Benchmarking and Key Metrics Utilized by HSCT Administrators Clint Divine, MBA, MSM Administrative Director, BMT 1
When you ve seen one HSCT program, you ve seen one HSCT program Although, there are many common components! 2
Goals of the organization should set the focus of your Quality, Productivity & Financial Metrics Metrics need meaning! Utilize metrics and KPIs for: Staffing needs, position justifications Quality Assurance Revenue Cycle Strategic planning 3
Challenges Substantial variation in HSCT center characteristics Centers have different care models to optimize the use of available resources Identifying external benchmarks; Utility of comparative external benchmarks 4
The Value of Dashboards, Metrics (a/k/a KPIs) Provides a user-friendly, visual summary of Operational and Clinical information. Utilize to track data, improve operational and clinical performance Promotes transparency and improves accountability. Dashboards provide a means to assess and manage an center s performance, utilizing key metrics: Quality Assurance, Process Improvement Clinical Outcomes Financial Growth Strategies, Strategic Planning 5
The Utility of Metrics are limited without Operational Effectiveness Goals What are you trying to track and/or analyze? Evaluate resource utilization? Reduce volume variability? Use existing capacity more effectively? Create and/or track a unit P&L? Address staff stress, workflow inefficiencies? Measure an operational function that impacts quality? Address regulatory requirements? Contrast your staffing model with other departments? Goals should drive what you are measuring Measures should not drive goals! Dashboards track designated indicators after goals are adopted 6
Key Administrative Focus Areas Volume Capacity planning Strategic planning, Growth strategies Acuity vs Procedure-based metrics Length of Stay Mortality Re-admissions Cost and Resource utilization Managed Care / Payer reimbursement Analyze by Type of Transplant (e.g. Auto, Allo, MUD, Cord, Haplo) Analyze by Disease Type Staffing 7
BMT ACTUAL VS BUDGET BY FISCAL YEAR 400 300 ACTUAL BUDGET 200 100 366 381 402 425 429 372 380 430 430 300 191 186 0 FY10 FY11 FY12 FY13 FY14 FYTD15 (NOV) 55 MONTHLY TRANSPLANTS VS BUDGET 45 35 25 15 5-5 TRANSPLANTED SCHEDULED TO BE TRANSPLANTED BY MONTH END BUDGET
# of Transplants BMT Program Annual Volume, by Type (CY06-14) 350 300 303 298 250 215 230 200 179 164 178 166 152 150 138 129 90 101 105 100 80 76 82 47 56 48 46 47 50 33 31 35 50 18 40 49 6 8 16 27 28 26 31 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 Allo Related 8 16 27 28 26 40 31 49 50 Allo Unrelated 6 18 31 35 48 46 47 76 82 Auto 33 56 80 101 105 129 152 178 166 Total HSCT 47 90 138 164 179 215 230 303 298 Allo (MUD) CY08 CY09 CY10 CY11 CY12 CY13 CY14 MUD (non-cb) 26 30 34 33 40 65 71 Cord 5 5 14 13 7 11 11 TOTAL 31 35 48 46 47 76 82 9
Auto-Transplant Trends 10
