Hospital Performance Appraisal by peisty474

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									Hospital Performance Appraisal
Community Medical Center

Prepared By:
Scott Regan
Regan & Partners
April 17, 2009

MANAGEMENT REPORT
                                             Table of Contents
Hospital Performance Appraisal Report Card                  1
Patient Care Costs                                          2
Clinical Outcomes                                           3
Case Management, PFS                                        4
Human Resources                                             5
Revenue-Enhancement Opportunities                           6
                                                                          Cost-Reduction Opportunities

                                   Hospital
                               Performance                     Patient Care Costs                Case Management, PFS
                                  Appraisal              ALOS, Medicare             $5.00 MM   Avoidable Days           $1.22 MM
                                                         Laboratory Costs           $0.92 MM   Payer Denials            $3.06 MM
                                                         Radiology Costs            $0.20 MM   Bad Debt                 $2.25 MM
  Community Medical Center                               Full-Time Equivalents      $7.92 MM




  Your Hospital Performance                                    Clinical Outcomes                    Human Resources
           Index:                                        Adverse Events             $0.18 MM   Employee Turnover        $7.06 MM

                      74
                                                         Hospital Prof. Liability   $0.59 MM   Premium Labor Costs      $1.39 MM




        Your Prior Year HPI:                                      Revenue-Enhancement Opportunities
                      NA
                                                                       Clinical                        Revenue Cycle
                                                         Discharges per Bed         $2.97 MM   Days in A/R             $13.53 MM
  The Hospital Performance Index is a                    O.R. Utilization           $2.53 MM
  measure of the organization’s overall                  E.D. Diversion             $0.17 MM
  performance compared to the top-                       E.D. LWBS                  $0.47 MM
  quartile benchmark performers. Top-
  performing hospitals achieve an                     Cost-Reduction Opportunities                                   $29,790,275
  indexed score of 90 or greater.                     Revenue-Enhancement Opportunities                              $19,091,880
                                                      Total Opportunity                                              $48,882,155
                                                      Percent of Operating Budget                                          26.3%


Community Medical Center – Hospital Performance Appraisal – Page 1
                                   Hospital                                 Patient Care Costs
                               Performance
                                  Appraisal




                                                                                       Performance




                                                                                                      Performance
                                                                                                      Top-Quartile




                                                                                                                        Opportunity
                                                                                                                          Gross
  Community Medical Center




                                                                                           Your
                                                             Opportunity
  Operating profit margin, ALOS, and
  operating expense per adjusted
  discharge all reflect overall operational
  efficiency, and, thus, only the smallest               Operating Profit Margin      2.15%          7.44%            $9,830,922
  opportunity is reflected in the numbers
  reported on page 1. In this case,                      ALOS, Acute Care                4.92          4.07           $9,423,050
  Medicare ALOS, with an opportunity of                  ALOS, Case-Mix Adjusted         3.94          2.58          $14,241,936
  $5.00 million, is the most conservative
                                                         ALOS, Medicare                  5.98          5.04           $5,001,280
  selection.
                                                         Operating Exp per Adj D/C    $8,548         $8,181           $7,813,196
  Similarly, FTEs and FTEs case-mix
  adjusted represent a single opportunity,                  Case-Mix and Wage Adj     $6,479         $5,467          $21,524,103
  with the most conservative being                       Lab Cost per Adj D/C          $285           $242             $924,360
  reported on page 1. In this case, FTEs
  per 100 adjusted discharges, with an                   Radiology Cost per Adj C/C    $257           $248             $201,454
  opportunity of $7.92 million, is the most              Pharmacy Cost per Adj D/C     $263           $331                            $0
  conservative selection.
                                                         FTEs per 100 Adj D/C            6.10          5.59           $7,916,308
  All benchmarks are supplied by                           Case-Mix Adjusted             4.88          3.61          $19,635,691
  Solucient’s Comparative Performance
  of U.S. Hospitals.



