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Developing an
Organizational Scorecard
Mike Trachta, CEO
Waverly Health Center
Outline
• Balanced Scorecard Introduction
• Performance Indicator Reports
• WHC’s Strategic Plan
• WHC’s Organizational Scorecard
• Conclusion
Definition of Balanced
Scorecard
A new approach to strategic management was
developed in the early 1990's by Drs. Robert
Kaplan (Harvard Business School) and David
Norton. The balanced scorecard is a
management system (not only a measurement
system) that enables organizations to clarify
their vision and strategy and translate them into
action. It provides feedback around both the
internal business processes and external
outcomes in order to continuously improve
strategic performance and results. When fully
deployed, the balanced scorecard transforms
strategic planning from an academic exercise
into the nerve center of an enterprise.
Definition - continued
• The balanced scorecard suggests that
we view the organization from four
perspectives, and to develop metrics,
collect data and analyze it relative to
each of these perspectives:
• The Learning and Growth Perspective
• The Business Process Perspective
• The Customer Perspective
• The Financial Perspective
Balanced Scorecard
Performance Measurement
& Indicators
Performance Indicator Reports
• Created to provide an in-depth
look at the financial, operational
and satisfaction/quality
performance of WHC
• Multiple ratios selected, defined,
and results displayed graphically
over 5 year period
• WHC performance compared to 2
benchmarks
Benchmark Methodology
• External Benchmark
– Iowa hospitals classified as Rural
• Examples: Grinnell Regional Medical Center, Unity Healthcare in Muscatine, &
Skiff Medical Center in Newton
• Local Competitors
– Average of three nearest hospitals: Allen Health System, Covenant
Medical Center, & Sartori Memorial Hospital
• Financial Indicators Report
– Income Statement & Balance Sheet data used to manually calculate each
ratio
• Operating Indicators Report
– Ratio’s formulas, definitions, & values taken from IHA report generated
using income statement & utilization information
• Satisfaction and Quality IndicatorsReport
– Measurements of Patient Satisfaction, Employee Satisfaction and Quality
Indicators are compared to Press Ganey, Institute for Quality Healthcare,
Iowa Hospital Association databanks and others.
Financial Performance
Indicator Report
Key Ratios
Profitability Ratio – Operating
Margin
• Formula
– Operating Margin = Operating Income /
Operating Revenue
• Directly affected by markup ratios,
contractual allowances, & cost
control
• A higher ratio and increasing trend
is preferred
Profitability Ratio – Operating
Margin
Operating Margin
12%
11.4%
10%
9.0%
8.6%
8% 7.6%
7.5%
6% 5.9%
4.0%
4% 3.5%
3.7% 3.6%
2.8%
2.8%
2% 2.4%
1.5%
1.6%
0%
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Liquidity Ratio – Days Cash,
Current
• Formula
– Days Cash = (Cash + Limited-use Assets) /
[(Expenses – Depreciation)/365]
• Provides an estimate of the number
of days expenses WHC has in cash
& short-term investments
• Higher ratios imply a greater ability
to meet liabilities
Liquidity Ratio – Days Cash,
Current
Days Cash on Hand - Current
70
60 57.5
59.4
54.5
50
40 36.3
Days
30
24.9
23.6
20.4
20 22.2 21.4
20.6
10 12.3
0
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Capital Structure – Long-term
Debt to Capitalization
• Formula
– LT Debt to Capitalization = LT Debt /
(LT Debt + Fund Balance)
• Indicates what level of assets is