Growth Rate Growth from Prior Rate Year from Prior Year Year Total Transplants Total Transplants Auto Auto Allo Transplant Transplant Allo Allo RelatedAllo Allo Related Unrelated Allo Unrelated Auto Growth RateGrowth Rate Auto Allo Allo RelatedAllo Allo Related Unrelated Allo Un FY91 293 293 210 210 83 8373 73 10 10 FY92 279 279 190 190 89 8954 54 35 35-4.8% -9.5% -4.8% -9.5% 7.2% 7.2% -26.0% -26.0% 250.0% FY93 335 335 207 207 128 128 96 96 32 32 20.1% 20.1% 8.9% 8.9% 43.8% 43.8% 77.8% 77.8% -8.6% FY94 422 422 302 302 120 120 91 91 29 29 26.0% 45.9% 26.0% 45.9% -6.3% -6.3% -5.2% -5.2%-9.4% FY95 480 480 303 303 177 177 137 137 40 40 13.7% 13.7% 0.3% 0.3% 47.5% 47.5% 50.5% 50.5% 37.9% FY96 528 528 318 318 210 210 158 158 52 52 10.0% 10.0% 5.0% 5.0% 18.6% 18.6% 15.3% 15.3% 30.0% FY97 538 538 322 322 216 216 157 157 59 59 1.9% 1.3% 1.9% 1.3% 2.9% 2.9% -0.6% -0.6% 13.5% FY98 541 541 290 290 251 251 179 179 72 72 0.6% -9.9% 0.6% -9.9% 16.2% 16.2% 14.0% 14.0% 22.0% FY99 634 634 320 320 314 314 238 238 76 76 17.2% 10.3% 17.2% 10.3% 25.1% 25.1% 33.0% 33.0% 5.6% FY00 532 532 263 263 269 269 191 191 78 78-16.1% -17.8% -16.1% -17.8% -14.3% -14.3% -19.7% -19.7% 2.6% FY01 569 569 254 254 315 315 196 196 119 119 7.0% -3.4% 7.0% -3.4% 17.1% 17.1% 2.6% 2.6% 52.6% FY02 578 578 250 250 328 328 230 230 98 98 1.6% -1.6% -1.6% 4.1% 4.1% 17.3% 17.3% -17.6% FY03 589 589 258 258 331 331 215 215 116 116 1.9% 3.2% 1.9% 3.2% 0.9% 0.9% -6.5% -6.5% 18.4% FY04 638 638 290 290 348 348 192 192 156 156 8.3% 12.4% 8.3% 12.4% 5.1% 5.1% -10.7% -10.7% 34.5% FY05 613 613 274 274 304 304 152 152 152 152-3.9% -5.5% -3.9% -5.5% -12.6% -12.6% -20.8% -20.8%-2.6% FY06 681 681 336 336 345 345 160 160 185 185 11.1% 22.6% 11.1% 22.6% 13.5% 13.5% 5.3% 5.3% 21.7% FY07 703 703 331 331 372 372 182 182 190 190 3.2% -1.5% 3.2% -1.5% 7.8% 7.8% 13.8% 13.8% 2.7% FY08 690 690 300 300 390 390 189 189 201 201-1.8% -9.4% -1.8% -9.4% 4.8% 4.8% 3.8% 3.8% 5.8% FY09 711 711 290 290 421 421 180 180 241 241 3.0% -3.3% 3.0% -3.3% 7.9% 7.9% -4.8% -4.8% 19.9% FY10 837 837 392 392 445 445 205 205 240 240 17.7% 35.2% 17.7% 35.2% 5.7% 5.7% 13.9% 13.9% -0.4% FY11 865 865 410 410 455 455 223 223 232 232 3.3% 4.6% 3.3% 4.6% 2.2% 2.2% 8.8% 8.8% -3.3% FY12 848 848 422 422 426 426 170 170 256 256-2.0% -2.0% 2.9% 2.9% -6.4% -6.4% -23.8% -23.8% 10.3% FY13 900 900 447 447 453 453 182 182 271 271 6.1% 5.9% 6.1% 5.9% 6.3% 6.3% 7.1% 7.1% 5.9% 11
BMT Inpt and Outpt Volume (CY14) Autologous (n=166) Inpatient 51% (n=84) Allogeneic (n=132) Inpatient 87% (n=115) Outpatient 49% (n=82) Inpatient 99 (55.3%) Outpatient 80 (44.7%) Outpatient 13% (n=17) CY10 CY11 CY12 CY13 CY14 124 (57.7%) 91 (42.3%) 150 (65.2%) 80 (34.7%) 193 (63.7%) 110 (36.3%) 199 (66.8%) 99 (33.2%) 12
What s missing? Transplant center benchmarks for staffing: APPs BMT Coordinators Long-term Follow-up Apheresis Staffing Quality Management Clinic staffing Data managers 13
ASBMT Staffing Model Working Group: Goals: Develop core measures for HSCT operational and performance metrics Serve as a resource to HSCT centers and administrators; and ultimately Payer and Accreditation Organizations 14
Is your HSCT program staffing for Adult, Pediatric, or both? Adult only Pediatric only Adult & Pediatric combined Some shared Adult & Pediatric staffing (e.g. Quality, financial coordinator, donor/search coordinator, etc. ) 15
Is your HSCT program staffing dedicated or shared with any of the below categories (choose one): BMT patients only BMT / Benign Hematology BMT / Hematological Malignancy BMT / Acute Leukemia (only) BMT / Cellular Therapeutics 16
How many transplants does your HSCT program perform annually? 1-24 25-54 55-89 90-189 190-269 270-349 350 17
