Having good insights into your healthcare business or medical practice can help you maximize income and minimize cost. Clarity comes from analysis and gives rise to clear KPIs and strategic shifts as may be required.

1. Business Analysis
For insight, strategic decision-making, and future outlook
by: Yinka Daramola

2. Summary 201X % Units Per Unit
Capitated Office Visits* $ 579,357.49 38.3% 5,952 $ 154.76
Non-Capitated Office Visits* $ 341,745.80 22.6%
CCM $ 219,043.50 14.5% 4,424 $ 49.51
Home Visits $ 98,016.59 6.5% 738 $ 132.81
Income from other Procedures $ 91,108.13 6.0%
HH-Certs $ 35,243.67 2.3% 844 $ 41.76
AAA/Echo/Car $ 33,401.78 2.2% 400 $ 83.50
SNF $ 30,560.76 2.0% 412 $ 74.18
Behavioral Health $ 19,989.95 1.3% 160 $ 124.94
Allergy Testing $ 8,634.67 0.6% 32 $ 269.83
Other Income* $ 53,871.50 3.6%
Total $ 1,510,973.84
Revenue Streams

3. Revenue Streams
Incentive & Other Income*
Capitated Incentive Income
Prop 56 snd Other Incentives CHG 109,876.98
SCMG Incentive and AHA 52,565.00
Molina Incentive and Prop 56 19,606.00
Vantage Incentive P 56 5,045.10
Centene Prop 56 1,601.00
Sub-Total 188,694.08
Non-Capitated Incentive Income
Noridian Incentive 27,085.35
Sub-Total 27,085.35
Other Income
Consulting Income 51,950.00
Medical Records 1,921.50
Sub-Total 53,871.50
Total 269,650.93
188,694.08
27,085.35
53,871.50
Capitated Incentive
Income
Non-Capitated
Incentive Income
Other Income
* Income is included in the relevant categories

4. Insurance P56 ($)
Molina 7,841.00
CHG 49,611.00
CCIPA 3,104.00
Vantage $5,849.00
Total 66,405.00
*Income earned from Prop 56 in 201X not yet received

5. $579,357.49
$341,745.80
$219,043.50
$98,016.59
$91,108.13
$35,243.67
$33,401.78
$30,560.76
$19,989.95
$8,634.67
$53,871.50
$1,510,973.84
Capitated Office Visits
Non-Capitated Office Visits
CCM
Home Visits
Income from other Procedures
HH-Certs
AAA/Echo/Car
SNF
Behavioral Health
Allergy Testing
Other Income
Total
Revenue Flows

6. 2017 2018 2019
Capitated Office Visits $534,932.82 $491,289.83 $579,357.49
$534,932.82
$491,289.83
$579,357.49
2017 2018 2019
Capitated Office Visits

7. 2017 2018 2019
Non-Capitated Office Visits 334,542.54 319,093.33 $314,660.45
334,542.54
319,093.33
$314,660.45
2017 2018 2019
Non-Capitated Office Visits

8. $198,082.26
$168,607.61
$219,043.50
2017 2018 2019
Chronic Care Management
2017 2018 2019
Chronic Care Management $198,082.26 $168,607.61 $219,043.50

9. Year 2017 2018 2019
Revenue (H-V) $127,454.43 $67,632.05 $98,016.59
$127,454.43
$67,632.05
$98,016.59
2017 2018 2019
Home Visits

10. 2017 2018 2019
Income from Other Procedures 236,109.20 109,302.78 91,108.00
Dropped business line** (80,227.92) (491.38)
Net Impact 155,881.28 108,811.40 91,108.00
-30% -16%
155,881.28
108,811.40
91,108.00
2017 2018 2019
Income from Other Procedures
** Hospitalist

11. 2017 2018 2019
Echo/Carotid/AAA 58,148.65 28,987.32 $33,401.78
58,148.65
28,987.32
$33,401.78
2017 2018 2019
Echo/Carotid/AAA

12. Staff 1 229,813.86 24.46%
Staff 2 121,710.28 12.95%
Staff 3 83,088.38 8.84%
Staff 4 64,433.76 6.86%
Staff 5 52,375.71 5.57%
Staff 6 46,964.23 5.00%
Staff 7 44,416.61 4.73%
Staff 8 44,198.75 4.70%
Staff 9 38,267.53 4.07%
Staff 10 36,299.10 3.86%
Staff 11 36,233.94 3.86%
Staff 12 33,171.15 3.53%
Staff 13 22,563.86 2.40%
Staff 15 21,736.52 2.31%
Staff 16 20,375.95 2.17%
Staff 17 15,998.24 1.70%
Staff 18 12,454.84 1.33%
Staff 19 7,998.62 0.85%
Staff 20 4,037.66 0.43%
Staff 21 3,084.13 0.33%
Staff 22 358.97 0.04%
Sub-Total 939,582.10 100.00%
Other direct operating costs 229,503.00
Total Staff and Operating Costs 1,169,085.10

13. Provider Productivity*** $
Provider 4 5.00
Provider 3 3,369.17
Provider 1 1,129,330.98
Provider 2 183,085.03
Total 1,315,790.18
*** skewed because of billing practices

