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FQHC Dental "Balancing Act": Establishing Productivity in CHCs
- 1. “ The FQHC Balancing Act ” Establishing Dental Encounters and Productivity in a Community Health Center Bob Russell, DDS,MPH
- 5. Goal #1 Establish a Bottom-line cost per encounter for providing dental care services
- 6. Goal #2 Monitor your Bottom-line cost per encounter annually
- 7. Goal #3 Allocate a proportion of total base 330 grant for dental operations
- 14. Total Dental Operational Revenues Should Not Be Only Revenues Generated By Patient Service Collections Dental Cost Centers must include a proportion of all grant and other revenue resources allocated to the health center.
- 15. Productivity Sites should calculate the gross productivity, utilizing full fee charges as one measure of productivity. Average gross charges, presuming that the fees are market rate fees, should exceed $400,000/dentist/year
- 18. Productivity = Encounters Many sites have 220 days of care/FTE , so the math would be 1.54 patients per hour (8 hour day) or 12.3 patients/day . You may want to benchmark the productivity of your current program to see if greater efficiency can occur that would allow you to see new patients.
- 26. WHY? Matching available resources to population demographics is considered adequate justification . Good data helps the dental clinic avoid the potential of appearing selective or “cherry picking” for the sake of financial gain only.
- 32. Rationale The FQHC is “still” available to all users within the centers fiscal and physical capacity
- 34. Questions?
Editor's Notes
- If dental represents 20% of the health centers over-all operational costs then dental should be allocated 20% of base 330 grant revenues on average.
- Revenue forecasts should not be limited to patient service collections but all revenue sources available to the health center: grants and subsidies.
- Other: Bonuses, gifts, etc…
- Other: local subsidies, awards
- Cost center must allocate a proportion of health center grant subsidies toward dental operations in proportion to over-all operational costs.
- 2700 is not the upper limit of an efficiently managed dental program – this value may serve as the minimum benchmark in some optimally equipped and designed operations.
- For financial solvency a health center must be able to sustain operational margins in their service area.
- This provides further reason for proportional non-productivity revenue allocations toward dental services: to cover unexpected uncompensated emergency care.
- The more non-patient service revenue available the less restrictive the health center’s admissions policies. Active promotions of services to all service population will assure adequate payer mix in each category. General Rule: Patients with less resources will demand services disproportionately to their demographic numbers (higher) – this is why managed appointments and resource allocation is critical.