survey to determine financial benchmarks

By Suzanne M. Adolphson, MSW, MHA

Director of Patient Care Services

Western University of Health Sciences

College of Dental Medicine

Survey To Determine

Financial Benchmarks

BACKGROUND Dental education has not yet developed a set of

benchmarks that evaluate relate to our financial

efficiency or our staffing ratios.

We often rely on established benchmarks that are from

a private dental practice, a large dental clinic or those

from medicine.

Data from private practice and medicine does not take

into account the specific nuances present in a dental

education setting.

Pre-doctoral students are often the slowest producers

working at the lowest fees.

SURVEY

Collected data from dental education facilities.

To establish useable benchmarks related to clinic

revenue.

To establish usable staffing ratios related to

clinical education.

To provide us with insight related to our unique

position in healthcare education.

Goals

SURVEY METHODOLOGY

The survey was awarded IRB exemption.

The 12 question survey was sent to the finance

directors/managers of 61 dental schools using Qualtrics

Survey Tool.

Qualtrics was used to ensure confidentiality of responses.

The survey collected data that is specific to pre-doctoral

dental (DDS/DMD) programs.

SURVEY METHODOLOGY (CONT.)

The data was complied and analyzed using simple

descriptive statistics.

Where applicable data was analyzed to determine any

statistical correlations that exist between the institution's

financial efficiency and the data related to clinic operations

and demographics.

SURVEY METHODOLOGY (CONT.) The survey collected data on categorical and numerical

variables.

Consisted of 12 questions.

7 questions related to clinic operations and demographics

1. Public system vs. private.

2. Number of pre-doctoral students admitted per class.

3. Number of chairs available for pre-doctoral students.

4. The number of full time staff or full time staff equivalents

dedicated to pre-doctoral clinical activities.

5. Patient appointments for the pre-doctoral students scheduled by the staff or students.

6. Submission of 3rd party claims using an electronic or paper format.

7. Payor mix of patient population.

SURVEY METHODOLOGY (CONT.)

Five areas of financial management:

1. % of production adjusted off

2. Average days in AR

3. % of AR over 90 days

4. % of AR over 120 days

5. Bad debt as an expense of % of net

revenue

DATA ANALYSIS

How many Schools responded to the survey and what

questions were answered?

• 61 Schools were solicited for information.

• 40 responded to at least one question, for a 66%

response rate.

• However, not all of the participants answered all of

the questions.

• Overall response rate 23 of the 61 Schools = 37%

response rate.

Questions Answered

40 of the 61 Schools answered at least one question = 66% response rate

Overall 23 of the 61 Schools answered all of the questions = 37% response

rate

TYPE OF SCHOOL

40 of the 61 Schools responded.

32.50% consider themselves private while

67.50% say public/state related.

SCHOOL TYPE

COMPARISON WITH FINANCIAL DATA

NUMBER OF PRE-DOCTORAL

STUDENTS

34 Schools responded

Average amount of students per School = 360.26

Ranges from 62 students to 1275 with the mean at 333

students.

NUMBER OF CHAIRS

27 Schools responded

Total chairs reported = 3615

Average number of chairs per School = 134

Number of clinical students per chair = 1.69** ** assumes ½ of the total students not in clinic

