· 2019-08-19 · budgeting process – not so much fun • multiple linked spreadsheets by...

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Leveraging Data Warehouse in the Healthcare Industry


Session Objectives

• Learn about Data Warehouse at Lone Star Circle of Care (LSCC) and impacts on the healthcare industry

• More specifically Community Health Centers (FQHCs)


What is a Federally Qualified Health Center (FQHC)?

• Established to increase the availability of primary and preventive health care services for low-income people living in medically underserved areas (safety net provider)

• Qualifying funding under Section 330 of the Public Health Service Act (PHS)

• Health Centers make up about $26.3 billion in revenue (Medicaid, Medicare, private insurance, and Federal and State grants)

• 1,373 Health Centers nation wide (~11,000 physical sites)

• Number of patients served 27.2 million

https://youtu.be/g77MsIoY15I

https://youtu.be/g77MsIoY15I



• Check out NACHC for a local FQHC near you:

• http://www.nachc.org/about-nachc/state-affiliates/state-regional-pca-listing/

http://www.nachc.org/about-nachc/state-affiliates/state-regional-pca-listing/


Big Data in Healthcare

• Volume of healthcare data at 153 exabytes in 2013

• Projected growth rates to 2,314 exabytes by 2020

• One exabyte is one quintillion bytes• Exabyte (1 000 000 000 000 000 000 bytes)• Leverage data to bend the cost curve


What’s in it for you?

Face the future with confidence

Be willing to try something

new and different

Agility to change will

prevail

Keep the end in mind


Who is Lone Star Circle of Care?• Lone Star Circle of Care (LSCC) is an integrated primary

and behavioral health care provider that also offers care coordination and access to specialty care

• LSCC was founded in 2001 in Georgetown, Texas, as a single clinic, and it has grown into a large clinical system with 21 physical locations in 6 counties

• LSCC is a private 501(c)(3) non-profit entity with the Federally Qualified Health Center (FQHC) designation; community health center


What Services do we provide?

• Family Medicine• Pediatrics

• Behavioral & Mental Health• Dentistry• Obstetrics & Gynecology

(OB/GYN)

• Pharmacy• Senior Care• Vision

• Access to Specialty Care


Who is Lone Star Circle of Care?

• 83,126 Unduplicated patients seen in 2018• 321,959 encounters (visits) in 2018

• 170,905 prescriptions dispensed in 2018• 1,703 babies delivered in 2018• 21 physical locations in 6 counties

• Over 600 employees• Over 130 Providers


Session Agenda

• Current state of BI360 at LSCC• Original implementation – 2012• Growing pains 2010 up to now• Moving into Budgeting and DW Modules• Future projects leveraging DW and more


Current State of BI360 at LSCC

2012

Reporter – since 2012

2012

Composer – since 2012

2012

Publisher – since 2012

2015

Budget – since 2015

2018

DW – since 2018




Be willing to try something new and different

Agility to change will prevail



Where did we start?

• Four ring data binders with over a hundred pages• Board reporting with limited dashboards or KPIs• Management Analysis• Operational Analysis• Financial Analysis • Various Excel data sheets linked to other Excel

data sheets• FRx reporting with Macros for formatting etc.


Evolution takes time!

2010 & Prior

Evolution of Reporting

Now

Evolution of Reporting + DW

Future


Budgeting Process –not so much fun• Multiple linked spreadsheets by location

• Approximately 130 linked Excel workbooks to provide summary analysis via pivot tables

• Had to remember to refresh often• Manual process to add new locations and accounts• Excel is not perfect and links would break often and

would take days to relink various workbooks• Limited time for analysis – board package was always

rushed• Spent entire time linking workbooks and maintenance of

the process• Don’t forget to run formatting Macros


Trend Analysis – boring and time consuming (THEN)• Multiple financial reports to summarize in trend format

• Trend Analysis was a static document • Not linked to database or general ledger• Accumulation of various reports and stats• Timing consuming to track down the data• Limited time for analysis and smart business

decisions


Operational data static and does not tell as story

• One main Excel workbook with static GP Data• 65 multi-sheet workbook to review• Static data not linked to GL details• Numbers with no graphical renditions• Printed into four ring binders for review• Reprinting for updating data was no small

feat to accomplish• Spent time compiling vs. analyzing data


Board of Directors KPIs circa 2010 (THEN)

• Manual process to accumulate the data and looks a little dated

• Top 10 tech trends 2010• The iPad and the rise of the tablets

• We are Facebook; resistance is futile – Catfishing was in• Check in, turn on, go out – Foursquare is cool

• Look, Ma! No Hands! Microsoft Kinect video games

• Watching the Web on TV, Blockbuster watch out for Netflix• The saga of the iPhone 4 with 3Gs!

• Escalation of the smartphone wars (more than just Apple vs. Blackberry) The Androids are coming!

