Innovative Approaches to Using Data to Demonstrate Value: Measuring & Reporting Clinical, Operational, Financial Improvement Jonathan Chapman Director, CHC Advisory Services AACHC/CVN Annual Conference 2019 Capital Link February 11, 2019 www.caplink.org 1
Using Data to Demonstrate Value • “Value?” • Using existing data to better identify, address, and/or convey health center performance and value • “Demonstrate?” • Utilizing this data and ‘value’ in operational and planning efforts 2019 Capital Link www.caplink.org 2
Capital Link • Launched in 1995, nonprofit, HRSA national cooperative partner • Offices in CA, CO, FL, MA, MO, and WV • Over $1.1 billion in financing for over 230 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 3
Goal: Improved Access to High Quality Care AND Financial Sustainability Staffing Financial Productivity Operations Improved Access & Financial Sustainability Patient Utilization Satisfaction Clinical Outcomes 2019 Capital Link www.caplink.org 4
Preparing for Value-Based Healthcare "Everyone's talking about it, no one really knows how to do it — everyone thinks everyone else is doing it, so we all say we're doing it." Deb Gage, president and CEO of Medecision 2019 Capital Link www.caplink.org 5
Defining “Value” 2019 Capital Link www.caplink.org 6
“Value?” Noun 1. the regard that something is held to deserve; the importance, worth, or usefulness of something. 2. a person's principles or standards of behavior; one's judgment of what is important in life. synonyms: principles, ethics, moral synonyms: think highly of, have a high opinion of, hold in worth, usefulness, advantage, benefit, gain, profit code, morals, standards, code of evaluate, assess, estimate, appraise, price, put/set synonyms: synonyms: Verb high regard, rate highly, esteem, set (great) store behavior"society's values are passed on to us as , good, help, merit, helpfulness, avail;More a price on"his estate was valued at $345,000" 1.estimate the monetary worth of (something). by, put stock in, appreciate, respect; More children" 2.consider (someone or something) to be important or beneficial; have a high opinion of. "Value" is what the customer is buying 2019 Capital Link www.caplink.org 7
Defining Organizational Value 2019 Capital Link www.caplink.org 8
Medical Value Equation 2019 Capital Link www.caplink.org 9
Medical Value Equation • Healthy Outcomes • Patient and Provider Experiences • Timely, Comprehensive Service Options • Conscientious Budgeting and Operations 2019 Capital Link www.caplink.org 10
Quadruple Aim 2019 Capital Link www.caplink.org 11
Preparing for Value 2019 Capital Link www.caplink.org 12
Transition to Value-Based System 2019 Capital Link www.caplink.org 13
Transition to Value-Based System Value Based Transition 2019 Capital Link www.caplink.org 14
Transition to Value-Based System 2019 Capital Link www.caplink.org 15
Transition to Value-Based System - HRSA 2019 Capital Link www.caplink.org 16
Transition to Value-Based System - CMS 2019 Capital Link www.caplink.org 17
Calculating Value 2019 Capital Link www.caplink.org 18
What to Measure? 2019 Capital Link www.caplink.org 19
How to Measure? 2019 Capital Link www.caplink.org 20
Expectations? 2019 Capital Link www.caplink.org 21
Key Performance Metrics Metric Why This Is Important Measuring stick of your business model; margins typically small 1 Operating Margin but need to be positive Is performance dependent upon large capital grants and/or other 2 Bottom Line Margin sources of non-operating revenue? 3 Personnel-Related Expense Consumes 70-75% of budget; key driver of financial performance Financial management starts with collecting your money 4 Days Net Patient A/R efficiently 5 Days Cash on Hand Is there enough liquidity to keep operations running smoothly? 6 Physician Productivity (visits) Productivity is the basis for revenue generation 7 Mid-Level Productivity (visits) Productivity is the basis for revenue generation 8 Dental Provider Productivity (visits) Productivity is the basis for revenue generation *Capital Link Performance Benchmarking Toolkit 2019 Capital Link www.caplink.org 22