Does your HSCT program perform transplants outpatient? Yes (Auto & Allo) Yes (Auto only) Yes (Allo only) No Not sure 18
What category best describes your institution? Academic Medical Center (DRG exempt) Academic Medical Center (non-drg exempt) Hospital and/or Health System For Profit Hospital or Health System Other 19
BMT New Patient Referral Volume CY10 CY11 CY12 CY13 CY14 Monthly Avg. 29.7 37.1 38.8 43.1 46.1 600 517 500 445 466 100 90 80 70 60 50 40 30 20 10 0 553 BMT Program - Monthly Referral Volume (CY14) 57 53 54 50 51 49 41 42 37 40 42 37 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 400 300 298 337 356 200 173 100 75 0 CY06 CY07 CY08 CY09 CY10 CY11 CY12 CY13 CY14 20
BMT Program Monthly Evaluations 60 50 40 30 20 39 34 36 43 52 49 47 32 20 39 40 30 43 25 33 27 35 39 38 28 38 36 44 51 Auto Allo Donor Total 10 0 1/13 2/13 3/13 4/13 5/13 6/13 7/13 8/13 9/13 10/13 11/13 12/13 1/14 2/14 3/14 4/14 5/14 6/14 7/14 8/14 9/14 10/14 11/14 12/14 Auto 25 26 15 22 25 18 30 15 14 15 16 12 19 15 14 12 20 23 27 15 29 21 14 31 Allo 10 7 14 11 19 21 13 9 5 19 17 15 15 7 16 12 9 12 9 12 7 11 18 11 Donor 4 1 7 10 8 10 4 8 1 5 7 1 9 3 3 3 6 4 2 1 2 4 12 9 Total 39 34 36 43 52 49 47 32 20 39 40 30 43 25 33 27 35 39 38 28 38 36 44 51 2008 2009 2010 2011 2012 2013 2014 Adult BMT Coord FTEs 3.0 4.0 4.0 4.0 4.0 4.5 5.0 # of Transplants 138 164 179 215 230 303 298 # of Work-ups 203 207 250 274 293 461 437 Monthly Avg. Workups 16.9 17.3 20.8 22.8 24.4 38.4 36.4 2011 2012 2013 2014 Adult BMT Coord FTEs 4.0 4.0 4.5 5.0 Avg. Evals per FTE 68.5 73.3 115.3 87.4 21
Physician & APP Productivity Metrics Adult BMT Physician (Inpt + Outpt) combined 2,500.00 2,000.00 1,500.00 1,000.00 500.00 - Physician 1 Physician 2 Physician 3 Physician 4 Physician 5 Physician 6 Physician 7 MGMA wrvu Productivity Benchmark (per 1.0 cfte) CY14: 3 of 7 BMT Physicians exceed the MGMA 90 th percentile (7,429 WRVUs for a 12 month period ). 22
Essential Productivity Metrics BMT Provider WRVUs (rolling 12-month summary) Provider name Provider type cfte Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-14 Dec-14 Jan-14 Rolling 12 WRVUs normalized by cfte Doc1 MD 0.90 635.9 652.4 535.7 462.2 531.1 660.3 851.9 473.7 335.1 553.9 1,108.4 311.8 7,112.4 8,392.6 Doc2 MD 0.25 128.6 322.7 153.5 218.5 31.1 147.5 252.9 323.5 418.1 163.7 120.7 352 2,632.8 11,183.80 Physician sub-total 1.15 764.5 975.1 689.2 680.7 562.2 807.8 1104.8 797.2 753.2 717.6 1229.1 663.8 9,745.2 19,576.4 NP1 NP 1.0 112.3 153 174.1 149.5 153.7 95.3 151.9 177.6 17.5 24.5 81.3 54.4 1,345.1 N/A NP2 NP 1.0 59.1 19.6 26.1 34.4 12.7 19.5 5.3 6.3 2.6 4.7 13.8 6.6 210.7 N/A Nurse Practitioner sub-total Grand Total 2.0 171.4 172.6 200.2 183.9 166.4 114.8 157.2 183.9 20.1 29.2 95.1 61 1,555.8 N/A 935.9 1147.7 889.4 864.6 728.6 922.6 1262 981.1 773.3 746.8 1324.2 724.8 11,301.0 Productivity Benchmark: MGMA 90th percentile is 8,230 (for 12 month time frame) Analysis: both BMT physicians exceed the MGMA 90th percentile for the 12-month reporting period 23
