Clinical Investment Fund FY 2020 Requests Department of XX Slides 2 and 4 should be submitted for each funding request, Slides 6-7 may be used if additional detail is required for requests Month DD, 2018 Department should submit no more than 4-5 slides per request

Clinical Investment Fund Request [Name of Funding Request] [Type brief description of funding request here] [Department Name ] Request Strategic Alignment: xx Operations: xx UPDATE PER REQUEST [Other impacts, such as market need] : xx (do not reference financial benefit to hospital) Total FY 2020 Request Amount: $

Clinical Investment Fund Request Hillsborough Emergency Department EXAMPLE Clinical Investment Fund Request Hillsborough Emergency Department Continuation of HBH Emergency Medicine subsidy to support 24/7 coverage and support of HBH IP and OP services Emergency Medicine Request Strategic Alignment: Subsidy aligns with the academic mission of the hospital as well as Triangle strategy goals Operations: HBH EM supports Med Center decompression and helps with access and LOS goals UPDATE PER REQUEST Total FY 2019 Request Amount: $200K

Clinical Investment Fund Request [Name of Funding Request] Initiative Name/Description Initiative Value Proposition (“Elevator Pitch”)   Criteria Assessment Explanation of Assessment A. Requested Financial Support for FY20 0 $ $$ $$$ $$$$ ($0) (<$100K) ($100-$500K) ($500K-$1M) ($1M+) Investment needed to launch or sustain the initiative FY20 request amount: $ Annual amount likely needed for FY21 and beyond: $ Further explanation: B. Financial Return (Low, Medium, High) Perceived financial impact (anticipated revenue minus steady state costs) to UNCFP C. Capacity Needs (Low, Medium, High) Projected resources required for full initiative deployment (staffing, coordination, bed/OR capacity, marketing, etc.) D. Implementation Risk (Low, Medium, High) Potential risk of implementation failure; ability to execute successfully E. Strategic Alignment (Low, Medium, High) Perceived alignment with system and UNCMC mission, and Triangle Strategy goals; opportunity for collaboration(s) within and across UNCMC F. Defined Success (Metrics) What metrics should be used to ensure that funds are used as intended and the investment is a success? Metrics e.g., productivity, access, LOS, etc. Please propose values for achieving metrics (e.g., dept./division exceeds MGMA median wRVU benchmark for fiscal year); furthermore, please describe qualitative aspects of success for the department, UNC Hospitals, and/or UNC Medical Center UPDATE PER REQUEST

Clinical Investment Fund Request Hillsborough Emergency Department EXAMPLE Clinical Investment Fund Request Hillsborough Emergency Department Initiative Name/Description Initiative Value Proposition (“Elevator Pitch”) Continuation of HBH Emergency Medicine funding Emergency Medicine was asked in 2015 to staff HBH ED with 24/7 coverage and an annual renewal option Acuity (and reimbursement) of patient population lower than at UNCMC ED   Criteria Assessment Explanation of Assessment A. Requested Financial Support for FY20 0 $ $$ $$$ $$$$ ($0) (<$100K) ($100-$500K) ($500K-$1M) ($1M+) Investment needed to launch or sustain the initiative $$  Please explain any anticipated support needed over a 5 year horizon beyond FY19 FY19 request: $XXM/K Anticipated Cumulative Support of $XXM/K over X year horizon B. Financial Return (Low, Medium, High) Perceived financial impact (anticipated revenue minus steady state costs) to UNCFP Med Subsidy supports ED providers and supports downstream departments C. Capacity Needs (Low, Medium, High) Projected resources required for full initiative deployment (staffing, coordination, bed/OR capacity, marketing, etc.)  Low Support will be committed to existing facilities at Hillsborough Hospital Request for funding to continue operations D. Implementation Risk (Low, Medium, High) Potential risk of implementation failure; ability to execute successfully E. Strategic Alignment (Low, Medium, High) Perceived alignment with system and UNCMC mission, and Triangle Strategy goals; opportunity for collaboration(s) within and across UNCMC  High  Aligns with Triangle Strategy priorities to “Improve Health” and “Increase Value” Supports system mission to be “the leading AMC” F. Defined Success (Metrics) What metrics should be used to ensure that funds are used as intended and the investment is a success? Door to doc (min) -- 19.7 Doc to dispo (min) -- 106 Overall LOS (min) -- 171 UPDATE PER REQUEST

Data Backup Please include 1-2 slides with any data that supports your request and/or describes the program(s) that would receive support Any backup that you would like to include related to your request.

Metric(s) of Success Please propose how success will be measured based on any investment from the CIF; the CIC intends to hold each department accountable based upon appropriate metrics How would we measure success with the investment requested? Only include if you need to add additional data.

Summary of Requests Initiative Name/Description FY 2019 Amount If the department is submitting multiple requests, please summarize all requests in table format Initiative Name/Description FY 2019 Amount Requested XX TOTAL $XX If there are multiple CIC application request for $$ please summarize them into a table with the totals.

Department of XX Scorecard Funds Flow Impact & Operating Performance TO BE COMPLETED BY UNCFP ADMIN Department of XX Scorecard Funds Flow Impact & Operating Performance A B C D = A+B+C E F = D + E UME GME Clinical Total Funds Flow Change FY17 Change in Net Assets FY17 Change in Net Assets in Funds Flow Funds Flow Impact Reserves Expense per Day Days of Cash Inpatient Visits Outpatient Visits Total Visits Prior YTD November Current YTD November Increase / (Decrease) Charges Net Receipts Adjustments Net wRVU Days in AR GCR NCR Increase/ (Decrease) FTE cFTE  

Department of XX Scorecard Compensation & Productivity TO BE COMPLETED BY UNCFP ADMIN Department of XX Scorecard Compensation & Productivity FY 2017 Compensation Total Department Comp Dept. Incentive or Other Payment % Incentive to Total Comp Dept. FTEs Dept cFTE Total Department Comp per FTE AAMC Median Total Comp per FTE % of AAMC Median Emergency Med Chair Professor Associate Assistant Instructor Grand Total Productivity Department net with RVUs MGMA wRVU Median % of MGMA wRVUs not Adj for cFTE