URBAN INDIAN HEALTH PROGRAM CY2012 Overview

URBAN INDIAN HEALTH PROGRAM CY2012 Using UDS Feedback Report as a Management Tool Susan Friedrich, JSI

URBAN INDIAN HEALTH PROGRAM CY2012  National performance  Program improvement  Ensuring the health of your patients Why is it important?

URBAN INDIAN HEALTH PROGRAM CY2012 Too much information and not enough time! A Snapshot Approach – focus on a few high impact measures for initial review to identify  Strengths  Possible areas of improvement Focusing Your Efforts

URBAN INDIAN HEALTH PROGRAM CY2012 Patient profile – who are you serving? Quality of care – are standards of care high? Efficiency – are we maximizing our resources? Financial security - are we in a good financial position? Snapshot of Performance

URBAN INDIAN HEALTH PROGRAM CY2012 Comparison Groups Program  Current year, prior year and 2 year change  Reported for total patients and AI/AN population Averages  Comparison group – Full Ambulatory, Limited Ambulatory or Information and Referral  National average (all UIHP programs)  BPHC Average (applicable to Full Ambulatory programs)

URBAN INDIAN HEALTH PROGRAM CY2012 Performance measures Access  Describes patients you serve Quality of Care  Utilization and GPRA measures Efficiency  Evaluates capacity Financial Cost/Viability  Assesses costs and viability Feedback Report

URBAN INDIAN HEALTH PROGRAM CY2012 Evidence that program is serving priority populations: % Growth in patients  AI/AN patients  % AI/AN of total patients  Total patients  % patients using medical services Patient demographics Patients with financial, cultural and linguistic barriers  % Uninsured, Medicaid, other public  % < 200% FPL Patient Profile

URBAN INDIAN HEALTH PROGRAM CY2012 Patient Profile Did you grow? Who are you serving?

URBAN INDIAN HEALTH PROGRAM CY2012 Evidence that program is delivering quality care:  GPRA Measures  Continuity of care  Prevalence rates Visits per patient (continuity) Rates of service use GPRA  Chronic Disease (diabetes control)  Routine and Preventive care (screenings, immunizations and assessments)  Behavioral health (tobacco, mental health and domestic violence) Quality of Care

URBAN INDIAN HEALTH PROGRAM CY2012 Quality of Care How do you compare? What is your performance? Are you improving or getting worse?

URBAN INDIAN HEALTH PROGRAM CY2012 Evidence that program is operating a cost effective services delivery model: Growth in visits Provider FTEs Panel size (patients/provider FTE) Visits per provider (productivity) Medical Team Ratio >1 Staff Ratios Efficiency

URBAN INDIAN HEALTH PROGRAM CY2012 Efficiency Did your visits grow with patients? Are you at capacity? How do you compare? Are you at capacity?

URBAN INDIAN HEALTH PROGRAM CY2012 Cost  Cost per patient and visit  % administrative costs  Charge to cost ratio  Surplus/deficit as % of total costs Diversification of Funding  % income from IHS  % income from patient service  IHS funding per AI/AN patient Financial Viability  Change in net assets as % of expense  Working capital to expense ratio  Debt to equity ratio Financial/Cost Viability Evidence that program is financially viable:

URBAN INDIAN HEALTH PROGRAM CY2012 Financial/Cost Viability Are your costs reasonable? Do fees cover costs?

URBAN INDIAN HEALTH PROGRAM CY2012 Provides formulas for all measures Format “replicates” the report format In the formula section, each measure is identified with:  A number  A name, corresponding to the name on the report  A formula for calculating the measure UDS Reference Guide

URBAN INDIAN HEALTH PROGRAM CY2012 % Pediatric: (T3A Lines 1-15, Col A+B) /(T3A L39 CA + T3A L39 CB) T= Table+ = add - = subtract L= Line * = multiply C= Column / = divide Calculations for Performance Measures

URBAN INDIAN HEALTH PROGRAM CY2012 Average Defined: The value obtained by dividing the sum of a set of quantities by the number of quantities in the set.  Program Type (Full Ambulatory, Limited Ambulatory, Information and Referral  UIHP National Averages (from all urban programs)  BPHC National (from FQHCs) Averages

URBAN INDIAN HEALTH PROGRAM CY2012 Compare your performance with peer groups  How do you compare with similar programs? Look at your performance over time  Are things trending in the right direction? Identify strengths and weaknesses Develop and implement strategy for improvement Identifying Strengths & Weaknesses

URBAN INDIAN HEALTH PROGRAM CY2012 Susan Friedrich or Priscilla Davis John Snow, Inc. (JSI) UDS Helpline: website: Contact Information