BOT HSC Management Work GroupJanuary 19, 2006

Making Life Betterthrough Research, Education & Healthcare TM

Stephen Klasko, MD, MBADean, College of Medicine & Vice President, USF Health

Our philosophy: Better Health, Better Life

Requires a new paradigm: USF Health

USF Health is an entrepreneurial academic enterprise for better health that consists of the Colleges of Medicine, Nursing, Public Health, the School of Physical Therapy, the USF Physicians Group, and our community partners.

• Our mission is to improve life by improving healththrough partnership, research, education and healthcare.

• Our commitment is to improve the full spectrum of health, from the environment, to the community, to the individual.

• Together, through talent and innovation, USF Health is developing real-world solutions to reach our shared value — making life better.

Requires Changing our DNA

Research Education Healthcare

Woman/Child

Brain

Heart

CRISP

Talent

Effic

ienc

yInnovation

Partnership

Quality &

Service

Outcomes:QUALITY

HEALTH

SAFETY

COST

LOYALTY

PROMINENCE

BetterLife

Sports Medicine

Better Health ... Better Life

Changing DNA of Health TM ….

People DNA• Medical• Nursing• Public health• Leadership

Process Transformation• Simplification• Six Sigma & Lean• Efficiency & Safety

Technology Innovation• Technology• Bioinformatics• Personalized healthcare

ProcessTechnology

Capacity

Practices

Inno

vatio

n

People

August 6, 2001 IDX National Users Conference

Picture here with me and student

USF PHYSICIANS GROUP

USF Physicians Group 04/05 Fiscal Year End Audit Update

• UMSA audit issued December 23rd

• MSSC audit still being finalized by E&Y – Delay due to revenue recognition issues

relative to CME program

Audit Corrective Action Plan - Update

• Monthly Bank Statement Reconciliation: This issue has been resolved.

• CME Revenues: The USFPG Department of Finance & Accounting is working closely with CME to identify, moving forward, revenues that should be restricted/unrestricted and deferred/non-deferred. USFPG is recommending to CME office that they recruit a higher level Finance Director or CFO to work with USFPG in appropriately classifying and accruing all CME revenue.

• Grant Revenues: Policies and procedures are under development that will apply to all parties involved in the grant process. In addition, acquisition software will replace the current system which will allow the HSC Dean’s Office to better track and classify grant revenues.

• Accounts Payable: The USFPG Department of Finance & Accounting, under new leadership, will develop both internal andexternal policies/procedures and workflows that will streamline the A/P process and accrue expenses in the appropriate time periods. This initiative is ongoing and critical as we transition from operating on a cash to an accrual basis.

ChargesFiscal Years 1999 - 2005

69% increase over last 7 fiscal years

$150,677,947

$166,514,958$171,691,843

$187,630,592 $202,866,610$218,400,320

$255,863,449

$275,639,624

$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

$300,000,000

$350,000,000

FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006Annualized

Annualized thru September 2005

Charges *

* 17% increase with practice wide fee schedule increase of 15% on July 1, 2004

$68,909,906

$59,441,901 $57,975,355

$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

$80,000,000

1st Quarter FY 2006 Actual 1st Quarter FY 2006 Budgeted 1st Quarter FY 2005 - Actual

