Department of Pathology Benchmarking Marty Lawlor Friday, November 8, 2013

Financial Metrics Questions vs. Answers Reviewing financial data rarely gives us the answers we are looking for. It will direct us to the questions we need to ask about changes in our operations.

HOSPITAL METRICS

Hospital Consolidated FY13 June YTD Financials

Hospital Financial Performance FY13 December YTD by Entity

Hospital Pathology Consolidated Statement

Hospital Pathology Consolidated Statement Individual Lab

Managing a Practice

Sources of Departmental Revenue Clinical Revenue Margin – Currently 36% Extramural Funding – Direct & Indirect Costs Educational Transfers Part A Transfers Clinical Ph.D. Transfer Professional Component Billing Additional Contractual Agreements

Part A Role as a lab director Services provided to the facility or for the benefit of patients in general (autopsies) Part B Services provided to individual patients Surgical pathology Transfusion medicine Interpretive services Faculty Provide Both Part A and Part B Services

Clarified Part A and Part B services and payments Eliminated professional component billing on routine laboratory tests for Medicare inpatients (other payors have adopted this policy) Defined reasonable compensation equivalent (RCE) Part A Transfer is Payment for Professional Services Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)

Autopsies Medical Administration Supervisory and Consulting Activities Medical Education Part A Services

Assure accuracy of test results Interact with medical staff Establish parameters for performance of tests Recommend additional diagnostic/therapeutic tests Advise lab personnel regarding aberrant results Clinical Laboratory Improvements of 1988 Codified the Role of Lab Director

Select, evaluate and validate test methodologies Direct performance and evaluation of quality control and quality assurance procedures Evaluate clinical data; establish process for review of tests prior to issuance of patient reports Assure compliance with accrediting agencies Clinical Laboratory Improvements of 1988 Codified the Role of Lab Director

RVU Report

Collections

PART A REPORTING

Clinical Incentive Payment Calculations The Pathology Incentive program is divided into four major categories: Extramural Consults, Outreach Part B Billings, Outreach Part A Payment and Department margin. Incentives are provided twice a year (July – December; January – June). Limits to total compensation are imposed by the Medical School. The current salary limit is 25% or $60,000 per year, which ever is higher, of base, academic, clinical supplement A and administrative differential (basically total compensation received less the incentive payments). Extramural Consults Outreach Part B Billings Outreach Part A Payment Department Margin

RESEARCH

FINANCIAL SUMMARY FOR FACULTY X

FINANCIAL SUMMARY FOR FACULTY Y

Research Incentive

NATIONAL BENCHMARKING ISSUES Phlebotomy – Is it housed in Pathology or Nursing? Pathology Informatics – Departmental or centralized? Send-outs – Are these shown as supplies? Complexity of Test Menu

Case Studies Why are the total supplies and supply metrics for Molecular Diagnostics up? Why are FTE’s up across the board in FY14? Why are FTE’s up in Molecular Diagnostics? Why is there an increase in FTE’s in the HLA Lab?

Questions