1. Molly Harper
Joy Jin
Matthew Lauck
Kaytriona Lewis

2. Project Overview
Business Plan
Goals and Objectives
Frequent User Statistics
Healthcare Reform Impact
External Assessment
Internal Assessment
Financial Analysis and Patient Volumes
Operational Plan
Marketing Recommendations
Final Recommendations

3. UIH Frequent Visitor Model
Care coordination
Observation
Appropriate follow-up
Multidisciplinary nurse and social work team
Innovative payment solutions

4. Need in Cook County
UIH: 4,394 Frequent User Visits representing 835 unique patients
Hospital Number of Number of ED Estimated Number of ED Number of
ED Visits visits from number of visits with uninsured ED
frequent users frequent user Medicaid visits
patients
John H. Stroger 77,073 11,561 2,513 8,653 42,776
Rush University 36,814 5,522 1,200 13,512 5,023
Medical Center
Mount Sinai 34,750 5,213 1,133 12,466 7,003
Saint Anthony 28,130 4,220 917 14,466 3,480
Norwegian 18,555 2,783 605 7,395 4,589
American
Saints Mary and 49,266 7,390 1,607 22,578 8,148
Elizabeth

7. Service Areas

8. Primary Service Area
2010 Median Household Income
(Variance)
Median Household Income Cook County Median
Household Income
60624 60612 60644 60639 60651 60609 60621
($13,777)
($21,320)
($27,012) ($28,237)
($28,799)
($31,516)
($34,224)

9. Primary Service Area-ED Covered
Services by Payer

10. Secondary Service Area
2010 Median Household Income
(Variance)
Median Household Income
Cook County Median
Household Income
60608
($25,916)

11. Secondary Service Area-
ED Covered Services by Payer

12. Service Areas- Expected Medicaid Growth

13. Target Population

14. Health Status-African Americans &
Hispanics

15. Workforce Development
Nurse Care Managers
Social Workers

16. What is an Observational Unit?

17. Types of Observational Units

18. Patient Volume
and
Financial Analysis

19. Patient Volume
2013 2014 2015 2016 2017
Frequent Visitors
187 234 428 476 476
Enrolled in Program
Additional ED Visits
388 706 1656 1945 1945
resulting from Backfill
5-year reduction of frequent visitor (FV)
ED visits by 6,640
Daily observation unit patient volume 1-2

20. Revenues
2013 2014 2015 2016 2017
Revenues:
Net Revenues from
854,468 898,281 1,948,165 2,292,085 2,341,365
Direct Patient Services
Shared Savings Revenues 500,591 1,278,385 2,390,832 2,719,308 2,777,773
Total Revenues $ 1,355,059 $ 2,176,666 $ 4,338,997 $ 5,011,392 $ 5,119,137
Direct Patient Services
ED visits for FV
Observation visits for FV
Backfill ED visits
Shared Savings
Shared Savings payments
Care coordination revenues

21. Shared Savings Revenues
Shared Savings revenues based on reduction in
payment for healthcare services for enrollees
Average annual Medicaid payments for ED FV were
$33,946 more than ED non-FV
Each ED visit reduction will reduce payments by
$5,132
The Shared Savings payments to UIH would be half

22. Expenses
2013 2014 2015 2016 2017
Expenses:
Fixed Costs
- New Hire Salaries &
$ 717,193 $ 833,829 $ 1,281,265 $ 1,418,499 $ 1,448,996
Benefits (38%)
- New Equip & Supplies $ 265,868 $ 46,185 $ 48,125 $ 48,610 $ 48,610
Total Fixed Costs $ 983,061 $ 880,014 $ 1,329,390 $ 1,467,109 $ 1,497,606
Total Varible Costs $ 1,070,197 $ 1,258,323 $ 1,967,061 $ 2,183,438 $ 2,230,382
Total Expenses $ 2,053,258 $ 2,138,337 $ 3,296,451 $ 3,650,547 $ 3,727,988
New care coordination staff (FTE:Patient ratio)
New I/S hardware and software
Variable costs estimated with cost-to-charge ratio

23. New Staff Details
Staff Title Year 1 Salary FTE Need
Program Administrator $50,000.00 1 for entire project
Medication Therapy Manager $115,000.00 1 for entire project
Nurse Case Manager $63,750.00 1 for 100 every patients enrolled
Health Social Workers $45,000.00 1 for every 50 patients enrolled
Information Systems /
$45,000.00 1.5 for entire project
Technology Staff

24. Assumptions
Market entry of 458 new Medicaid ED FV in 2015
Half of current (and future) Medicaid ED FV will
enroll in program
Reduction of FV total ED visits by 2 per Year
Half of FV ED visits will be sent to observation unit
Backfill ED visits have similar admission rate
Shared Savings payment model similar to Medicare
Project cost of capital is 13.14%
2.15% annual inflation rate

25. Financial Analysis Results
2013 2014 2015 2016 2017
Total Revenues $ 1,355,059 $ 2,176,666 $ 4,338,997 $ 5,011,392 $ 5,119,137
Total Expenses $ 2,053,258 $ 2,138,336 $ 3,296,451 $ 3,650,546 $ 3,727,988
Net Income (Loss) $ (698,199) $ 38,329 $ 1,042,546 $ 1,360,846 $ 1,391,149
Net Present Value = $1,938,764
Internal Rate of Return = 60.01%
Payback Period = 2.53
Favorable financial results
Project Risk is encompassed by ability to reduce total
FV ED visits per year to goal

26. Marketing

27. Product Development
Marketing Strategy
Primary Objectives:
Promote Medicaid frequent user enrollment into
coordinated care
Increase awareness amongst staff, clinicians and
external transport services
Empower patients

28. Marketing
Channels of Time
Reach Distribution Objective Frame
Frequent Users 3-1 months
Posters
before
Internal Clinicians Pamphlets Awareness
program
Word-of-mouth
deployment
Staff
1 month
Transport Awareness & before
External Meet with staff
Services Collaboration program
deployment

29. Marketing
Advantages
Easy to roll out
Low cost
Reach both internal and external audiences
Disadvantages
Unnecessary utilization of observation unit
Dependent on staff cooperation

30. Final Recommendations
We recommend UIH to incorporate a short-stay
observation unit within the hospital facility for the
following reasons:
Financial feasibility
Meet unaddressed needs
More time to improve care coordination and reduce
return

31. Thank you to…
UIH
 Stephen Brown, Associate Director of Clinical Practice & Business
Development
 David Barishman, Nurse Manager of Emergency Services
 Bill Devoney, Chief Financial Officer
 Dr. Gina Gaston, Assistant Professor at UIC
 Sheetal Gayal, Director of Business Planning & Decision Support
Mentors
 Boyede Sobitan
 Jim Lifton