CollectionsFiscal Years 1999 - 2005

53% increase over last 7 fiscal years

$63,919,105

$65,172,020$69,331,008

$74,454,939$83,642,942

$88,278,743$97,658,177

$104,099,508

$0

$20,000,000

$40,000,000

$60,000,000

$80,000,000

$100,000,000

$120,000,000

FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006Annualized

Annualized thru September 2005

Collections

$26,024,877$24,769,168

$23,072,611

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

$25,000,000

$30,000,000

1st Quarter FY 2006 Actual 1st Quarter FY 2006 Budget 1st Quarter FY 2005 Actual

DIO

OTOLARYN NEUROL

INT MED

RADIOL

NEUROSUR

PSYCH

PHYS THER PATH

ANESTHES

PEDS

SURG OPHTHALFAM MED

OB/GYN

-$600,000

-$400,000

-$200,000

$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

YTD Actual Gain/LossActual Group Gain is $468,609

Global RVUsFiscal Years 2000 - 2005

1,984,581

2,077,5802,307,714

2,527,5772,694,177 2,739,222

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005

* 38% increase over last 6 fiscal years

Global RVUs

242,149220,245

0

50,000

100,000

150,000

200,000

250,000

300,000

1st Quarter 2006 Actual 1st Quarter 2005 Actual

Physician Growth Rate *

*Based on credentialing database for Managed Care contracting

* 31% increase over last 6 fiscal years

306

328352

390 387400

415

0

50

100

150

200

250

300

350

400

450

FYE 99/00 FYE 00/01 FYE 01/02 FYE 02/03 FYE 03/04 FYE 04/05 Q1E 05/06

7% 7% 11% -1% 3% 4%

USF Dept

Total Active MDs Q1E 05/06

Acad Anes Model 3Cardiac CRISP 13Family Medicine 9Interdisciplinary Onc 129Internal Medicine 70Neurology 14Neurosurgery 11OB/GYN 23Ophthalmology 14Otolaryngology 7Pathology 4Pediatrics 49Psychiatry 20Radiology 18Surgery 31Grand Total 415

Collections Per Physician

$208,886

$198,695$196,963

$190,910

$244,145

$216,901$216,132

$175,000

$185,000

$195,000

$205,000

$215,000

$225,000

$235,000

$245,000

$255,000

FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005

Global RVUs Per Physician

6486

6334

6556

6481

6962

6848

6000

6100

6200

6300

6400

6500

6600

6700

6800

6900

7000

7100

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005

USFPG’s Payor Mix (FY 2005)4th Quarter FY 2004-05

Managed Care 47% (down 1 pt.)*(Top 10 payors comprise 85% of all Managed Care business)

Medicare 24% up 1 pt*Medicaid 8% flat*Commercial 10% flat*WorkComp 1% flat*Self Pay 8% flat*HCHCP 1% down 1 pt*

* As compared to 1st Quarter FY 2004-05

Top Managed Care Payors’ Collections

Campus Patient VisitsNorth Campus

North Campus Outpatient Visits

95,175

101,307

97,925

106,353122,432

131,260

127,507 131,296

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 AnnualizedFY 2006

34% increase over last 6 fiscal years

Annualized thru September 2005

Campus Patient VisitsSouth Campus

South Campus Outpatient Visits

76,773

71,084

71,264

70,63768,003

71,91275,182

79,412

010,00020,00030,00040,00050,00060,00070,00080,00090,000

FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2004 AnnualizedFY 2006

2% decrease over last 6 fiscal years

Annualized thru September 2005

Outline of Major Messages

“Strive for national prominence through excellence, professionalismdiversity, timeliness

and strategic growth.”

Entrepreneurial Academic Model

NationalProminence

True Integration:COM + HSC +

University

Creative Educational Models

Research ReallyMatters

ExcellenceEducationally superiorTechnologically superiorBuild superior patient safety, access and outcomesPut us on the mapUnique collaboration across health disciplines

• Develop practice-ready students who “get it”

• Joint degrees for emerging workforce

• 3rd / 4th year curriculum• Outcomes-based education

and training• Service learning and

community outreach

• Hire world class teams• Big ideas, research cores and

teams: e.g., Cell therapy, homeland defense, biotech

• Measure quality and productivity

• Goal: Top 50 public research universities

• Creative/successful practice and outreach models

• New strategic models for clinical sites, community partners: e.g. TGH, HLM, VA, ACH, outpatient teaching sites

• Interdisciplinary across departments, colleges, university

• Opportunities: Research cores, engineering, technology, international, MD/MBA, bioengineering, bioinformatics

Blueprint for Strategic Action

CREATIVE EDUCATIONAL MODELS

August 6, 2001 IDX National Users Conference

Picture here with me and student

College of Medicine

• USF invited by Harvard to join elite medical schools designing innovation in learning simulation– Field trip to follow