funded with long term debt
• A stable, lower ratio is preferred
Capital Structure – Long-term
Debt to Capitalization
LT Debt to Capitalization
0.6
0.54
0.5
0.4
0.3
0.22 0.22
0.2 0.19 0.19
0.17
0.15 0.14
0.1
0.0
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Capital Structure – Debt Service
Coverage (DSC)
• Formula
– DSC = (Net Income + interest expense +
Depreciation) / (Interest Expense + Debt
Principle)
• Measures ability to meet debt
service payments from cash flow
• A higher ratio is favorable and an
increasing trend is desirable
Capital Structure – Debt Service
Coverage (DSC)
Debt Service Coverage (DSC) Ratio
6
5.7
5.5
5 4.9
4.1
4
3.9
3.4
3.0 3.2
3
2.3
2
1.3 1.3
1
0
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Asset Management – Average
Age of Plant
• Formula
– Ave Age of Plant = Accumulated
Depreciation / Depreciation Expense
• Provides a rough estimate of the
age of WHC’s fixed assets
• Lower values indicate new facilities
and equipment
Asset Management – Average
Age of Plant
Average Age of Plant
15
13 12.8 13.4
11
10.0 10.1
Years
10.0
9.4
9
7.5
7.1
7 7.4 7.5 7.4
5
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Revenue Cycle – Days in AR
• Formula
– Days in AR = Net Patient AR / [Net
Patient Revenue/365]
• Measures liquidity, as well as how
efficient WHC is throughout the
revenue cycle
• A lower value and decreasing
trend is desirable
Revenue Cycle – Days in AR
Days in Patient Accounts Receivables
110
101.1
100
90
83.4
80 76.5
71.3 70.6
70
70.0 66.6 66.4
68.0
61.7
59.7
60 62.0
59.6
56.0
50
40
FY'00 FY '01 FY '02 FY '03 FY '04
WHC External Benchmark Local Competitors
Operating Performance
Indicators Report
Key Ratios
Outpatient Revenue Percentage
• Formula
– Outpatient Rev % = Total Outpatient
Charges / Total Charges
• Revenue indicator that tells what
percentage of WHC business is
generated in outpatient care
Outpatient Revenue Percentage
Outpatient Revenue Percentage
75%
72.2%
70.1% 70.3% 70.9%
70%
65% 64.4%
60.8%
60% 59.3% 58.2%
60.3%
56.8%
55%
52.1% 52.2% 53.5%
49.8%
50% 48.5%
45%
40%
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Contractual Allowance
Percentage
• Formula
– Contractual Allowance % = Total
Contractual Allowances / Total Charges
• Revenue indicator that provides an
estimate of the average discount
level third-party payors receive
• Lower ratios are preferred
Contractual Allowance
Percentage
Contractual Allowance Percentage
55%
50% 49.4%
45.2%
45%
42.0%
40%
36.6%
37.7% 37.6%
35% 34.6%
31.9%
30%
27.8%
26.5%
27.3% 27.6%
25%
23.6% 24.3%
21.0%
20%
15%
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Bremer County Market Share
Inpatient Market Share - Bremer County
50%
39.8% 4 1. 8 % 40.7%
38.2% 42.7%
40%
30% 22.0% 22.9% 2 1. 8 %
2 1. 4 % 19 . 6 %
20% 2 1. 3 %
2 0 . 1% 16 . 0 % 17 . 6 % 19 . 4 %
10%
1. 6 % 1. 6 % 1. 3 % 2 . 1%
2.3%
0%
2000 2001 2002 2003 2004
WHC Allen Covenant Sartori
Outpatient Market Share - Bremer County
50%
38.4%
40% 35.9%
30% 26.8%
25.9%
20% 12 . 2 %
11. 6 %
10% 4.0%
4.5%
0%
2000 2001 2002 2003 2004
WHC Allen Covenant Sartori
Butler County Market Share
Inpatient Market Share - Butler County
40%
33.3% 33.3% 35.8%
36.9% 37.2%
30%
19 . 0 % 18 . 3 % 19 . 9 %
20% 16 . 4 % 17 . 7 %
13 . 6 % 16 . 0 % 16 . 0 %
14 . 2 % 14 . 8 %
10% 7.3%
5.5% 6.2% 6.9% 6.5%
0%
2000 2001 2002 2003 2004
WHC Allen Covenant Sartori
Outpatient Market Share - Butler County
30%
27. 1% 27. 3%
2 5%
23. 1%
21. 4%
20%
14. 0% 13. 4%
15%
10 % 11. 7%
10. 6%
5%
0%
2000 2001 2002 2003 2004
WHC Allen Covenant Sartori
Average Length of Stay
