URBAN INDIAN HEALTH PROGRAMCY2012

Overview

URBAN INDIAN HEALTH PROGRAMCY2012

Using UDS Feedback Report as a Management Tool

Susan Friedrich, JSI

URBAN INDIAN HEALTH PROGRAMCY2012

National performance Program

improvement Ensuring the health

of your patients

Why is it important?

URBAN INDIAN HEALTH PROGRAMCY2012

• Too much information and not enough time!• A Snapshot Approach – focus on a few high

impact measures for initial review to identifyStrengthsPossible areas of improvement

Focusing Your Efforts

URBAN INDIAN HEALTH PROGRAMCY2012

• Patient profile – who are you serving?• Quality of care – are standards of care high?• Efficiency – are we maximizing our resources?• Financial security - are we in a good financial

position?

Snapshot of Performance

URBAN INDIAN HEALTH PROGRAMCY2012

Comparison Groups• Program

Current year, prior year and 2 year changeReported for total patients and AI/AN population

• AveragesComparison group – Full Ambulatory, Limited Ambulatory or

Information and ReferralNational average (all UIHP programs)BPHC Average (applicable to Full Ambulatory programs)

URBAN INDIAN HEALTH PROGRAMCY2012

Performance measures

• Access Describes patients you serve

• Quality of Care Utilization and GPRA measures

• Efficiency Evaluates capacity

• Financial Cost/Viability Assesses costs and viability

Feedback Report

URBAN INDIAN HEALTH PROGRAMCY2012

Evidence that program is serving priority populations:

• % Growth in patientsAI/AN patients% AI/AN of total patientsTotal patients% patients using medical services

• Patient demographics• Patients with financial, cultural and

linguistic barriers% Uninsured, Medicaid, other

public% < 200% FPL

Patient Profile

URBAN INDIAN HEALTH PROGRAMCY2012

Patient Profile

Did you grow?

Who are you

serving?

URBAN INDIAN HEALTH PROGRAMCY2012

Evidence that program is delivering quality care:

GPRA MeasuresContinuity of carePrevalence rates

• Visits per patient (continuity)• Rates of service use• GPRA

Chronic Disease (diabetes control)

Routine and Preventive care (screenings, immunizations and assessments)

Behavioral health (tobacco, mental health and domestic violence)

Quality of Care

URBAN INDIAN HEALTH PROGRAMCY2012

Quality of Care

How do you

compare?

What is your performance?

Are you improving or getting

worse?

URBAN INDIAN HEALTH PROGRAMCY2012

Evidence that program is operating a cost effective services delivery model:

• Growth in visits• Provider FTEs• Panel size

(patients/provider FTE)• Visits per provider

(productivity)• Medical Team Ratio >1

• Staff Ratios

Efficiency

URBAN INDIAN HEALTH PROGRAMCY2012

EfficiencyDid your

visits grow with patients?

Are you at capacity?

How do you

compare?

Are you at capacity?

URBAN INDIAN HEALTH PROGRAMCY2012

• Cost Cost per patient and visit % administrative costs Charge to cost ratio Surplus/deficit as % of total

costs• Diversification of Funding

% income from IHS % income from patient service IHS funding per AI/AN patient

• Financial Viability Change in net assets as % of

expense Working capital to expense ratio Debt to equity ratio

Financial/Cost Viability

Evidence that program is financially viable:

URBAN INDIAN HEALTH PROGRAMCY2012

Financial/Cost ViabilityAre your

costs reasonable

?

Do fees cover costs?

URBAN INDIAN HEALTH PROGRAMCY2012

• Provides formulas for all measures• Format “replicates” the report format• In the formula section, each measure

is identified with: A number A name, corresponding to the name

on the report A formula for calculating the

measure

UDS Reference Guide

URBAN INDIAN HEALTH PROGRAMCY2012

% Pediatric: (T3A Lines 1-15, Col A+B) /(T3A L39 CA + T3A L39 CB)

T= Table + = add - = subtractL= Line * = multiply C=

Column / = divide

Calculations for Performance Measures

URBAN INDIAN HEALTH PROGRAMCY2012

Average Defined: The value obtained by dividing the sum of a set of quantities by the number of quantities in the set.

Program Type (Full Ambulatory, Limited Ambulatory, Information and Referral

UIHP National Averages (from all urban programs)BPHC National (from FQHCs)

Averages

URBAN INDIAN HEALTH PROGRAMCY2012

• Compare your performance with peer groupsHow do you compare with similar programs?

• Look at your performance over timeAre things trending in the right direction?

• Identify strengths and weaknesses• Develop and implement strategy for improvement

Identifying Strengths & Weaknesses

URBAN INDIAN HEALTH PROGRAMCY2012

Susan Friedrich or Priscilla DavisJohn Snow, Inc. (JSI)

UDS Helpline: 1-866-698-5976email: helpuds@uihpdata.netwebsite: www.uihpdata.net

Contact Information