CIBMTR Data Reporting Are you proactively managing your CIBMTR reporting? Are you consistently meeting the 90% CPI requirement? Are you ready for Autologous CPI implementation? January 2015: Monitor Only Monitor Auto forms with the earliest completion date of 12/3/07 8/31/14 May 2015: Partial Implementation at 75% To meet CPI, 75% of the Auto forms with the earliest complete date of 12/3/07-12/31/14 September 2015: Fully Implemented at 90% To meet CPI, 90% of the Auto forms with the earliest complete date of 12/3/07 4/30/15 24
OUTSTANDING CIBMTR FORMS 500 400 300 200 100 0 CURRENTLY DUE PAST DUE 3,500 3,250 3,000 2,750 2,500 2,250 2,000 1,750 1,500 1,250 1,000 750 500 250 0 CIBMTR Reports Submitted (CY09-CY14) 3,210 2,298 1,924 1,818 1,801 1,911 CY09 CY10 CY11 CY12 CY13 CY14 Year Monthly AVG FTE Avg. per FTE CY09 164.8 3.0 641.3 CY10 151.5 4.0 454.5 CY11 150.1 4.0 450.3 CY12 159.3 4.0 477.8 CY13 191.5 5.0 459.6 CY14 267.5 5.0 642.0 25
UHC Benchmarking Outcomes + Resource Utilization analysis 26
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UHC Resource Utilization Average Direct Cost per Discharge Case Time Period: Utilization Comparison Center 2 Center 3 Center 4 2013-Q1 to 2014-Q1 Accommodations $11,003 $29,656 $21,582 $49,098 ICU $771 11 $1,274 20 $21,439 707 $48,633 130 Other Accommodations $120 59 $0 1 $0 240 $227 82 Routine Accommodations $10,112 144 $28,382 270 $143 39 $237 11 Ancillary Services $268 $451 $708 $810 Other Ancillary Services $36 34 $68 40 $168 660 $252 73 Physical Therapy $54 26 $267 92 $233 628 $265 106 Respiratory $178 29 $115 15 $307 441 $293 55 Cardiac Diagnostic Services $72 $76 $88 $108 EKG/Telemetry $44 47 $18 48 $20 268 $18 88 Other Cardiac Services $28 21 $58 32 $68 103 $90 23 Diagnostic Imaging $221 $570 $253 $558 CT/MRI $132 49 $366 91 $149 229 $259 51 Nuclear Medicine $10 6 $0 0 $10 40 $15 8 Other Diagnostic Imaging $17 40 $23 46 $32 190 $91 61 X-Ray $62 78 $182 223 $62 604 $193 116 Laboratory $1,799 $3,276 $4,274 $6,622 Miscellaneous $120 $32 $284 $2,431 Other Spec. Dx Svcs. $64 $309 $81 $123 Surgical Services $2,547 $481 $5,474 $2,095 Anesthesia $0 0 $11 7 $38 61 $32 35 Med. Surg. Supplies $1,885 144 $103 111 $4,979 709 $1,196 132 OR Services (Incl Labor/Del) $634 144 $352 129 $437 201 $699 122 Other Surgical Services $28 29 $15 8 $20 50 $167 34 Transplantation $35,868 $37,200 $21,167 $48,228 Treatment $26,252 $19,075 $47,978 $39,685 Blood $5,618 134 $4,992 206 $3,711 668 $6,410 118 Dialysis $58 5 $238 11 $249 26 $26 2 Other Treatment $504 23 $736 87 $99 58 $870 46 Pharmacy & IV Therapy $20,025 144 $13,102 270 $43,913 709 $32,370 135 Total Cost # Of Patients $78,213 144 $91,127 270 $101,889 709 $149,758 135 Expected Cost $64,320 $78,999 $72,648 $85,762 Cost Index 1.22 1.15 1.40 1.75 LOS Index 0.91 0.72 1.09 1.01 Mortality Index 0.36 0.38 0.79 0.71 29
2015 Tandem Meetings Making the case for additional staffing Craig Conway, Administrative Director Stem Cell Transplant & Cell Therapy Program March 12, 2014 2014 Rising Tide
What is your role within your HSCT program? BMT Administration BMT Advanced Practice Professional (NP/PA) BMT (RN /non-rn) Coordinator, or other nursing personnel Quality Management Financial Coordinator / Finance Social Worker / Case Management Pharmacy Payer Other 31
Does your HSCT program have any capacity issues? Yes (inpatient & outpatient) Yes (inpatient only) Yes (outpatient only) No Not sure 32