• Formula
– Ave LOS = Total Patient Days / Total
Discharges
• Utilization measure that estimates
the average length of stay a
patient remains at WHC
• Decreasing trend or lower LOS is
generally preferred
Average Length of Stay
Average Length of Stay - Overall
8
7.7
7
5.9
6
5 4.6 4.3 4.5 4.7 4.6
4
3.1 3.1 3.3
3.0
3 3.5
2
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Average Length of Stay - Acute Care
5
4.3 4.2
4
3.7 3.6
3.5 3.5 3.5
3.6
3.3 3.4
3
3.1 2.6
2.7 2.8
2.5
2
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Inpatient & Ambulatory Surgery
Trends
Births & Outpatient Visits Trends
Births
1,000
782 840
800
748 720 759
600
400
200 186 180
86 88 114 100
- 107
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Outpatient Visits
400,000
300,000 296,085
217,677 224,478 222,376 224,695
200,000
110,224 121,684 131,656 134,044
100,000 95,778
76,179 77,050
-
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Operating Expense per Adjusted
Patient Day - Overall
• Formula
– Op Exp per Day = (Total Operating
Expense x IP %) / Total Patient Days
• Cost indicator that estimates the
level of resources used to treat a
patient during an inpatient day
• A decreasing trend or lower rate is
preferred
Operating Expense per Adjusted
Patient Day - Overall
Operating Expense per Adjusted Patient Day
$1,400
$1,348 $1,325
$1,300 $1,249
$1,196
$1,200
$1,155
$1,086 $1,088
$1,100 $1,115
$1,028
$1,000
$989
$900
$800
$789
$700
$600
$588
$500
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
FTEs per Adjusted Occupied Bed
• Formula
– FTEs per Bed = (FTE x IP%) / Ave Daily
Census
• Cost indicator that estimates the
number of employees assignable to
inpatient beds
FTE per Adjusted Occupied Bed
FTEs per Adjusted Occupied Bed
5.5
5.2
5.0
4.8 5.0
4.6 4.9
4.5 4.6
4.0 4.3 4.3
4.0
3.6
3.5
3.0
3.0
2.6
2.5
2.0
FY ' 00 FY '01 FY ' 02 FY ' 03 FY ' 04
WHC External Benchmark Local Competitors
Satisfaction and Quality
Performance Indicators Report
Key Ratios
Outpatient Satisfaction
• Outpatient Satisfaction Score
– This is the overall score for WHC during the quarter out of
a possible 100. It is the result of a Press Ganey Survey that
is sent to select outpatients during the period. The overall
score displayed takes the following categories into
consideration: registration, facility, test or treatment,
personal issues, and overall assessment. An increasing
trend and higher score is preferred.
– Outpatient Percentile Rank: This is an indication of how
WHC's satisfaction score compares to other institutions
included in the groups or databases.
Outpatient Satisfaction
Outpatient Overall Satisfaction Score
100
95
90 91 90 90
85
80
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
Outpatient - Percentile Ranking
100%
80%
62%
60% 48%
61% 42% 43%
58%
40% 37%
41%
20% 35%
0%
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
All Facilities 51K - 150K Procedures Iowa Hospitals
Inpatient Satisfaction
• Inpatient Satisfaction Score
– This is the overall score for WHC during the quarter out of
a possible 100. It is the result of a Press Ganey Survey that
is sent to select inpatients on a monthly basis. The overall
score displayed takes the following things into
consideration: admitting, rooms, meals, nurses, tests &
treatment, family & friends, physicians, discharge, and
personal issues. An increasing trend and a higher score is
preferred.
– Inpatient Percentile Rank: This is an indication of how
WHC's satisfaction score compares to other institutions
included in the groups or databases.
