health center strongcouncilbackup.flywheelsites.com/wp...hch...trends.pdf · through health center...
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![Page 1: Health Center Strongcouncilbackup.flywheelsites.com/wp...hch...trends.pdf · Through Health Center Performance and Growth Trends. ã2017 Capital Link 2 Capital Link -Overview •Launched](https://reader033.vdocuments.mx/reader033/viewer/2022060421/5f182fb586af9e56fd310283/html5/thumbnails/1.jpg)
ã 2017CapitalLink 1www.caplink.org
JonathanChapmanDirector,CHCAdvisoryServicesNHCHCFallTrainingSymposium
October4,2017
HealthCenterStrong:DemonstratingHealthCarefortheHomelessValueThroughHealthCenterPerformanceandGrowthTrends
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ã 2017CapitalLink 2www.caplink.org
CapitalLink- Overview• Launchedin1995,nonprofit,HRSAnationalcooperativeagreementpartner
• OfficesinCA,CO,MA,ME,MO,SCandWV
• Over$1.1billioninfinancingforover225capitalprojects- Directassistance tohealthcentersandcomplementarynonprofitorganizationsinplanningforandfinancingoperationalgrowthandcapitalneeds
- Industryvisionandleadership inthedevelopmentofstrategiesfororganizational,facilities,operationalandfinancialimprovements
- Metricsandanalyticalservices formeasuringhealthcenterimpact,evaluatingfinancialandoperatingtrendsandpromotingperformanceimprovement
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ã 2017CapitalLink 3www.caplink.org
WhatDoesSuccessLookLike?
TimeandResourcestoPlan
ProductiveTeams
ImprovedandStableOperations
StaffandPatientSatisfaction
ImprovedPatientOutcomes
FinancialSustainability
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ã 2017CapitalLink 4www.caplink.org
WhatDoesSuccessLookLike?
Youcan’tmanagewhatyoudon’tknowand…Youcan’tknowwhatyoudon’tmeasure
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ã 2017CapitalLink 5www.caplink.org
KeyPerformanceMetricsMetric WhyThisIsImportant
1 OperatingMargin Measuringstickofyourbusinessmodel;marginstypicallysmallbutneedtobepositive
2 BottomLineMargin Isperformancedependentuponlargecapitalgrantsand/orothersourcesofnon-operatingrevenue?
3 Personnel-RelatedExpense Consumes70-75%ofbudget;keydriveroffinancialperformance
4 DaysNetPatientA/R Financialmanagementstartswithcollectingyourmoneyefficiently
5 DaysCashonHand Isthereenoughliquiditytokeepoperationsrunningsmoothly?
6 PhysicianProductivity(visits) Productivityisthebasisforrevenuegeneration
7 Mid-LevelProductivity(visits) Productivityisthebasisforrevenuegeneration
8 DentalProviderProductivity(visits) Productivityisthebasisforrevenuegeneration
*CapitalLinkPerformanceBenchmarkingToolkit
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ã 2017CapitalLink 6www.caplink.org
TTBEAM!
AssessingPerformance
• TRACK
• TREND
• BENCHMARK
• EVALUATE
• ACT
• MONITOR
Revise
Reward
Review
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ã 2017CapitalLink 7www.caplink.org
HRSA– SponsoredHighPerformersStudy
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ã 2017CapitalLink 8www.caplink.org
HRSA-SupportedHighPerformanceStudy:Purpose
Seektoshedlighton2keyquestions:
1. Dohealthcentersthatexcelinprovidinghighqualitypatientcaredobetterorworsethanotherhealthcentersfinancially?
2. Whatdohealthcentersthatachievehighqualityandthestrongestfinancialresultslooklike?Whatdotheydodifferently/betterthantheirpeers?
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ã 2017CapitalLink 9www.caplink.org
HRSA-SupportedHighPerformanceStudy:AnalyticApproach
• WestudiedacohortofHRSA2014QualityLeaderAwardees- 180healthcentersforwhichwehave4yearsofaudits
• ControlGroup:HealthcentersthatdidnotreceiveaQualityLeaderaward- 360healthcentersforwhichwehave4yearsofaudits
• Studytimeperiod:2010- 2013
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ã 2017CapitalLink 10www.caplink.org
Similarities/DifferencesintheDataSet
• Patients• Urban/rurallocation• Medicaidexpansionstate(ornot)• Budgetsizeandregionallocation
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ã 2017CapitalLink 11www.caplink.org
Similarities/DifferencesintheDataSet
• SizeandLocation
$0
$5
$10
$15
$20
$25
$30
$35
2010 2011 2012 2013
Millions
TotalOperatingRevenue
QualityAwardees(75th)
QualityAwardees(Median)
QualityAwardees(25th)
Control(75th)
Control(Median)
QualityAwardeesmorelikelytobefromNortheast(HRSARegions1&2)andlesslikelytobefromtheSoutheast(Region4)orSouthwest(Region6)
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ã 2017CapitalLink 12www.caplink.org
TotalOperatingRevenue
$0
$5,000,000
$10,000,000
$15,000,000
$20,000,000
$25,000,000
$30,000,000
$35,000,000
$40,000,000
2012 2013 2014
HighPerformers75th
HighPerformersMedian
HighPerformers25th
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ã 2017CapitalLink 13www.caplink.org
Data
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ã 2017CapitalLink 14www.caplink.org
OverallFinding
Clinicalqualityandstrongfinancialperformancegohandinhand!
QualityAwardeesperformbetteronkeyfinancialratios!!