Does your HSCT program have a dedicated Survivorship / LTFU clinic? Yes (within BMT program) Yes (separate from BMT program) No Not sure Future plans, but not implemented yet. 33
Which positions are most in demand for your HSCT program (rank 1 st, 2 nd & 3 rd ) Physicians Advanced Practice Professionals (NP/PA) BMT (RN / non-rn) Nurse Coordinators, and other nursing personnel Pharmacists Data Management Quality Management Administrators Cell Processing, Laboratory Financial Coordinators Social Workers, Case Managers Other 34
Executive communications Executive steering committee or executive champion Consensus on Stem Cell strategic and associated business operational plans Support operational needs and break down barriers to achieving strategic and operational plans and objectives Tell the evolving program story (no such thing as over-communication) Quarterly meetings Monthly reports 35
Executive communications: communicating staffing needs Adult BMT Program Positions Job Description FTE Fixed / Variable Reviewed / Approved by Shared Position Hard to fill (y/n) Date to Post Date to Fill Comments 1.0 (shared with Lung = 0.5 FTE) Shared with Lung transplant program 8/1/2012 Aug-12 Previously approved by the PRRC as a shared Adult BMT / Lung transplant position. Adult BMT Program Financial Coordinator Fixed Adult BMT Program Infusion Clinic Nurse Manager 1.0 Fixed y 8/1/2012 Aug-12 Set up Temp location, policies, hire staff etc...required to manage licensed professional and unlicensed staffs, manage clinical day to day operations for the outpatient infusion services for pre and post transplant patients (20 chairs and 8 infusion rooms totaling 28). Includes responsibility for financial, quality, safety, regulatory, and customer satisfaction metrics or others as defined by the organization. Adult BMT Program Outpatient Clinic Practice Manager 1.0 Fixed y 8/1/2012 Aug-12 Set up temp space and physician practice/rev cycle, etc Responsible for the structure and daily operations of the adult BMT outpatient physician practice (Hospital-based) and unlicensed outpatient clinic staff. Includes financial, quality, safety, regulatory, and patient satisfaction metrics. Medical Social Worker_T109XE 1.0 Fixed y 8/1/2012 Aug-12 Set up extensive outpatient support services. FACT (B3.9.1.3) - BMT programs must have designated social services staff. Will cross cover Pediatric BMT Department Health/CON requires a pharmacist experienced with the use of cytotoxic therapies, blood components, hemodynamic support of the transplant patient, and the management of immunosuppressed patients. Set up clinical drug protocols, coordination with SH pharm FACT (B3.9.1.1) - BMT programs must have pharmacy staff knowledgeable in the use and monitoring of pharmaceuticals used by the program. Clinical Pharmacy Specialist_T008XE 1.0 Fixed y 8/1/2012 Aug-12 Subtotal, FTEs to fill by August 2012 4.0 Shared with Pediatric transplant program Regulatory requirement for Blood and Marrow Transplant program as per the Department of Community Health/CON and the Foundation for the Accreditation of Cellular Therapy (FACT). The CON requires data management personnel designated to the BMT service. FACT:B9 - BMT programs must collect all data required to complete Transplant Essential Data Forms of the CIBMTR; by law all BMT programs must