• USF hosted Carnegie Foundation, recognized among enmostinnovative schools in rewriting the national plan for med education

• Paul Wallach, Vice Dean of COM, invited to give keynote at AAMC on ambulatory medical education

• New hospital affiliations– SMH– UCH– Lakeland Regional

College of NursingCelebrating Accomplishments: Excellence in Education• The College of Nursing recently received approval from the Board for

Trustees to begin a Nurse Anesthesiologist Program. The College has a site visit with the Council on Accreditation of Nurse Anesthesia Educational Programs on February 7-8, 2006 for accreditation of the program.

• The Charter Class for the new Doctor of Nursing Practice, 14 students, began in Fall 2005.

• The Charter Class for the Accelerated bachelor degree graduated in Fall 2005. This program puts students with a bachelor degree in another field on an accelerated path to a bachelor degree, or master’s degree, in Nursing.

• College of Nursing baccalaureate students graduating in Summer 2005, have attained a 100% pass rate on The National Council LicensureExamination (NCLEX®).

College of Public Health

With School of Physical Therapy, established the first DPT/MPH in the nation

Established undergraduate minor in public health that produces over 2500 undergraduate students taking classes in the College of Public Health each semester

Ad hoc workgroup developing recommendations for a new DrPH, a professional doctoral degree

Enhanced capacity of Office of Technology and Assessment for distance learning, supported by a new off-campus fee

Provide outstanding educational programs for public health leaders and professionals

Global Health: The students get it

Students from all three of our colleges created an “international health service corps”

Panama Initiatives

City of Knowledge USF AgreementsCollaboration agreement July 2004Gorgas-USF Collaboration Aug 2005Admissions Application for USF Health as an Academic Program Oct 2005

Two years of visiting faculty in public healthTen students in the past year with field projects and internships in the City of KnowledgeTwo collaborative NIH grant applicationsAdjunct faculty and USF alumniCity of Knowledge-USF Health Events

Professor Arosemena to visit USF Nov 2005One week course in international health education March 2006Certificate for Humanitarian Assistance in the Americas April 2006Vaccinology in the Tropics June 2006

Where are we Going Together

Establish a formal presence on the City of Knowledge campusCreate an advisory group to help guide USF programsDevelop masters and doctoral degrees in collaboration with the Panama Ministry of Health and Universidad de PanamaEstablish study abroad programsShort courses and certificate programs

Clinical researchSocial marketingHealth educationEntrepreneurship in health care

Establish formal linkages between researchers in SENACYT/INDICASAT, Gorgas and other Panamanian health research organizations

Enhancing the Global Agenda

Malaysia---exploration of public health programs

Venezuela----series of educational programs

Dominican Republic---HIV, tropical disease educationIndia

US delegation for public health schoolsNursingCardiovascularHIV education

Our Newest Dual Degree DPT/MPH

Integrates Doctor of Physical Therapy (DPT) and Master of Public Health (MPH) Degrees

• Four Years Total: 3 Years DPT, 1 Year MPH• Public Health Coursework Integral to DPT Curriculum

– Introduction to Public Health– Biostatistics– Principles of Health Policy and Management

• Opportunity to Pursue a Variety of Concentration Areas• Population-Based Prevention Approaches to Health• USF’s DPT/MPH is the First Such Formal Pairing in a

US University

Doctor of Physical Therapy Degree

Trajectory for National Prominence

• USF Board of Trustees Approval May 2004

• FL Board of Governors Approval October 2004

• Charter DPT Class of 2008 Enrolled August 2005

• DPT Class of 2009 Fully Enrolled By Christmas 2005

USF DPT Class of 2009 Admissions Update

as of December 5, 2005

Applications Received 83

Applications Reviewed 51

Admissions Offers Extended Full - 20 Contingent - 14 34

Acceptances Received 22

Overall GPA of Incoming Class 3.53

GPA - Prerequisites 3.50

GPA - Upper Division 3.62

Doctor of Physical Therapy Degree

ENTREPRENEURIAL ACADEMIC PRACTICE

Technology—Electronic Health Records

Dr Jay Wolfson leading Tampa Bay RHIO project, awarded $467,000 for health information project around diabetes, asthma

