COO Report to the Board January 2020 Patient Revenue Enhancement - PowerPoint PPT Presentation

COO Report to the Board January 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 (862) ($99,981) * Projections based on starting 2 January w/ improvement in volumes lanes but during contracting in additional clinic October, final contract with UC days at EWC Berkeley only expands by 1 lane this year; discussions underway to add 2 nd lane for FY21 • Primary Care Tactics include overbooking, group visit, (11,043) ($1,308,756 * Several recent retirements with Clinic: 3% Volume accepting walk in visit Epic have created vacancies that • Peds/Adult med/Family Med adding extra are being actively recruited (esp. increase slot each AM session effective 11/15 Eastmont Wellness); offers made • Provider-level productivity improved and but not accepted, additional close to targets since December recruitment underway • Labor & Actively working with community clinics in (116) ($603,459) 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 (6,287) ($932,503) * Letters mailed out slowly in Services: 5% visits/ day- implemented August batches delaying patient calls. • New templates with 2 additional visits/day volume increase and open-access principles implemented February 17th • Working with Alameda Alliance to outreach to members requiring Pap Smear/ Cervical screenings — 10k letters sent 3 • LEAN office involved to help with daily huddles; provider engagement

Patient Revenue Enhancement Strategy: Update Initiative Strategy/ Update Var YTD $ Var YTD Issues Trend HGH IOP Leverage operational resources between HGH and FMT 1.60 $118,014 campuses and decrease of 2 therapist FTE by year end. One of the 2 FTEs has been transitioned out. BHS Contract: 1 Received confirmation from Alameda County that payment Completed. will be made in January, 2020. time payment to BHCS EPIC Charge Charge capture will be realized in the last quarter of FY 20. Prof Fee billing Daily HB & PB calls tracking revenue capture activity and reconciliation issue Capture: 2% addressing work queues real time. prohibit posting of Prof improvement Hiring EPIC consultant to assist in finding solution for charge Fee; issues in EPIC. Daily bed reconciliation for border patients. 4

Population Health Stated in $000's January, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 1,186 1,407 220 15.7% 7,913 9,734 1,821 18.7% Registry 144 34 (110) (326.6)% 1,970 234 (1,737) (742.4)% Purchased services 289 327 39 11.8% 2,106 2,291 186 8.1% Materials and supplies (10) 9 19 202.0% 253 66 (187) (283.6)% Outside medical services 440 351 (88) (25.2)% 3,468 2,459 (1,009) (41.0)% General & administrative expenses 132 17 (115) (694.5)% 526 116 (410) (353.9)% Repairs/maintenance/utilities - 0 0 100.0% 2 2 (0) (18.6)% Building/equipment leases & rentals - - - 0.0% - - - 0.0% Depreciation 0 0 (0) (313.0)% 1 0 (1) (350.8)% Total operating expense 2,181 2,145 (36) (1.7)% 16,241 14,902 (1,339) (9.0)% - - - - FTEs 115 132 16 12.4% 119 132 12 9.4% SYS Adjusted Patient Days 30,657 31,166 (509) (1.6)% 205,661 212,388 (6,727) (3.2)% FTEs / SYS Adj Occupied Bed 0.12 0.13 (0.02) (11.4)% 0.12 0.13 (0.01) (6.9)% Expense / SYS Adj Patient Day $ 71.14 $ 68.83 $ 2.31 3.4% $ 78.97 $ 70.17 $ 8.80 12.5% • Outside Medical Services cost drivers include high cost purchased clinical services from UCSF, CPMC required for HPAC and uninsured patients and delayed claims payments for Royal ambulance. ACTIONS • Patient Financial Services has instituted changes in claims processing to help realize better UCSF payments associated with timely claims. Additional staffing resources is expected to help catch up with past invoicing which will increase OMS expenses in short term. 5

Provider Delivery Stated in $000's January, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 4,230 4,338 108 2.5% 26,523 29,479 2,956 10.0% Registry 26 1 (25) (2249.7)% 189 8 (181) (2350.2)% Contracted physician services 6,092 6,353 261 4.1% 44,847 44,474 (373) (0.8)% Professional Services - - - 0.0% - - - 0.0% Purchased services 377 429 52 12.1% 1,863 3,002 1,139 37.9% Materials and supplies 130 77 (53) (68.3)% 487 541 54 10.0% Outside medical services - - - 0.0% - - - 0.0% General & administrative expenses 188 242 54 22.1% 1,556 1,695 139 8.2% Depreciation 0 0 0 38.6% 0 1 0 38.6% Total operating expense 11,044 11,441 397 3.5% 75,465 79,200 3,735 4.7% - - - - FTEs 293 313 20 6.3% 278 310 33 10.6% Worked RVUs (wRVU) 81,361 83,573 (2,213) (2.6)% 556,082 585,012 (28,930) (4.9)% wRUVs/ Physician FTE 278 267 10.68 4.0% 2,000 1,887 113.16 6.0% Expense / wRVU $ 135.74 $ 136.90 $ (1.16) (0.8)% $ 135.71 $ 135.38 $ 0.33 0.2% 6