• App-tastic - $47 billion business in 2018• Privacy matters or end thereof

• Net neutrality

• Don’t worry we all evolved:


BI360 to the Rescue

• Implemented Budget Module in Spring of 2015• Significantly reduced the maintenance time

involved in budgeting• Flexible nature of BI360 means added

accounts or departments are simple to accommodate

• Easily created scenarios allowing for iterative approach

• Much more time for analysis• Templates for the BOD presentation can be

reused YOY and allow for quick updates


Industry Specific Issues…

• Budgeting at the employee level• Providers are the drivers of revenue• Support staff for those providers is the primary driver

of expense• 68% of opex is comprised of salary & burden

• Provider turnover can have a huge impact on revenue

• Many employees split time between clinics and/or service lines

• Revenue inputs are specific to clinics• Provider productivity• Payer mix• Payer rates• Seasonality


Key Indicators circa 2019 (NOW)• Fully automated approach from the GP tables• Six month trending report

• Including various balance sheet and statement of operations indicators

• Graphical trend rendition of all the key stats for the board of directors review

• See full cash cycle days in A/P, A/R, & Cash on hand all in one graph

• Cost per patient and Personnel related expenses as a % or Revenue


Operations Data with BI360 circa 2019 (NOW)• Fully automated approach

• Site Flash reporting is comprised of the following:• TTM trend reporting forwards and

backwards to include the future budget periods

• Current Month + YTD Actuals• PYTD Actuals as well• Various Key Stats • KPIs & Trend Graphs

• Reports are living and breathing data and analysis – Accounting is fun again!


Operations Data circa 2019

• Key Stats and graphs are built directly into reporting functionality

• Can run live reports and drill into GL detail

• Eliminated multi-tab approach and separate trend reporting

• One stop shop to review and analyze your P/L

• Matrix view of 88 budget centers


Healthcare data frontier…. • Wearable devices, remote monitoring, online diagnostics tools,

proliferation of electronic medical records

• No longer are the devices or tools themselves at the center of attention, but rather the data is at the heart of it all

• Data insights need to provide and empower clinicians and providers are actually improving outcomes!

• Growth in telehealth market

• Reducing cost

• Population Health


Specialty Care Project – How the heck can we make that happen?• Process claims for 4 specialties and LSCC

would act as a Payor, currently contracted with two and growing

• Reporting requirements by Specialist both claims dollars and volume, track expenditures by program allotment requirement of external stakeholder

• Oh wait it gets better, we are going to open up 16 additional specialty types

• Calculating IBNR for year GAAP analysis• How are we going to handle volume of CMS

1500 forms from multiple specialty types….


Future expansion of our Specialty Care DW needs…

• Rheumatology• Cardiology

• Endocrinology• Gastroenterology• ENT

• Allergy• Orthopedics• Hematology

• Nephrology• Neurology

• Infectious Diseases• Physical Therapy• Pain Medicine

• Pulmonology• Dermatology• Urology

• Neurology


Future State of BI360 DW • Currently have majority of Great Plains tables in Bi360 DW

• General Ledger• Cash• Accounts Payable• Fixed Assets (future)

• Recently added ExponentHR – Payroll/HRIS system• Future NextGen (EMR) + Microsoft BI functionalities• Enhance budgeting and rolling forecast data + further automation of

financial reporting• Other future opportunities

• Call Center Data• Patient Portal Data• Claim activity (VBC and Payor contracting)• Specialty Care Project• Microsoft Power BI • Provider Dashboards• Dynamics 365 + Bi360 Cloud

BI360 DW

NextGen (EMR)

Great Plains

ExponentHR


Completing the health data picture (recent Modern Healthcare Optum Article)…

• There’s a scene in the classic movie “The Wizard of Oz” that shows Dorothy’s house tossed around in the air by the force of a twister. From the start of the movie until that point, the film is shot in dull, black-and-white tones – a monotone wash of gray.

• Then the house crash-lands in Oz. When she opens the door of her home for the first time, Dorothy is greeted by a spectacular vista of color and layers of marvelous detail.

• She’s opened the door to an entirely new world!

• Social Determinants of Health (SDOH)• Improve care, costs and accuracy

• Serve communities and lower expenditures• Positive Health outcomes


Key Takeaways and Resources

Websites:

• https://lonestarcares.org/

• http://www.nachc.org/

• https://www.pwc.com/us/en/industries/health-industries/health-research-institute.html

• https://www.hfma.org/

• https://www.healthcarefinancenews.com/

• https://www.fridayfwd.com/

• https://havenhealthcare.com/vision

• Keep the end in mind from the reporting perspective• Don’t hesitate to reach out to Solver for general

questions or development• Identify your data sources and find a way to get

them into the DW• Don’t be afraid to let your reporting evolution

happen!

https://lonestarcares.org/


http://www.nachc.org/

https://www.pwc.com/us/en/industries/health-industries/health-research-institute.html

https://www.hfma.org/

https://www.healthcarefinancenews.com/

https://www.fridayfwd.com/

https://havenhealthcare.com/vision


Your feedback is valuable:

www.solverglobal.comwww.solverglobal.com

THANK YOU!



· 2019-08-19 · budgeting process – not so much fun • multiple linked spreadsheets by...

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