)% 34.1 (18)% HIGHLAND 130.3 154.4 (24.1) (16)% 144.5 151.3 (6.8) (4)% 157.0 (17)% SAN LEANDRO 27.7 41.2 (13.5) (33)% 28.8 33.1 (4.3) (13)% 29.5 (6)% Average Length of Stay 4.9 5.6 (0.7) (13)% 4.9 5.1 (0.2) (4)% 5.4 (9)% ALAMEDA 4.0 5.4 (1.4) (26)% 4.3 5.1 (0.8) (16)% 4.7 (15)% HIGHLAND 5.4 5.7 (0.3) (5)% 5.4 5.2 0.2 4 % 6.0 (10)% SAN LEANDRO 4.0 5.4 (1.4) (26)% 3.9 4.5 (0.6) (13)% 4.2 (5)% Case Mix Index ALAMEDA 1.354 1.347 0.007 1.320 1.347 (0.027) 1.347 HIGHLAND 1.516 1.432 0.084 1.438 1.432 0.006 1.432 SAN LEANDRO 1.486 1.657 (0.171) 1.471 1.657 (0.186) 1.657 Occupancy 62% 78% (16)% 68% 72% (4)% 74% ACTIONS • Overall, patient activity trended downward in the month due to COVID-19 pandemic, and will continue to be below budget in the next several months. Management will track and flex staff down as needed • Created a PIT model (provider in triage) in the ED to increase patient flow and reduce LWBS (SLH). • Continue collaboration with S-ATC to increase transfers from HGH ED to SLH when appropriate 9