Hosted lieutenant governor at COPHWorking with Dr Patel

USF Practice Group signed an EMR deal with Allscripts/IDX

2nd largest academic practice group HERDeal calls for Centers for Advanced Health Care to be national model

PEOPLEDr Ruben Quintero

Internationally renowned fetal surgeon

Phil Schaengold, JD, MBAVice Dean, Clinical AffairsFormer CEO Sinai, GWU, Syracuse, Hahnemann

Lennox Hill, MD, PhDUrogynecologyPelvic Reconstructive Surgery

SEARCHES

Chair of OrthopaedicsQuick, Leonard, Kieffer

Chair of RadiologyReplacing Dr Silbiger

AVP of DevelopmentWitt, Kieffer

Organizational Development

Vice Dean, EducationPaul Wallach, MD

Vice Dean, ResearchAbdul Rao, MD, D Phil

Vice Dean, ClinicalChief Operating Officer

Phillip Schaengold, JD, MBAMo Kasti

Chief Financial Officer, Assoc Dean & VP FinanceJoann Strobbe, PhD

Assoc Dean and VP for Board and Presidential AffairsPatricia Haynie, PhD

Dean PetersenDean Burns

Hospital Update

TGHMCCACCUCH/PepinSMHLakeland

Facilities Update

CAHC NorthBond rating

CAHC SouthDavis Island Suit

CAMLSDRI

MCC Joint UseJoint Affiliation Committee

Graduate Medical Education Update

Anesthesia—Probation site visitOrthopaedics---New program

UCHLakeland

Transitional at UCH---New programHand fellowship at TGH---Withdrawn

What Keeps Me Up at Night

DevelopmentResearch strategy and directionUSF Health Future LeadersHospital SupportNew Medical SchoolsLCME

Physician Supply and Economic Development:

Leveraging Existing Strengths– Support expansion plans at established medical schools and

expand residency training slots.• The expansion plans at the established schools will produce

(in aggregate) almost 200 new seats more cost effectively than new schools and can bring additional seats on line quickly, as early as the 2007/08 academic year.

• All existing medical school positions should be fully funded. Increasing medical school seats without first fully supporting existing seats will hinder efforts to improve program quality.

• Support expansion of additional residency training slots using a matching funds methodology. Medical school capacity has already been increased such that new Florida graduates exceed first year residency positions.

• Continued expansion of Medical School seats will need to be coupled with a strategy for assuring a high quality applicant pool.

Physician Supply and Economic Development:

Leveraging Existing Strengths

Support efforts to increase the national recognition of Florida’s medical schools. The ability to attract high quality students and continue to import new physicians depends upon the growing eminence of our health sciences centers.

• USF has been nationally recognized as having one of the country’s most innovative curriculums.

• In partnership, with industry USF is developing a leading edge national CME program.

• USF has made great strides in increasing NIH research grants in key areas.

– Leverage investments in and strength of established Medical Schools in strategic partnerships to develop innovate, cost effective new Medical School capacity in Orlando & Miami.

• Changing • The Leadership DNA

• Innovation • Safety • Creativity • Service• Accountability• Sustainability

ChangeCulture

ProminenceIn

Health

SustainableResults

Changing culture requires changing the leadership DNA

The Approach

ProcessTechnology

Capacity

PracticesInno

vatio

n

People

Identify Talents

Identify Talents NominationNomination

Review Board Selection of Top Talents

Review Board Selection of Top Talents

1 year Program(Training + Projects)

Coaching & Mentoring

Indiv Development Plan360

Assessment 360

Assessment

Top Talents… Solid Mechanisms … Aligned with Future NeedsTop Talents… Solid Mechanisms … Aligned with Future Needs

RESEARCH