Ambulatory Care – Volumes January BUDGET # VAR % VAR YTD BUDGET # VAR % VAR PYTD % Var PRIMARY CARE SUMMARY Highland 6,100 6,351 (251) (4)% 39,317 41,717 (2,400) (6)% 40,926 (4)% HGH Same Day Clinic 1,050 1,267 (217) (17)% 7,210 8,175 (965) (12)% 7,130 1 % AH Primary Care 0 0 - 0 % 176 294 (118) (40)% 300 (41)% Eastmont 3,027 4,339 (1,312) (30)% 22,290 28,204 (5,914) (21)% 25,726 (13)% Hayward 2,910 3,050 (140) (5)% 18,638 19,370 (732) (4)% 20,262 (8)% Newark 2,062 2,354 (292) (12)% 14,207 15,026 (819) (5)% 14,800 (4)% Fairmont 104 84 20 24 % 504 599 (95) (16)% 416 21 % Total primary care 15,253 17,445 (2,192) (13)% 102,342 113,385 (11,043) (10)% 109,560 (7)% SPECIALTY CARE SUMMARY Highland 7,386 7,548 (162) (2)% 53,190 52,198 992 2 % 54,118 (2)% Alameda 1,006 1,020 (14) (1)% 6,895 6,815 80 1 % 7,623 (10)% Hayward 426 434 (8) (2)% 2,605 2,766 (161) (6)% 2,536 3 % Newark 132 148 (16) (11)% 754 949 (195) (21)% 749 1 % Eastmont 1,387 1,657 (270) (16)% 8,818 10,920 (2,102) (19)% 9,281 (5)% Total specialty care 10,337 10,807 (470) (4)% 72,262 73,648 (1,386) (2)% 74,307 (3)% Total visits 25,590 28,252 (2,662) (9)% 174,604 187,033 (12,429) (7)% 183,867 (5)% ACTIONS • Same Day Clinic transition to Urgent Care beginning 3/17. • Adult and Pediatric templates have been increased to 10 appointments per session (AM and PM) across all sites. • Ambulatory leadership along with Women Services leadership is partnering with the STAR team to implement structural change at the Women’s Clinic. New templates w/ additional slots went into effect February 17 th ; will expect increased performance in February financials 7

Ambulatory Care – Financials Stated in $000's January, 2020 BUDGET $ Var % Var YTD BUDGET $ Var % Var Salaries and wages 4,083 4,437 353 8.0% 29,414 30,380 966 3.2% Registry 59 10 (49) (488.8)% 617 70 (547) (781.8)% Contracted physician services 3 3 - 0.0% 21 21 - 0.0% Purchased services 98 114 16 13.7% 794 797 3 0.4% Pharmaceuticals 47 106 59 55.6% 448 713 266 37.3% Medical Supplies 242 265 23 8.5% 1,471 1,825 354 19.4% Materials and supplies 40 72 32 43.9% 349 504 156 30.9% General & administrative expenses 12 17 5 27.1% 58 119 62 51.7% Repairs/maintenance/utilities 20 33 13 38.8% 141 236 96 40.5% Building/equipment leases & rentals 551 195 (356) (183.1)% 1,752 1,363 (389) (28.6)% Depreciation 40 81 41 50.3% 471 567 96 17.0% Total operating expense 5,198 5,332 134 2.5% 35,534 36,596 1,062 2.9% - - - - FTEs 484 529 45 836.0% 497 521 24 4.5% Clinic Visits 25,590 28,252 (2,662) (9.4)% 174,604 187,033 (12,429) (6.6)% FTES / Clinic Visit 1.89 1.87 0.02 1.0% 1.99 1.95 0.04 2.2% Expense / Clinic Visit $ 203.12 $ 188.74 $ 14.38 7.6% $ 203.51 $ 195.67 $ 7.85 4.0% NOTE: Variance in Building/Equipment/Leases/Rentals due to significant back-taxes paid for Hayward Wellness Center. ACTIONS Active recruitment of Primary Care providers for EWC. (Currently 4 vacancies) 8