Karl Rebay, Director, Moss Adams Health Care Consulting Group

Transcription

1 Date: October 12, 2015 From: Subject: Karl Rebay, Director, Moss Adams Health Care Consulting Group Benchmark Information Provided Moss Adams has provided to Arch Health Partners certain benchmarking information, used in the presentation to Palomar Health Board of Directors October 12, This benchmarking information is derived from the Medical Group Management Association ( MGMA ) 2015 Datadive system which presents survey results based on 2014 financial and operational performance. More specifically, the results were filtered to Western United States, hospitalowned and/or integrated groups, median amounts. We provided median practice revenue, provider cost and net investment amounts for 2014 as well as median net investment amounts for previous years. Karl Rebay Director for Moss Adams LLP (949) or karl.rebay@mossadams.com.

2 MISSION To heal, comfort, and promote health in the communities we serve CORE VALUES Excellence Service Integrity Innovation VISION To be the top choice for health care services of those expecting a superior patient experience and the highest quality of care

3 DEANNA KYRIMIS, M.B.A., DIPOL CHIEF EXECUTIVE OFFICER

4 ARCH LEADERSHIP Deanna Kyrimis, Chief Executive Officer & Executive Director 20+ Years Physician Group Practice Leadership Joined Arch Health Partners 12/1/2014

5 MEDICAL FOUNDATION PALOMAR HEALTH MULTI-YEAR STRATEGY Formed 2010 Purpose Stabilize Primary Care Services Establish a Hospital/Physician Organization Elevating Care Strengthen Physician Alignment Enhance Recruitment of Physicians Enhance Infrastructure to Support Quality Initiatives Growth Strategy: Expanded Geographic Coverage through Development of New Practice Sites & Aligned Physicians Medical Foundation vs. Employment California Corporate Practice of Medicine Medical Foundation Alternative

6 ARCH PILLARS CLINICAL RESEARCH CHARITY PATIENT CARE COMMUNITY EDUCATION NOT FOR PROFIT MEDICAL FOUNDATION

7 CARE MANAGEMENT CASE MANAGEMENT ARCH PALOMAR OUTPATIENT CARE INPATIENT CARE DISCHARGE PLANNING

8 PATIENT COORDINATED PALOMAR HEALTH DISTRICT FIRST MEDICAL FOUNDATION PHYSICIANS INDEPENDENT PHYSICIANS COOPETIVE COMPETITION CARE

9 ARCH LEAVING THE PAST MOVING INTO THE FUTURE NEW CEO NEW FOCUS Improve Performance of Organization Address Challenges Address Financial Gap Apply Triple Aim Across Organization Clinical Integration Across Physician Community FY 16 YEAR OVER YEAR IMPROVEMENT Improved Bottom Line net of Provider Compensation $6.5M Operating Expense reductions net of inflationary increases 14.3%

10 Finance Moving into the Future FY16 Q1 UPDATE Bob Walsh, C.P.A. Director of Finance

11 FOUNDATION DEVELOPMENT Business Plan ECG Management Consultants THE PROMISE October, 2009: The results presented today illustrate the projected performance of the medical foundation. These figures represent an estimate based on present fact and actual results will vary

12 OCTOBER 2009 ECG ASSUMPTIONS* *ECG Consultant Report October, 2009 Arch Actuals vs. ECG Assumptions YEAR NET NEW PHYSICIAN FTEs * TOTAL PHYSICIAN FTEs * TOTAL PHYSICIAN COUNT * ARCH ACTUAL TOTAL PHYSICIAN FTEs ARCH VARIANCE TO ASSUMPTION ARCH ACTUAL TOTAL PHYSICIAN COUNT ARCH VARIANCE TO ASSUMPTION

