Analyzing Your Key Performance Measures

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  • 1. Analyzing Your KeyPerformance Measures Gina Mazza RN, BSN Total Performance Director March 2011
  • 2. Foundation for this Presentation• Insights from Fazzi’s work with hundreds of home health and hospice agencies• Benchmark comparisons from Operational/Financial Service: BestWorks• Insights from current realities for home health care ©2011
  • 3. Quality and Financial Matrix ©2011
  • 4. Strategic Management Model What’s Going To Happen?What Should WeDo About It? What Are The Implications? ©2011
  • 5. Two Approaches to Benchmarking• Internal Benchmarking: Identifying, measuring and tracking over a period of time.• Comparative Benchmarking: Tracking performance indicators AND comparing them to national standards and best practice standards, i.e. top 20%. ©2011
  • 6. Quality Performance Measures Home Health Compare Hospitalization Rate Home Health Process Measures Patient Satisfaction Measures ©2011
  • 7. HHCAHPS: Initial Results Fazzi National Database Care of Patients 89%Overall Rating of Care 85%Communications BtwnProviders and Patients 85% Specific Care Issues 82% Likelihood of Recommending 81% ©2011
  • 8. HHCAHPS: Best Practice Results Fazzi National Database Care of Patients 94%Overall Rating of Care 93%Communications BtwnProviders and Patients 91% Specific Care Issues 89% Likelihood of Recommending 91% ©2011
  • 9. Key Financial Performance Measures Profit Margin Case Mix Weight Cost per Visit Staffing Ratio ©2011
  • 10. Profit Margin National Top Performers AverageMedicare Profit 11.6% 29%Home Health 3.85% 13.2%All Payers ©2011
  • 11. Impact of Underscoring and Revenue Revenue/ 500 SOCAverage Case What it Would Episode Mix Weight Net Revenue Mean $2,192.97* National $2,872.79 $1,436,395 N/A 1.31** 1.25 $2,741.21 $1,370,606 ($65,789) 1.20 $2,631.56 $1,315,782 ($120,613) 1.15 $2,521.92 $1,260,958 ($175,438) 1.10 $2,412.27 $1,206,134 ($230,262) 1.05 $2,302.62 $1,151,309 ($285,086) 1.00 $2,192.97 $1,096,485 ($339,910) .95 $2,083.32 $1,041,661 ($394,735) ©2011 *Current CMS Standardized 60 Day Rate for Episodes as of Jan. 1, 2011 **MedPAC, Report to the Congress: Medicare Payment Policy, June 2010
  • 12. Medicare Episode Drivers Medicare Case Mix All Cost/Nsg Profit Weight Visits Visit National 11.6% 1.2 16 $157 Average Top 29% 1.26 15 $138Performers ©2011
  • 13. Home Health All Payers Drivers Nsg Non Profit Cost/ Visits/ Visiting Margin Nsg Visit Day Staff National $157 6.8/ 3.85% 4.2 Average 100 ADC Top $138 6.6/100 13.2% 5Performers ADC ©2011
  • 14. How ShouldWe Approach Change? “Never change things by fighting the existing reality. Instead, build a NEW model that makes the existing model obsolete." Buckminster Fuller ©2011
  • 15. New Options That Are Now Being Initiated1. Accountable Care Organizations (ACOs): Work together, lower costs and improve quality.2. Bundled Payments: One payment to cover the services for the patient across health sectors.3. Value Based Contracting: Rewards and penalties.4. Patient Centered Medical Home Program: Physician manages cases and share in savings.5. Care Transition Programs: Improve quality and improve patient experience during transitions of care. ©2011
  • 16. What Are the Goals of All These Initiatives?1. Save money.2. Improve quality outcomes.3. Improve patient experience.4. Address patients with chronic disease.5. Reduce unplanned hospitalization. ©2011
  • 17. What Should the Goals of Every Home Care Agency Be?1. Save money – Reduce cost/visit and cost/episode.2. Improve quality outcomes – Top 1/3 of Home Health Compare measures.3. Improve patient experience – Top 1/3 of HHCAHPS.4. Address patients with chronic disease – Create a teach back/chronic disease education program.5. Reduce unplanned hospitalization – Be in top 10% of lowest hospitalization rates in the country. ©2011
  • 18. To Be a Success, Remember… If all you do… Is all you did. Then all you’ll get… Is all you got. ©2011
  • 19. Questions and Answers ©2011
  • 20. Fazzi Associates 413-584-5300www.fazzi.com ©2011