Community Medical Center – Hospital Performance Appraisal – Page 2
                                   Hospital                                     Clinical Outcomes
                               Performance
                                  Appraisal




                                                                                        Performance




                                                                                                       Performance
                                                                                                       Top-Quartile




                                                                                                                      Opportunity
                                                                                                                        Gross
  Community Medical Center




                                                                                            Your
                                                             Opportunity
  Clinical outcomes are a measure of the
  organization’s clinical effectiveness.
  Readmission rates are established by
  Leapfrog, the adverse events rate is a                 14-Day Readmit Rate, CABG      4.7%           5.1%                         $0
  benchmark established by the Institute                 14-Day Readmit Rate, PCI       3.9%           5.0%                         $0
  for Healthcare Improvement, and the
  hospital professional liability loss cost              14-Day Readmit Rate, CAP       4.2%           4.7%                         $0
  per bed is derived from the ASHRM                      Adverse Events1                  1.31          1.00          $175,300
  annual Hospital Professional Liability
                                                         Professional Liability2       $4,727         $3,100          $588,893
  Analysis and is largely predicated by the
  state in which th hospital resides.




                                                         1Per   1,000 patient days
                                                         2Loss   cost per bed




Community Medical Center – Hospital Performance Appraisal – Page 3
                                   Hospital                                Case Management, PFS
                               Performance
                                  Appraisal




                                                                                                   Performance
                                                                                  Performance




                                                                                                   Top-Quartile




                                                                                                                     Opportunity
                                                                                                                       Gross
  Community Medical Center




                                                                                      Your
                                                             Opportunity
  National benchmark data does not exist
  for avoidable days, payer denials, or
  bed debt. The theoretical goal for all
  healthcare organizations in each of                    Avoidable Days                  841                 421   $1,217,678
  these categories is zero.
                                                         Payer Denials        $6,110,982        $3,055,491         $3,055,491
  Thus, the target set for the organization
  is a 50 percent improvement in each of                 Bad Debt             $4,500,381        $2,250,191         $2,250,191
  the three areas, which has shown to be
  possible with the use of advanced
  performance improvement
  methodologies.




Community Medical Center – Hospital Performance Appraisal – Page 4
                                   Hospital                                Human Resources
                               Performance
                                  Appraisal




                                                                                                   Performance
                                                                                  Performance




                                                                                                   Top-Quartile




                                                                                                                    Opportunity
                                                                                                                      Gross
  Community Medical Center




                                                                                      Your
                                                             Opportunity
  Employee turnover is a benchmark
  established by the Institute for
  Healthcare Improvement and other
  healthcare human resources                             Employee Turnover          17.5%           10.0%         $7,063,716
  organizations. Many organizations have
  successful surpassed this target, with                 Premium Labor Costs   $2,791,209       $1,395,605        $1,396,605
  turnover rates below 5.0 percent
  National benchmark data does not exist
  for premium labor costs. The theoretical
  goal for all healthcare organizations in
  this category is zero.
  Thus, the target set for the organization
  is a 50 percent improvement in this
  area, which has shown to be possible
  with the use of advanced performance
  improvement methodologies.




Community Medical Center – Hospital Performance Appraisal – Page 5
                                   Hospital                     Revenue-Enhancement Opportunities
                               Performance
                                  Appraisal




                                                                                        Performance




                                                                                                       Performance
                                                                                                       Top-Quartile




                                                                                                                         Opportunity
                                                                                                                           Gross
  Community Medical Center




                                                                                            Your
                                                             Opportunity
  O.R. utilization benchmarks are
  established by the American Society of
  Anesthesiologists and reflect the
  utilization rate required to fully optimize            Discharges per Bed             35.25         61.48            $2,970,794
  the operating suite.
                                                         O.R. Utilization               52.0%         85.0%            $2,526,769
  National benchmark does not exist for
  E.D. diversion hours, but the theoretical              E.D. Diversion Hours               481           241            $16,722
  target of 0 has been established by                    E.D. Left Without Being Seen   6.3%          2.0%               $47,122
  many hospitals; an improvement rate of
                                                         Days in Net A/R                       68             41      $13,530,472
  50 percent is used here. The E.D. left
  without being seen benchmark was
  derived from the National Hospital
  Ambulatory Medical Care Survey.
  All other benchmarks are supplied by
  Solucient’s Comparative Performance
  of U.S. Hospitals.




Community Medical Center – Hospital Performance Appraisal – Page 6

								
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