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ã 2017CapitalLink 15www.caplink.org
OperatingMargin
0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 8.0% 9.0%
2012 2013 2014 2015 2016
HCHGrantees- Median
NationalMedian
HighPerformersMedian
BenchmarkMedian
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ã 2017CapitalLink 16www.caplink.org
DaysCashonHand
0
25
50
75
100
125
150
2012 2013 2014 2015 2016
HCHGrantees- Median
NationalMedian
HighPerformersMedian
BenchmarkMin
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ã 2017CapitalLink 17www.caplink.org
Personnel-RelatedExpensesAsPercentofOperatingRevenue
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
2012 2013 2014 2015 2016
HCHGrantees- Median
NationalMedian
HighPerformersMedian
BenchmarkMax
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ã 2017CapitalLink 18www.caplink.org
DaysinNetPatientReceivables
0
10
20
30
40
50
60
70
2012 2013 2014 2015 2016
HCHGrantees- Median
NationalMedian
HighPerformersMedian
BenchmarkMax
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ã 2017CapitalLink 19www.caplink.org
HCHGrantees-OperatingRevenue&ExpensePerPatient
2016NationalMedians:Revenue$904;Expense$842
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ã 2017CapitalLink 20www.caplink.org
2016NationalMedians:Revenue$230;Expense$214
HCHGrantees-OperatingRevenue&ExpensePerVisit
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ã 2017CapitalLink 21www.caplink.org
330GrantDollarsperUninsuredPatient
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
2013 2014 2015
HCHGrantee75%
National75%
HCHGranteeMedian
NationalMedian
HCHGrantee25%
National25%
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ã 2017CapitalLink 22www.caplink.org
Information
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ã 2017CapitalLink 23www.caplink.org
QualityAwardeesAchieveStrongerOverallResults,Despite…
• Proportionallylessgrantfunding
• Slightlylessfavorablepayermix
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ã 2017CapitalLink 24www.caplink.org
HowDoQualityAwardeesAchieveStrongerOverallResults?
• Slightlydifferentserviceandstaffingmix• Bettercollections• Higherutilization• Higherproductivity
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ã 2017CapitalLink 25www.caplink.org
PayerMix:PatientsperPayerasaPercentageofTotalPatients
0%
10%
20%
30%
40%
50%
60%
2013 2014 2015 2016
HCHGranteeMedianMedicare
HCHGranteeMedianMedicaid
HCHGranteeMedianPrivate
HCHGranteeMedianSelf-Pay
NationalMedianMedicare
NationalMedianMedicaid
NationalMedianPrivate
NationalMedianSelf-Pay
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ã 2017CapitalLink 26www.caplink.org
PayerMix:CollectionsperPayerasaPercentofTotalCollections
0% 10% 20% 30% 40% 50% 60% 70% 80%
2013 2014 2015 2016
HCHGranteeMedianMedicare
HCHGranteeMedianMedicaid
HCHGranteeMedianPrivate
HCHGranteeMedianSelf-Pay
NationalMedianMedicare
NationalMedianMedicaid
NationalMedianPrivate
NationalMedianSelf-Pay
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ã 2017CapitalLink 27www.caplink.org
HCHGrantees- MedianGrowth
2016NationalMedian:Patients5.0%;Visits6.9%
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ã 2017CapitalLink 28www.caplink.org
PhysicianVisitsperPhysicianFTE
2,500
2,750
3,000
3,250
3,500
3,750
2012 2013 2014 2015 2016
HCHGranteeMedian
NationalMedian
HighPerformersMedian
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ã 2017CapitalLink 29www.caplink.org
Mid-LevelVisitsperMid-LevelFTE
2,000
2,250
2,500
2,750
3,000
3,250
3,500
2012 2013 2014 2015 2016
HCHGranteeMedian
NationalMedian
HighPerformersMedian
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ã 2017CapitalLink 30www.caplink.org
Knowledge
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ã 2017CapitalLink 31www.caplink.org
OtherDistinguishingCharacteristics-HighPerformers
• Evenhigherutilization
• Higherproportionofenablingservicesandstaff
• Newerfacilities
• Lowermid-leveltophysicianratio
• Heavierpediatricfocus
• Longeraveragetenureofmanagementstaff
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ã 2017CapitalLink 32www.caplink.org
Conclusions
• QualityAwardeesappeartobestrongerfinanciallyprimarilydueto:- Revenuemaximization- Positiveengagementwithpatients,whichdriveshigherutilization
- Productiveteams
• HighPerformersaregoodatalltheaboveANDarestrongoncostcontrol(particularlystaffingcosts)
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ã 2017CapitalLink 33www.caplink.org
DistinguishingCharacteristics–HCHGrantees
• HCHGranteeMedianisprimarilyfollowingNationalmediantrendsalthoughdoingbetterinDaysinA/R
• Havereversed2013outcomesandnowrevenuesexceedexpensesonbothpatientsandvisits
• MediansrelyonMedicaidmorethanNational
• SimilardownwardtrendasNationalinproviderproductivity
• Positivegrowthtrendswithvisitshavingagreaterincreasethanpatients
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ã 2017CapitalLink 34www.caplink.org
PerformanceEvaluationProfiles(PEP)
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ã 2017CapitalLink 35www.caplink.org
Value&ImpactofHealthCenters
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ã 2017CapitalLink 36www.caplink.org
WhatDoesSuccessLookLike?
TimeandResourcestoPlan
ProductiveTeams
ImprovedandStableOperations
StaffandPatientSatisfaction
ImprovedPatientOutcomes
FinancialSustainability
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ã 2017CapitalLink 37www.caplink.org
Wisdom