Inpatient Satisfaction
Inpatient Satisfaction Score
100
95
Score
90
86 88
88
85 85
80
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
Inpatient Satisfaction Score - Percentile Rank
100%
91% 94%
Percentile Rank
80% 84%
77% 75%
60% 60% 59%
40% 39%
20%
0%
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
Small Facility All Press-Ganey
Emergency Department Patient
Satisfaction
• Emergency Department Satisfaction Score
– This is the overall score for WHC during the quarter out of
a possible 100. It is the result of a Press Ganey Survey that
is sent to every emergency department patient that was not
admitted during the period. The overall score displayed
takes the following categories into consideration: arrival,
nurses, doctors, tests, family & friends, personal &
insurance information, personal issues, and overall
assessment. An increasing trend and higher score is
preferred.
– Emergency Department Percentile Rank: This is an
indication of how WHC's satisfaction score compares to
other institutions included in the groups or databases.
ED Patient Satisfaction
Emergency Department Satisfaction Score
100
95
90 91
89 89 90
85
80
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
Emergency Department - Percentile Rank
100%
86% 86% 89% 94%
80% 69% 77%
60%
Percentile
57%
60% 60%
56%
40% 44% 53%
20%
0%
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
All Facilities Small ED Iowa ED
Ambulatory Surgery Patient
Satisfaction
• Ambulatory Surgery Satisfaction Score
– This is the overall score for WHC during the quarter out of
a possible 100. It is the result of a Press Ganey Survey that
is sent to select ambulatory surgery patients during the
period. The overall score displayed takes the following
categories into consideration: registration, facility, nursing,
physician, personal issues, and overall assessment. An
increasing trend and higher score is preferred.
– Ambulatory Surgery Percentile Rank: This is an indication
of how WHC's satisfaction score compares to other
institutions included in the groups or databases.
Ambulatory Surgery Satisfaction
Ambulatory Surgery Satisfaction Score
100
95
Score
91
90 89 90
89
85
80
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
Ambulatory Surgery Satisfaction Score - Percentile Rank
100%
80%
Percentile
60%
45%
40% 40%
22%
38% 22%
20% 12%
19% 10% 12%
0% 9% 8%
Aug-04 Nov-04 Feb-05 May-05 Aug-05 Nov-05
Quarter End Date
All Facilities < 3,000 Procedures All Iowa
Employee Satisfaction
• Employee Satisfaction Score
– Employee satisfaction is measured using an Press
Ganey Associates Employee Perspective Survey.
The results graphically displayed on the
following page are from a survey conducted in
June, 2004.
– Employee satisfaction is measured in two ways.
First, there is a Satisfaction Score, which is out of
a possible 100. The second metric is percentile
rank, which is how WHC employee satisfaction
compares to other satisfaction levels included in
the group or database.
Employee Satisfaction
Employee Satisfaction Survey - Part I
100 100%
90 82 90%
76
80 80%
69%
70 63 70%
Percentile
56 53 53 54
60 60%
Score
51% 50
50 50%
40 45% 40%
30 25% 30%
15%
20 20%
4%
10 16% 2% 10%
- 0%
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Employee Satisfaction Survey - Part II
100 100%
90 90%
79%
80 73 77% 80%
70 68 67 73 70%
65
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62
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40 40%
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Score Percentile
T
Employee Turnover
• Formula
– Employee Turnover = Number of Separations /
Total Employees
• Definition
– This is the ratio of the number of employee
separations to the total sum of employees. It is
an indicator of employee satisfaction, where a
lower employee turnover rate indicates higher
employee satisfaction because there were fewer
voluntary separations.
Employee Turnover
Employee Turnover Rate
6%
5.0% 4.8%
5%
4.5%
3.9% 4.0%
4% 4.1%
3.5% 3.5%
3.8% 3.1% 3.2%
3.5% 3.7%
3% 3.2%
3.2% 3.0% 2.7% 3.1%
2.3% 2.5%
2%
1%
0%
Q1 - Q2 - Q3 - Q4 - Q1 - Q2 - Q3 - Q4 - Q1 - Q2 -
2003 2003 2003 2003 2004 2004 2004 2004 2005 2005
WHC Turnover Rate Comparison Rate
Medication Error Rate
• Formula
– Medication Errors Rate = (Total Number
of Medication Errors / Total number of
Doses administered) * 10,000
• Definition
– This is the rate of total medication errors
that occurred per 10,000 doses
administered. It is a quality indicator and
a lower rate or decreasing trend is
preferred.