13 5 YEAR TRENDING $5,000, $- $(5,000,000.00) $(10,000,000.00) $(15,000,000.00) $(20,000,000.00) $(25,000,000.00) ECG "ASSUMPTION" NOI $(5,065,000.00) $(971,000.00) $(431,000.00) $730, $1,257, ARCH NOI $1,692, $(1,668,062.00) $(7,592,379.00) $(18,900,000.00) $(21,300,000.00) $(15,630,000.00) INDUSTRY MEDIAN NOI $(5,173,572.50) $(5,759,437.50) $(12,442,718.00) $(14,403,778.40) $(15,515,324.00) $(14,357,464.00)

14 Industry Comparison Per MD FTE MGMA INDUSTRY AVERAGE INVESTMENT PER PHYSICIAN FTE AHP FY15 ACTUAL INVESTMENT PER PHYSICIAN FTE AHP FY16 REVISED BUDGETED INVESTMENT PER PHYSICIAN FTE $ 231,572 $ 367,594 $ 242,909

15 2016 Budget Summary

16 FY16 YTD PERFORMANCE Two Months Ended August 31, 2015 ACTUAL BUDGET VARIANCE Net Operating Income (Loss) $ (3,052,922) $ (3,067,988) $ 15,066

17 Support Per Physician FTE FY 2016 Budget $500,000 $400,000 $300,000 AHP $336,470 $242,909 MGMA West Region Average = $231,572 $200,000 $212,654 $201,327 $190,000 $100,000 $

18 HOSPITAL SUPPORTED PHYSICIAN ORGANIZATION INVESTMENT (5 year cumulative) $80,000,000 $70,000,000 $60,000,000 $50,000,000 $40,000,000 $30,000,000 $20,000,000 $10,000,000 $- MGMA Median PH Investment

19 FY16 Year over Year Improvement Improved Bottom Line net of Provider Compensation $6.5M Operating Expense reductions net of inflationary increases 14.3%

20 Quality Management at Arch Health Partners The Future of HealthCare Vivek Nazareth, MD Dennis Mamaril, MD Fritz Steen, RN

21 ARCH HEALTH PARTNERS QUALITY DEPARTMENT TRIPLE AIM EDUCATION RISK MANAGEMENT & PATIENT SAFETY NEW VENTURES; keeping up to date MANAGING QUALITY Physician Independent Medical Group (Center for Healthcare) Orthopedic Associates of North County Escondido Cardiology Associates North County Geriatrics Escondido Pulmonary and Sleep Medicine

22 Medical Quality Awards Awarding Organization Award Integrated Healthcare Association Excellence in Healthcare Most Improved Top Performer California Association of Physician Groups Exemplary Award Elite Award

23 Quality and Patient Satisfaction Results Integrated Healthcare Association (IHA) Senior Score Results 4 stars out of possible of 5 End Fiscal Year 2015 with Patient Satisfaction at or exceeding internal goals for Access (70 th ), overall (68 th ) and care of the provider (65 th ) Integrated Healthcare Association Commercial HMO Results, 65% of the overall 20 quality measures showed improvement over 2013 measurement yr. California Association of Physician Groups (CAPG) Standards of Excellence "Elite" status for 2015 IHA Excellence in Healthcare award meeting Triple Aim 2014 and 2015

24 2015 IHA Medicare Stars Rating San Diego County Medical Groups

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26 2015 San Diego Recipients Only 23 out of 205 eligible physician organizations received this award. Arch Health Partners (2014 & 2015) Kaiser Permanente Sharp Community Medical Group

27 Well Managed Care Metric Arch Health Partners MCG Well Managed SCMG YTD Commercial Med-Surg Days/ Senior Med-Surg Days/ Readmit Rate: 8.95%(17.5%) Date Thru June 2015

28 Care Management, Utilization and Risk Mitigating risk by Listening to our patients, providers and staff, making necessary corrections, reevaluate and act Appropriate utilization of resources; safely transition patient from Hospital to home TEAM-based care using EB guidelines. Preventive Care and Chronic Care Management. Pharmacy team OUTREACH.

29 Goal: *Top Performing Medical Group High Quality Patient Care Increased Patient Satisfaction * Manage Per Capital Costs Well

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