advancing the financial strength of los angeles county clinics...• launched in 1995, nonprofit,...
TRANSCRIPT
![Page 1: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/1.jpg)
AFS 102 Training Program
December 5, 2019
Susan Petrie, MBA Chief Operating Officer, Capital Link
Advancing the Financial Strength of Los Angeles County Clinics: Monitoring and Improving Health Center Performance
![Page 2: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/2.jpg)
• Launched in 1995, nonprofit, HRSA national cooperative agreement partner
• Offices in CA, CO, FL, MA, MO, and WV
• Over $1.2 billion in financing for over 234 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 2
Capital Link - Overview
![Page 3: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/3.jpg)
2019 Capital Link www.caplink.org 3
Advancing Financial Strength (AFS) Program Overview
Program Developed with CCALAC • Tools, Trainings, Technical Assistance
Goal: Improve Health Center Financial Sustainability and Increase Readiness for Growth.
CEO/COO CMO/Clinical Team
CFO/Finance Team
Board Members
![Page 4: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/4.jpg)
2019 Capital Link www.caplink.org 4
Goal: Financial Sustainability and Access to High Quality Care
![Page 5: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/5.jpg)
Benchmarking/Dashboards
![Page 6: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/6.jpg)
2019 Capital Link www.caplink.org 6
Performance Improvement
![Page 7: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/7.jpg)
2019 Capital Link www.caplink.org 7
Benchmarking
A standard or point of reference against which things may be compared or assessed.
![Page 8: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/8.jpg)
2019 Capital Link www.caplink.org 8
Benchmarking/Best Practices
What metrics should I track?
What to compare performance to?
What does it mean?
![Page 9: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/9.jpg)
2019 Capital Link www.caplink.org 9
Capital Link’s Performance Benchmarking Toolkit
http://caplink.org/california-clinics
![Page 10: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/10.jpg)
Data Sources for Benchmarking
![Page 11: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/11.jpg)
2019 Capital Link www.caplink.org 11
CA FQHCs Performance Trends
http://caplink.org/ca-trends-2019
![Page 12: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/12.jpg)
2019 Capital Link www.caplink.org 12
Capital Link’s Benchmarking Toolkit
![Page 13: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/13.jpg)
Performance Trends: Key Metrics
![Page 14: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/14.jpg)
3.5%
5.9%
4.7%
5.7% 5.6%
6.3%
4.8% 4.5%
3.7%
4.3%
3.6% 3.1%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
2015 2016 2017 2018
CCALAC Operating Median CA FQHCs Median NATIONAL Median
2019 Capital Link www.caplink.org 14
Operating Margin
![Page 15: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/15.jpg)
2019 Capital Link www.caplink.org 15
Bottom-Line Margin
5.5%
6.8%
4.9%
5.9%
6.8% 7.3%
5.3% 5.4% 5.1%
5.5%
4.4% 4.1%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 16: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/16.jpg)
2019 Capital Link www.caplink.org 16
Personnel-Related Expenses as a Percentage of Operating Expenses
72.0%
68.0%
72.1%
69.3%
70.8% 70.6%
72.5%
71.2% 70.9%
70.2%
71.8% 71.5%
65.0%
66.0%
67.0%
68.0%
69.0%
70.0%
71.0%
72.0%
73.0%
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 17: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/17.jpg)
2019 Capital Link www.caplink.org 17
Days in Net Patients Receivables
54
48
43 40
44
38 37 38 41 41
39 38
0
10
20
30
40
50
60
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 18: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/18.jpg)
2019 Capital Link www.caplink.org 18
Days Cash on Hand
43
59
81
97
71 79
92 94
53
63 67
71
0
20
40
60
80
100
120
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 19: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/19.jpg)
2019 Capital Link www.caplink.org 19
Physician Visits per Physician FTE
2,500
2,600
2,700
2,800
2,900
3,000
3,100
3,200
3,300
3,400
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 20: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/20.jpg)
2019 Capital Link www.caplink.org 20
Mid-Level Visits per Mid-Level FTE
2,000
2,200
2,400
2,600
2,800
3,000
3,200
3,400
3,600
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 21: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/21.jpg)
2019 Capital Link www.caplink.org 21
Dental Visits per Dental Provider FTE
1,500
1,700
1,900
2,100
2,300
2,500
2,700
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 22: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/22.jpg)
2019 Capital Link www.caplink.org 22
Median Growth Rates – Patients
1%
13%
7%
5%
3%
7%
4% 3% 3%
5% 5%
3%
0%
2%
4%
6%
8%
10%
12%
14%
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 23: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/23.jpg)
2019 Capital Link www.caplink.org 23