Medication Error Rate
Medication Errors Rate
14
12
11.6
Error Rate (per 10,000 doses)
10.6
10.1 10.1
10
9.7 9.2 10.1 9.5
9.5 9.4
9.0 8.2
8
7.9 7.8
6.8
6.9
6
4.7
4.2
4
3.5 3.9
2
3rd Q 2003 4th Q 2003 1st Q 2004 2nd Q 2004 3rd Q 2004 4th Q 2004 1st Q 2005
WHC CAH Combined All Units
Patient Fall Rate
• Formula
– Patient Fall Rate = (Total number of falls /
Total Patient Days) * 1,000
• Definition
– This is the ratio of number of patient falls
per 1,000 patient days. It is a quality
indicator and a lower rate or decreasing
trend is desirable.
Patient Fall Rate
Patient Fall Rate
6
5.5
5
4.6
4.4
4.3
4.1
Fall Rate per 1,000 Days
4.3 3.9
4
4.0 4.1
3.5
3.6 3.5 3.5
3.4
3
2.0
2
1.3 1.3
1.0
1
0.0 0.0
0
3rd Q 2003 4th Q 2003 1st Q 2004 2nd Q 2004 3rd Q 2004 4th Q 2004 1st Q 2005
WHC CAH Combined All Units
Hospital Acquired Infections -
Pneumonia
• Formula
– HAI Pneumonia Rate = Number of HAI
Pneumonia Occurrences / Total Patient
Days in Period
• Definition
– This is the ratio of total healthcare acquired pneumonia
cases in a period to the total number of patient days in the
period. It provides an indication of the quality of care
patient's receive and a decreasing trend or lower rate is
desirable.
HAI - Pneumonia
HAI - Pneumonia
0.0009
0.0008
0.0008
0.0007
0.0007
0.0006
0.0005
0.0004
0.0003 0.0003 0.0003
0.0003 0.0003
0.0002
0.0002
0.0001
0 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3rd Q 2003 4th Q 2003 1st Q 2004 2nd Q 2004 3rd Q 2004 4th Q 2004 1st Q 2005
WHC All Units
Strategic Plan Background
• Select group put together to examine
WHC mission statement and strategic
plan
• Internal and External Environment
examined
• Four broad focus areas identified
– Pursuing Excellence
– Improving Efficiencies
– Fostering Growth
– Increasing Community Involvement
Pursuing Excellence
• Goals:
– Develop a workforce of employees
committed to pursuing excellence
– Increase Patient Satisfaction
– Improve employee communication
processes
Improving Efficiencies
• Goals
– Improve medical technology available
– Increase educational opportunities
available to patients and staff
– Maintain supplies inventory in the most
efficient manner possible
– Monitor and utilize patient feedback to
improve efficiencies and delivery of care
Fostering Growth
• Goals
– Ensure physical facilities are constructed
to meet current and future patient/staff
needs
– Foster partner relationships to benefit
WHC
– Increase marketing efforts to community
members
Increasing Community
Involvement
• Goals
– Increase hospital and community
involvement by staff
– Centralize community health education
– Improve public relations/marketing effort
as related to community involvement and
education
Balanced Scorecard
As of July 25, 2005
Balanced Scorecard
• Actual
– Most recent quarterly data for WHC
• Target
– External benchmark or internal goal
• Status
– Favorable more than 3% difference from
target in a positive direction
– Meets target within plus or minus 3% of target
– Unfavorable more than 3% difference from
target in a negative direction
Pursuing Excellence - Quality
• Medication Errors Rate
– Actual = 10.1
– Target = 7.77
• Patient Fall Rate
– Actual = .97
– Target = 3.49
• HAI – Pneumonia
– Actual = 0
– Target = 0
Pursuing Excellence –
Patient Satisfaction
• Inpatient Satisfaction
