A Balancing Act: Fulfilling the Mission, Sustaining the Margin

Transcription

1 A Balancing Act: Fulfilling the Mission, Sustaining the Margin

2 LEGACY OF CARE

3 LEGACY OF CARE

4 A NEW APPROACH Inpatient Hospital Care Community-Based Health Center Primary Care and Prevention

5 MISSION Improve the health and well-being of our community Be a presence of the love of Jesus in the lives of all we serve and with whom we partner

6 DISASTER STRIKES Hurricane Katrina decimates our only community health center in the Carrollton Shopping Center

7 EXPANDED ACCESS Post-Katrina, the need for primary and preventive care grew Before ,000 patients served annually Today - 55,000 patients served annually We administer health care at10 locations citywide, in areas of high need Integrated care anchored by technology and systems that are paperless

8 OUR FOOTPRINT - PRESENT DAY

9 10 COMMUNITY HEALTH CENTERS

10 7 COMMUNITY SCHOOLS Phillis Wheatley Community School Homer Plessy Community School St. Mary's Academy Akili Academy of New Orleans St. Rita Catholic School Harriet Tubman Charter School Kipp Morial School

11 MOBILE SERVICES

12 LEADER IN HEALTH CARE DELIVERY RECOGNIZED NATIONALLY We ve become a leading innovator in health care, improving patient outcomes and the patient experience

13 OVERCOMING CHALLENGES Balance MISSION with a focus on sustainability Diversify service options Focus on integrated, whole-person health care Build on innovation for the future

14 Integrated, Whole-Person Health Care

15 MARILLAC MODEL: INTEGRATED TEAM CARE PATIENT- CENTRIC SERVICES Continuous Quality Improvement Patient s Desires & Needs Open Access Patient Panels Population Registries PRIMARY CARE TEAM MD/MA NP/MA Care Coordinator CARE MANAGEMENT Nurse CM BH CM PharmD Project Collaboratives Continuous Quality Improvement Outcome and Results Measures PROACTIVE TREATMENT

16 TEAM STRUCTURE Primary Care Team (Shared Panel) MD/MA NP/MA Care Coordinator Patient Access Complex Care Team (by Health Center) Nurse Care Manager Behavioral Health Specialist Clinical Pharmacist

17 Think about the community need and the long-term business model Understanding ROI and creating a business model that keeps programs thriving

18 Create Sustainable Programs

19 SCHOOL SERVICES Pre-Katrina s Seton Program vs. Today s School Services Daughters of Charity Health Centers now offers evidence-based mental health counseling, vision and hearing screenings, and dental services to consenting students at schools across the greater New Orleans area. In addition, we provide services through two mobile medical and two mobile dental health units (The Tooth Bus).

20 DIABETES CARE Diabetes Prevention Program a $350,000 Humana Communities Benefit charitable grant from the Humana Foundation seeded the development of a program designed to reduce a person s chances of developing Type 2 diabetes, a condition that affects many in the New Orleans area.

21 ADDICTION SERVICES Opioid Addiction Services only Medicaid-covered Soboxone program locally National epidemic, true community need Stigma no longer attached to diagnosis, treatment Smoking Cessation Program FREE help to quit smoking

22 EVERYONE NEEDS A HELPING HAND AT SOME POINT Care Fellowship Team Intro Video - PLAY Our new Care Fellowship program in collaboration with UnitedHealthcare connects people to critical resources like health care appointments, food, housing, counseling, job training and more.

23 INNOVATION Technology health information exchange electronic medical records, bi-directional interfacing disease registry Integration of medical, behavioral health, pharmacy and dental services Coordination of social services/closing the loop New methods of patient engagement patient portal

24 Promote Program Diversification

25 WHEN MISSION SUPERSEDES FINANCE

26 FRAMEWORK AND PROCESS Questions to ask Does program fit my mission, have I developed a needs-assessment, is there a consistent payor source or path to sustainable funding? Is there supply/demand, revenue, have I developed an expense evaluation/pro forma (how many people will I see, what s the net return on investment)? Mission: can it be performed for the reimbursement/revenue that s generated? Things that are out your control things you can t budget for or predict Legislation Policy

27 ALTERNATIVE FUNDING SOURCES Consider other sources of revenue for long-term sustainability: Fundraising Grants Partnerships with local government and neighborhood groups Supplementing the losses in a program through other service lines with a strong margin

28 LONG-TERM SUSTAINABILITY PHARMACY 340b drug pricing, strong margin VS. DENTAL Low Medicaid reimbursement rates, profit loss

29 Build Innovation For The Future

30 As a non-profit organization, a major part of fulfilling your mission should be diversification of services and income streams. You really need a balancing act between billable services, philanthropy, and operational efficiencies all in one. - Michael G. Griffin

31 VALUE-BASED REIMBURSEMENT Balancing costs with revenue to sustain/maintain high-quality

32 HOLISTIC APPROACH TO HEALTH CARE Addressing social determinants of health helps to reduce incidents of bad health outcomes and improves health equities and disparities Mental Health - It s just as dangerous and debilitating as any other chronic disease In 2016, some 10 percent of children under the age of 18 lived in households without a parent who had completed high school, 3 27 percent lived in mother-only households, 8 percent lived in father-only households, and 19 percent were in families living in poverty. - National Center for Education Statistics

33 MISSION AND MARGIN Things to Remember: Be innovators Find ways to sustain programs Champion efforts

34 Thank You