Median Growth Rates – Visits
5%
14%
10% 9%
6%
9%
7% 7%
5%
7% 6%
5%
0%
2%
4%
6%
8%
10%
12%
14%
16%
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 24: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/24.jpg)
2019 Capital Link www.caplink.org 24
CCALAC Growth Rates by Service Line 2015-2018 Median Health Center
5% 5%
10% 12%
23%
12%
0%
5%
10%
15%
20%
25%
Medical
Patient
Growth Rate
Medical Visit
Growth Rate
Dental Patient
Growth Rate
Dental Visit
Growth Rate
Mental Health
Patient
Growth Rate
Mental Health
Visit Growth
Rate
![Page 25: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/25.jpg)
2019 Capital Link www.caplink.org 25
CCALAC Median Health Center: Service Mix by Year
77% 79% 77% 75%
6% 8% 10% 13% 4% 4% 4% 5% 4% 3% 3% 4%
0%
20%
40%
60%
80%
100%
2015 2016 2017 2018
Enabling Visits as a Percentage of Total Visits
Mental Health Visits as a Percentage of Total Visits
Dental Visits as a Percentage of Total Visits
Medical Visits as a Percentage of Total Visits
![Page 26: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/26.jpg)
2019 Capital Link www.caplink.org 26
CCALAC Patients per Payer as a Percent of Total Patients (Median Health Center)
47% 55% 60% 64% 64% 65%
82% 81%
87% 86% 86% 85%
0%
20%
40%
60%
80%
100%
120%
140%
160%
2013 2014 2015 2016 2017 2018
CCALAC Medi-Cal
Medicaid Collections as Percentage of Total Collections
Medicaid Patients as Percentage of Total Patients
45%
35% 29% 27% 24% 24%
5%
5%
3% 3%
3% 2%
0%
10%
20%
30%
40%
50%
60%
2013 2014 2015 2016 2017 2018
CCALAC Self-Pay/Uninsured
Self-Pay Collections as Percentage of Total Collections
Self-Pay Patients as Percentage of Total Patients
![Page 27: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/27.jpg)
Evolving Business Models
![Page 28: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/28.jpg)
2019 Capital Link www.caplink.org 28
Transition from FFS to Value-Based Reimbursement
![Page 29: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/29.jpg)
*Capital Link Performance Benchmarking Toolkit
2019 Capital Link www.caplink.org 29
Transition from FFS to Value-Based Reimbursement
![Page 30: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/30.jpg)
2019 Capital Link www.caplink.org 30
Medical Patients per Medical Provider FTE
750
800
850
900
950
1,000
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 31: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/31.jpg)
2019 Capital Link www.caplink.org 31
Medical Team Productivity: Medical Patients per Medical Staff FTE
260
270
280
290
300
310
320
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 32: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/32.jpg)
2019 Capital Link www.caplink.org 32
Cost per Patient
$851 $868 $875 $940
$887 $959
$1,049 $1,075
$801 $837 $873 $917
$0
$200
$400
$600
$800
$1,000
$1,200
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 33: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/33.jpg)
2019 Capital Link www.caplink.org 33
Cost per Visit
$193 $204 $204
$219 $201
$220 $230 $239
$208 $218
$233 $242
$0
$50
$100
$150
$200
$250
$300
2015 2016 2017 2018
CCALAC CA FQHCs Median NATIONAL Median
![Page 34: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/34.jpg)
2019 Capital Link www.caplink.org 34
CCALAC Medical Support Staff by Medical Provider Median Health Center
![Page 35: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/35.jpg)
How Does Your Health Center Compare?
![Page 36: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/36.jpg)
2019 Capital Link www.caplink.org 36
Performance Evaluation Profile (PEP)
![Page 37: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/37.jpg)
2019 Capital Link www.caplink.org 37
![Page 38: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/38.jpg)
2019 Capital Link www.caplink.org 38
![Page 39: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/39.jpg)
2019 Capital Link www.caplink.org 39
![Page 40: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/40.jpg)
2019 Capital Link www.caplink.org 40
![Page 41: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/41.jpg)
2019 Capital Link www.caplink.org 41
![Page 42: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/42.jpg)
2019 Capital Link www.caplink.org 42
Resources
http://caplink.org/california-clinics
![Page 43: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/43.jpg)
Benchmarking is an Ongoing Process!!
![Page 44: Advancing the Financial Strength of Los Angeles County Clinics...• Launched in 1995, nonprofit, HRSA national cooperative agreement partner • Offices in CA, CO, FL, MA, MO, and](https://reader033.vdocument.in/reader033/viewer/2022052816/60a958cd9985706c66484b46/html5/thumbnails/44.jpg)
2019 Capital Link www.caplink.org 44
Questions? Contact Us
Tony Skapinsky—CA Office Project Consultant Tel: 805-544-2355 [email protected]
Jose Fonseca—CA Office Associate Project Consultant Tel: 805-819-8909 [email protected]
Susan Petrie Chief Operating Officer Tel: 617-988-2248 [email protected] Jonathan Chapman Chief Project Officer Tel: 225-241-6855 [email protected]