– Actual = 88.0
– Target = 88.0
• Outpatient Satisfaction
– Actual = 90.1
– Target = 88.0
• Ambulatory Satisfaction
– Actual = 89.6
– Target = 88.0
• Emergency Department Satisfaction
– Actual = 89.1
– Target = 88.0
Pursuing Excellence –
Committed Workforce
• Employee Satisfaction
– Actual = 25th percentile
– Target = 50th percentile
• Employee Turnover
– Actual = 2.5%
– Target = 3.5%
Pursuing Excellence –
Committed Workforce
• Salary per FTE
– Actual = $40,027
– Target = $40,910
• Benefits per FTE
– Actual = $10,806
– Target = $10,077
• FTEs per Occupied Bed
– Actual = 5.28
– Target = 3.02
Improving Efficiencies -
Operational
• Acute Care Length of Stay
– Actual = 3.1
– Target = 3.3
• Operating Expenses per Patient Day
– Actual = $1,487
– Target = $822
• Supply Expense Ratio
– Actual = 16.5%
– Target = 16.5%
Improving Efficiencies –
Financial
• Operating Margin
– Actual = 8.5%
– Target = 3.2%
• Days Cash – Current
– Actual = 39.7
– Target = 49.0
• Debt Service Coverage
– Actual = 3.2
– Target = 5.1
• Days in AR
– Actual = 82.3
– Target = 60.0
Fostering Growth
• Inpatient Market Share
– Actual = 17.4%
– Target = 20.9%
• Outpatient Market Share
– Actual = 34.0%
– Target = 32.4%
• Births
– Actual = 137
– Target = 100
Fostering Growth
• Ambulatory Surgeries
– Actual = 1,929
– Target = 1,828
• Average Age of Plant
– Actual = 4.0
– Target = 10.1
Balanced Scorecard
As of July 25, 2005
Mission Statement:
Waverly Health Center strives to provide the highest quality, patient-focused health care.
Actual Target Status
Pursuing Excellences
Quality
Medication Errors Rate 10.10 7.77
Patient Fall Rate 0.97 3.49
HAI - Pneumonia - -
Patient Satisfaction
Inpatient Satisfaction Score 88.0 88.0
Outpatient Satisfaction Score 90.1 88.0
Ambulatory Satisfaction Score 89.6 88.0
Emergency Department Satisfaction Scores 89.1 88.0
Committed Workforce
Employee Satisfaction 25% 50%
Employee Turnover 3% 4%
Salary per FTE $ 40,027 $ 40,910
Benefits per FTE $ 10,806 $ 10,077
FTEs per Occupied Bed 5.28 3.02
Status:
Favorable = Meets Target = Unfavorable =
Actual Target Status
Improving Efficiencies
Operational
Acute Care Length of Stay 3.1 3.3
Operating Expenses per Patient Day $ 1,487 $ 822
Supply Expense Ratio 16.5% 16.5%
Financial
Operating Margin 8.5% 3.2%
Days Cash - Current 39.7 49.0
Debt Service Coverage 2.0 5.1
Days in AR 82.3 60.0
Fostering Growth
Inpatient Market Share 17.4% 20.9%
Outpatient Market Share 34.0% 32.4%
Births 137 100
Ambulatory Surgeries 1,929 1,828
Average Age of Plant 4.0 10.1
Status:
Favorable = Meets Target = Unfavorable =
Limitations
• Use of historical data
– Reflects past decisions, not predictive of future
results
• Variations in service mix among
benchmark hospitals
• No consensus on good performance
– Outperforming benchmarks good enough?
• Potential data quality concerns
– Hospitals reporting accurate information to
I.H.A.?
Questions???
Sources:
• Arveson, Paul. “What is the Balanced
Scorecard?”
www.balancedscorecard.org/basics. 1998
• Flex Monitoring Team Briefing Paper. Financial
Indicators for Critical Access Hospitals. May,
2005.
• Iowa Hospital Association. “Databank Program
Manual.” October 2004.
• Gapenski, Louis. Understanding Healthcare
Financial Management. 2003.
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