14. CPT Code CPT Code Description Payment Total
99215 Office Visit - 99,212.23
99397 Preventive Care - 19,251.67
G0439 ANNUAL WELLNESS 250.17 17,035.59
96130 PSYCL TST EVAL PHYS/QHP 1ST 39.36 5,495.77
20926 REMOVAL OF TISSUE FOR GRAFT 440.00 5,236.41
99496 TRANS CARE MGMT 7 DAY DISCH 207.49 4,677.65
99407 BEHAV CHNG SMOKING < 10 MIN 24.74 4,324.09
76942 ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT FOR ASPIRATION
INJECTION
52.46 3,498.46
20610 DRAIN/INJECT, JOINT/BURSA HIP KNEE SUBACROMIAL 45.33 3,433.57
J7321 SODIUM HYALURONATE 20-25 MG 74.83 3,178.35
90662 FLU VACC PRSV FREE INC ANTIG 52.30 2,807.51
G0446 INT BH TX RDUC CVD RSK BI-AN 15 MIN 27.11 2,324.56
G0447 FCE-FCE BEHAVRL CNSL OBESITY 15 MIN 53.42 1,856.62
J0897 PROLIA 1,103.46 1,121.87
96151 ASSESS HLTH/BEHAVE SUBSEQ 47.08 1,042.61
G0008 ADMN FLU VAC NO FEE SCHED SAME DAY 17.33 1,031.87
36415 VENIPUNCT, ROUTINE 5.88 1,013.70
G0442 ANNUAL ALCOHOL MISUSE SCREEN 15 MIN 38.64 949.89
96372 THER/PROPH/DIAG INJ, SC/IM 18.56 856.16
G0101 CERV/VAG CANCR SCR;PELV&CLN BRST EX 40.91 775.48
80305 DRUG TEST PRSMV DIR OPT OBS 12.35 741.98
G0444 ANNUAL DEPRESSION SCREENING 15 MIN 38.64 584.23
93000 ELECTROCARDIOGRAM, COMPLETE 12.22 502.71
Other 0.08 2,132.05
Total 183,085.03
Direct Productivity*
- Steve

15. Other Direct Operating Costs $ $
Net Rental Expense 84,000.00 84,000.00
EMR 27,513.76 44,443.34
Medical Supplies and Disposables 18,496.34 46,131.50
Transportation 3,557.41 4,546.46
Postage 1,618.37 1,402.79
Malpractice Insurance 12,218.36 11,290.71
Other Operating Infrastructure Costs 42,802.49 36,036.30
Medical Billing 39,296.27 46,250.35
Total 229,503.00 274,101.45

16. Month Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total
s PSYCH DIAG EVAL
W/MED SRVCS
$1,913.36 $1,723.96 $1,597.98 $841.04 $1,229 $1,731.39 $2,220.29 $1,722.26 $1,796.79 $2,084.37 $1,646.98 $1,482.53 $19,989.95
Grand Total $1,913.36 $1,723.96 $1,597.98 $841.04 $1,229 $1,731.39 $2,220.29 $1,722.26 $1,796.79 $2,084.37 $1,646.98 $1,482.53 $19,989.95
Cost Center Contract Physician ($6,629.50)
Gross Return $13,360.45
Total Units 14 13 13 9 11 12 17 12 16 15 15 13 160
Behavioral Health $19,989.95
Gross Technical Cost ($6,629.50)
Gross Return $13,360.45
Gross Margin 66.84%
% of Total Revenues 1.32%
33.16%
66.84%
Behavioral Health
Gross Technical Cost Gross Return
Behavioral Health

17. Echo/Carotid/AAA $33,401.78
Gross Technical Cost ($7,470.00) -22.4%
Gross Return $25,931.78 77.6%
% Return 77.64%
% of Revenues 6.03%
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
76706 AAA $617.75 $617.75 $2,111.42 $1,488.60 $988.40 $1,446.28 $617.75 $370.65 $247.10 $123.55 $8,629.25
76881 US XTR NON-VASC COMPLETE $88.77 $96.48 $185.25
93000 ELECTROCARDIOGRAM, $150.97 $151.05 $168.07 $145.36 $124.41 $143.11 $147.68 $34.03 $153.50 $277.05 $411.92 $15.72 $1,922.87
93306 TTE W/DOPPLER, COMPLETE $1,443.55 $2,065.67 $1,242.39 $2,171.35 $814.87 $980.31 $1,192.30 $1,279.86 $1,632.62 $1,927.64 $2,337.87 $659.91 $17,748.34
93880 EXTRACRANIAL STUDY $467.15 $323.56 $286.96 $827.20 $143.48 $573.92 $580.36 $503.64 $323.56 $430.44 $143.48 $4,603.75
93978 VASCULAR STUDY $312.32 $312.32
Grand Total $2,061.67 $3,559.12 $2,411.65 $5,255.33 $2,571.36 $2,685.74 $3,366.62 $2,435.28 $2,480.33 $2,882.23 $3,016.82 $675.63 $33,401.78
Units 16 25 21 36 19 20 28 17 17 19 21 5
Cost Center Susana Bagdasarova ($7,470.00)
Gross Return $25,931.78
77.6%
22.4%
Echo/Carotid/AAA Gross Technical Cost
Echo/Carotid/AAA

18. Staff Needs Matrix
#
Support
Required?
Supporting
Personnel*
* Work Location Name
Coverage
Required
HEDIS Manager 1 N HQ/Remote Yinka N
Referral Coordinator 1 N HQ Joellen N
Scheduler 1 N HQ/Remote Gabriela N
Incoming Calls/Customer Service Rep 1 N HQ/Remote Sara Y
Billing Coordinator 1 Y 1HQ/Remote Yinka Y
Provider 1- Medical Assistant 1 Y HQ Jovany Y
Provider 2- Medical Assistant 1 Y HQ Mireya Y
Provider 3- Medical Assistant 1 Y HQ Chioma Y
CCM Case Manager 1 N 1HQ Eva Y
Document and Prescription Manager 1 Y 1HQ Alejandro Y
Front Desk Medical Receptionist 1 Y HQ Mara Y
11
Provider 1 1 HQ Dr D
Provider 2 1 HQ/SNF Steven
Provider 3 1 HQ/Residential Udoh
Grand Total 14