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A Dental Incentive System that Works - Safety Net Dental Clinic

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					A Dental Incentive System
that Works
Juris M. Svarcbergs,DMD,MPH
Dental Director
CAMcare Health Corporation


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Background
 The early years
     „Do gooders‟
      Focus on „ideal service‟
      Dedication to cause or philosophy




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Background
 Traditional professional „formula‟
      Work in itself a reward
         (a non-monetary incentive)
      Salary adequate compensation
           (your paycheck is the reward)
      Administration outlook
           (we‟re not the private sector)



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Background
 The Changing Times
       Burdened with debt Graduates
       Business oriented Dentists
       MBA Administrators
       The realization:“To do Good,
            we must do Well!”

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Driving Forces in today‟s
environment
  Decreased grant funding opportunities
  Mainstreamed care delivery
       Competition for patients
       Competition for revenue
  Increased opportunity for Revenue
        generation


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The New Environment

  200,000
  180,000
  160,000
  140,000
  120,000
  100,000                                                Goal
   80,000                                                Actual
   60,000
   40,000
   20,000
        0
            Profitability


                       Cost Center Analysis
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DENTAL PRODUCTIVITY


 Target is 2,400/DDS



 Annualized Rate:
    2,639 enc/DDS



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Improvements in MIS, CIS
  Enable accurate dental data collection

  RVU capabilty for correlation of amount
    of care with visit info

  Provider profiles


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Why not become ……
      competitive
in today‟s environment with
MOTIVATED and
EFFICIENT PROVIDERS!?!

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Let‟s Try an Incentive System!
Money always
  works!
Should we Increase
  salary?
Should we consider
  commissions?
How do we tie work
  produced to
  paycheck?

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The Dilemma(s)
  Increased Revenue can only be
  generated with
  Administrators don‟t want to lose
            over expenditures
  Providers don‟t        administrators to
  share income or „commission's‟ fairly


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Available Incentive Systems
  % of Provider generated charges
  % of collections of Provider‟s production
          “x” % of Medicaid income
          “y” % of Self Pay income
  $‟s per R.V.U. generated
  The „mathematician's dream‟ formula

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Satisfaction
  Can you really be happy if you
     Can‟t figure out your take home
         pay or bonus
      Can‟t „trust‟ the figures of billing
         or admin people
      You have to treat some patients
         in ways to benefit your income

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Real Life




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How to Build an Effective
Incentive Program:
   The “5 Commandments”

 Simple and easy to understand
 Allay administration fears
 Empower providers
 Make the reward memorable
 Relate the incentive directly to the
 organization‟s income level
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The CAMcare Incentive Plan
  Guaranteed base                      Security
  salary: Reasonable and
  contractual
                                       Budgeting

 Good fringe benefits                  Goodwill and
 Health coverage,                      competitive edge
 malpractice,CME time &                Only one concern-
 coverage, pension
                                       PRODUCTIVITY


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The CAMcare Incentive Plan
  Quarterly Goals                     600 visits/ FTE
                                       (not 599!!) (individual
                                      provider not group
                                      average)

  Quarterly Payout                    10% of base salary in
                                      contract-exactly
                                      (prorated for quarter i.e
                                      2.5% of annual base
                                      salary)
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„Bonus Payout‟ Example
 Dr. XYZ had 645                     CHC submitted bill
 patient visits this                 for approx. $64,500
 quarter                             to all payors
 At $80K contract/yr,                CHC expects to get
 Dr.XYZ rec‟d                        min. 2.5 times what
 $20,000 in base                     pays out docs
 salary                              CHC gets
 Reaching/Goal gets                  $42,500
 $2,000 Bonus                         (Doc gets $22,000)
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Special Request for Payout!
Goal Achievers:




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Bonus is Recognition of
Achievement
  Bonus checks are separate and usually
  presented by CEO




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And it‟s part of total Package
Professional Compensation Package:
1. Base Salary            $ 80,000
2. Health Coverage           5,604
3. Soc.Security Taxes        4,142
4. CME Allowance              1,500
5. Vacation,CME,Personal,
      Holidays,Sick, time     8,941
6. Malpractice Coverage       3,800
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Add up Total Package
Total Value………………$ 103,987
If Loan Repayment-add 25,000
TOTAL Package without Bonus:
               $128,987 !!!

Is another $ 8,000 worth the effort???

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Results: Avg.Encounters/DDS
    3,000
    2,800
    2,600
    2,400
    2,200                                    1998
    2,000                                    1999
    1,800                                    2000
    1,600                                    2001
    1,400
    1,200
    1,000
                    Visits/DDS


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Results: RVU‟s per DDS/yr.




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Results: DDS‟s reaching goal
     90.00%

     80.00%

     70.00%

     60.00%
                                                             1998
                                                             1999
     50.00%
                                                             2000
     40.00%                                                  2001

     30.00%

     20.00%

     10.00%

      0.00%
              1998          1999        2000          2001




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DENTAL VISITS by Year
 14500
 14000
 13500
 13000
                                                        1998
 12500
                                                        1999
 12000                                                  2000
 11500                                                  2001
 11000
 10500
 10000
         1998     1999              2000         2001

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The Bottom Line: Dental Cost
Center $ EPI (profitability)
      60,000

      50,000

      40,000

      30,000
                                                       EPI/DDS
      20,000

      10,000

          0
               1998      1999       2000        2001




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          CAMcare
          Revenue & Expenses

                            CAMcare Health Corporation
                            Annual Revenue vs Expense
                11


                10                                                            Revenue
    Million s
$




                                                                              Expenses
                 9


                 8
                     1997    1998               1999            2000   2001
                                               Year

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S = R/E
 Choose a „goal‟ that directly influences
   the organization‟s income level
 Offer a definite bonus amount that is
         „BIG‟ yet „small‟
 Support providers in achieving goal
         at every level


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S = R/E
 Make the reward memorable
   (timing, amount, presentation)

 Report to Board as a “Dental
 Department defining” event!
    (Dental exceeds expectations)


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Who are the „Satisfied
Customers‟?
  Providers                               Board
   (and support staff)

  CEO                                     Patients

  CFO                                     Community


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Simply
Satisfying!

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posted:11/2/2011
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