Operating Margins - Medians 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark 2019 Capital Link www.caplink.org 23
Personnel-Related Expense as a Percent of Operating Revenue - Medians 73.00% 72.00% 71.00% 70.00% 69.00% 68.00% 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark 2019 Capital Link www.caplink.org 24
Days Cash on Hand - Medians 70 60 50 40 30 20 10 0 2014 2015 2016 2017 Arizona FQHC US FQHC Benchmark 2019 Capital Link www.caplink.org 25
Physician Visits per Physician FTE - Medians 4,000 3,500 3,000 2,500 2,000 2014 2015 2016 2017 Arizona FQHC US FQHC 2019 Capital Link www.caplink.org 26
Mid-Level Visits per Mid-Level FTE - Medians 4,000 3,500 3,000 2,500 2,000 2014 2015 2016 2017 Arizona FQHC US FQHC 2019 Capital Link www.caplink.org 27
Key Performance Metrics Metric Why This Is Important Medical Provider Productivity (patients) Becomes more important in transition to team-based care 9 Medical Team Productivity 10 Who are your teams? How do they perform? Cost (Revenue) Per Visit 11 How are your visit costs changing over time? Cost (Revenue) per Patient 12 With the move to PCMH, how are patient costs changing? 13 Medical Support Staff Ratio How strategic is the staffing of the medical teams? 14 Non-Clinical Staff Ratio Non-clinical employees are not revenue drivers 15 Visit/Patient Growth Rates Are visits growing faster than patients? Is demand growing? * Capital Link Performance Benchmarking Toolkit 2019 Capital Link www.caplink.org 28
Total Patients per Provider FTE - Medians 950 900 850 800 750 700 650 600 550 500 2014 2015 2016 2017 Arizona - Total Patients per Provider FTE US - Total Patients per Provider FTE 2019 Capital Link www.caplink.org 29
Total Unduplicated Patients per Total FTE - Medians 135 130 125 120 115 110 105 100 2014 2015 2016 2017 Arizona - Total Unduplicated Patients per Total FTE US - Total Unduplicated Patients per Total FTE 2019 Capital Link www.caplink.org 30
Organizational Productivity per FTE - Medians 1000 800 600 400 200 0 2014 2015 2016 2017 Arizona - Total Unduplicated Patients per Total FTE Arizona - Total Patients per Provider FTE US - Total Unduplicated Patients per Total FTE US - Total Patients per Provider FTE 2019 Capital Link www.caplink.org 31
Operating Revenue & Expense per Patient - Medians $1,000 $950 $900 $850 $800 $750 $700 2014 2015 2016 2017 Arizona - Operating Revenue per Patient Arizona - Operating Expense per Patient US - Operating Revenue Per Patient US - Operating Expense Per Patient 2019 Capital Link www.caplink.org 32
AZ Operating Revenue & Expense per Patient - Percentiles AZ FQHC Revenue / Patient AZ FQHC Expense / Patient 2019 Capital Link www.caplink.org 33
Medical Services Cost per Patient - Medians Arizona Arizona Median 2019 Capital Link www.caplink.org 34
Percentage of Patients 18+ with BMI And Follow Up Documented – Percentiles Arizona FQHC, UDS 2019 Capital Link www.caplink.org 35
Conveying Value 2019 Capital Link www.caplink.org 36
Conveying Organizational Value • Dashboards – Recognize Representation, Audience, etc • Celebrate through Organizational Alignment and Actions • Create and/or Acknowledge Traditions • Engagement – Social Media, Virtual Meetings, Visual, Share All Successes • Connect – Meetings, Talk, Deliberate Encouragement • Have Fun with It – Puns, Anniversaries, Contests • Lead by Example • Establish a Champion Accountable to Oversee/Coordinate 2019 Capital Link www.caplink.org 37
Basic Visuals 2019 Capital Link www.caplink.org 38
HRSA’s Emphasis 2019 Capital Link www.caplink.org 39
HRSA’s Press Releases 2019 Capital Link www.caplink.org 40
HRSA’s Messaging 2019 Capital Link www.caplink.org 41
Previous Economic Impact Report 2019 Capital Link www.caplink.org 42
Recent Value & Impact Report 2019 Capital Link www.caplink.org 43
Recent Value & Impact Report 2019 Capital Link www.caplink.org 44
Anticipated Value & Impact Report 2019 Capital Link www.caplink.org 45
Anticipated Value & Impact Report 2019 Capital Link www.caplink.org 46
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