STAFFING • Number of staff

dedicated to pre-

doctoral students

•25 Schools

responded

• Total staff

reported 974.80

STAFF TYPE NUMBER AVERAGE PERCENT

DENTAL ASSISTANTS 265.70 10.63 27.3%

DISPENSARY STAFF 174.00 6.96 17.8%

FINANCIAL STAFF 215.30 8.61 22.1%

ADMINISTRATIVE/CLERICA

L

319.80 12.79 32.8%

STAFFING AVERAGES

AVERAGE NUMBER OF STAFF 9.75

AVERAGE NUMBER OF STUDENTS

PER STAFF

18.74

AVERAGE NUMBER OF CHAIRS PER

STAFF

13.74

STAFFING

DENTAL ASSISTANTS

DENTAL ASSISTANTS N=25

NUMBER OF DENTAL ASSISTANTS REPORTED 265.7

AVERAGE NUMBER OF DENTAL ASSISTANTS 10.63

AVERAGE NUMBER OF STUDENTS PER DENTAL

ASSISTANTS

16.94

AVERAGE NUMBER OF CHAIRS PER DENTAL ASSISTANTS 12.60

STAFFING

COMPARISON WITH FINANCIAL DATA

DENTAL ASSISTANTS (CONT.) AVERAGE = 10.63

STAFFING

DISPENSARY STAFF

DISPENSARY STAFF N=25

TOTAL NUMBER OF DISPENSARY STAFF 174

AVERAGE NUMBER OF DISPENSARY STAFF 6.96

AVERAGE NUMBER OF STUDENTS PER

DISPENSARY STAFF

25.08

AVERAGE NUMBER OF CHAIRS PER DISPENSARY

STAFF

19.25

STAFFING

COMPARISON WITH FINANCIAL DATA

DISPENSARY STAFF (CONT.) AVERAGE = 6.96

STAFFING

FINANCIAL STAFF

FINANCIAL STAFF N=25

TOTAL NUMBER OF FINANCIAL STAFF 215.3

AVERAGE NUMBER OF FINANCIAL STAFF 8.61

AVERAGE NUMBER OF STUDENTS PER FINANCIAL

STAFF

20.92

AVERAGE NUMBER OF CHAIRS PER FINANCIAL

STAFF

15.56

STAFFING

COMPARISON WITH FINANCIAL DATA

FINANCIAL STAFF (CONT.) AVERAGE = 8.61

STAFFING

ADMINISTRATIVE STAFF

ADMINISTRATIVE STAFF N=24

ADMINISTRATIVE STAFF REPORTED 319.8

AVERAGE NUMBER OF ADMINISTRATIVE STAFF 12.79

AVERAGE NUMBER OF STUDENTS PER ADMINISTRATIVE

STAFF

14.08

AVERAGE NUMBER OF CHAIRS PER ADMINISTRATIVE STAFF 10.47

Staffing

Comparison with Financial Data

Administrative Staff (cont.) Average = 12.79

PATIENT

APPOINTMENT SCHEDULING

BY POLICY, WHO SCHEDULES THE PATIENT

APPOINTMENTS? N=24

CLINIC STAFF 37.04%

PRE-DOCTORAL STUDENTS 14.81%

BOTH STUDENTS AND CLINIC STAFF 48.15%

Patient Appointment Scheduling

Comparison with Financial Data

3RD PARTY BILLING

HOW DO YOU MOST OFTEN SEND YOUR

THIRD PARTY CLAIMS?

ELECTRONIC 44%

PAPER 16%

BOTH ELECTRONIC AND PAPER 40%

3RD PARTY BILLING

COMPARISON WITH FINANCIAL DATA

FINANCIAL DATA

% OF PRODUCTION WRITTEN OFF (EXCLUDING BAD

DEBT)

% OF PROD. WRITTEN-

OFF

NUMBER OF

RESPONSES

PERCENT

0-15% 15 60%

16-20% 4 16%

21-30% 5 20%

31-50% 1 4%

+50% 0 0%

FINANCIAL DATA

SPECIFIC TO YOUR PRE-DOCTORAL CLINIC WHAT IS

YOUR AVERAGE DAYS IN AR

DAYS IN AR NUMBER OF

RESPONSES

PERCENT

0-30 DAYS 5 20%

31-45 DAYS 2 8%

46-60% DAYS 9 36%

+60 DAYS 9 36%

FINANCIAL DATA

SPECIFIC TO YOUR PRE-DOCTORAL CLINIC,

WHAT IS YOUR PERCENT OF AR AT 90 DAYS

% OF AR AT 90 DAYS NUMBER OF RESPONSES PERCENT

0-15% 13 54.17%

16-20% 2 8.33%

21-30% 5 20.83%

+30% 4 16.67%

FINANCIAL DATA

SPECIFIC TO YOUR PRE-DOCTORAL CLINIC

WHAT BEST REPRESENTS YOUR BAD DEBT

AS A PERCENT OF NET REVENUE

% OF BAD DEBT NUMBER OF RESPONSES PERCENT

0-5% 9 39.13%

4-6% 6 26.09%

7-9% 6 26.09%

+10% 2 8.70%

CONCLUSIONS

1. Related to Financial efficiency:

60% of the respondents adjust off 0-15% of production.

36% of the respondents find that their Average Days is AR

are at 60 days.

54.17% of the respondents report their percent of AR at 90

days is 15%.

30.13 % of the respondents report bad debt as a % of net

revenue is 0-3%

CONCLUSIONS

2. Related to Staff Information

Average number of staff = 9.75

Average number of student per staff = 18.74

Average number of chair per staff = 13.74

NEXT STEPS

More participation is needed to be able to use the data

effectively.

Revise survey that looks at the information based on the

entire School operation not just information related to pre-

doctoral students.

Revise survey to include patient encounters and provide

analysis that cross tabulates patient encounters with

financial information and staffing information.

Create a blog or website that allows for Schools to put their

input as to what questions might be asked.

QUESTIONS AND DISCUSSION