report allogeneic transplant information and outcomes to the SCTOD managed by the CIBMTR. (B3.9.1.6) BMT programs must have data management staff sufficient to comply with B9. BMT Program Data Manager 1.0 Fixed y 8/1/2012 Nov-12 Shared with Pediatric transplant program FACT (B3.8) - BMT programs should have at least one person, approved by the Program Director, responsible for establishing and maintaining systems to review, modify and approve all policies and procedures to monitor compliance and performance of the program; the FACT inspector will look for proof that such an individual is in place. BMT Program Quality Coordinator 1.0 Fixed y 8/1/2012 Nov-12 Adult BMT Program Care Coordinator 1.0 Fixed y 8/1/2012 Nov-12 Set up complex medical case management services. Department of Health/ CON requirements: A transplant coordinator to provide transplant coordination including follow-up and post coordination of care. Adult BMT Program Search Coordinator 1.0 Fixed Shared with Pediatric transplant program y 8/1/2012 Nov-12 Must be CHTC Certified Adult BMT Program Infusion Clinic Nurse 4.0 Variable y 8/1/2012 Nov-12 BMT outpatient infusion clinic will be open 7 days a week Nursing Assistant_W024XN 1.0 (two-0.5) Variable Sept/Oct Nov-12 BMT outpatient infusion clinic will be open 7 days a week Administrative Secretary_JV151XN1 (Infusion clinic secretary) 1.0 (two-0.5) Variable Sept/Oct Nov-12 BMT outpatient infusion clinic will be open 7 days a week RN (Physician Consults/clinic)_N049XN 2.0 Variable Sept/Oct Nov-12 Cross train to infusion Pheresis RNs & Manager 0.0 - Do not plan to hire for these positions. Will continue to use contract services - Mi Blood, and SH manager. Manager will be responsible for Billing, Compliance, Safety, etc. Adult BMT Program Clinical Support Associate 1.0 Variable Sept/Oct Nov-12 Subtotal, FTEs to fill by November 2012 13.0 RN (5S IP Unit)_N049XN 2.0 Variable after Jan Subtotal, FTEs to fill after January 2013 2.0 Grand total, FTEs needed to implement adult BMT program 19.0 4.0 FTEs - August 2012 Acronyms: 13.0 FTEs - November 2012 CHTC Certified Hematopoietic Transplant Coordinator 2.0 FTEs - after January 2013 CIBMTR Center for International Blood and Marrow Transplant Research 19.0 Total FTEs FACT Foundation for the Accreditation of Cellular Therapy 36
Executive Summary: Executive Communications Executive Report: Stem Cell Transplant & Cell Therapy Program For month, year (sample template) Program Operations o Administration o Inpatient o Outpatient Financial Operations o Budget o Per patient & per FTE metrics o Charge Capture o Insurance Human Resources 37
Program assessment: what s going on? What has changed? Volume Acuity Services Location (to IP or OP) Safety outcomes Quality outcomes Financial outcomes Accreditation, certification, or regulatory change What type of staff support do I need to maintain or improve upon strategic or operational plans and objectives Can current staffing address the change(s)? 38
Program assessment: what has changed monthly and quarterly? Operational Dashboard Volume (productivity) New pt visits Return pt visits Admissions Discharges Acuity Nurse : pt ratio Pt Satisfaction (%) Physician Midlevel Nurse Care Manager Clinic Wait Time Quality Falls / pt days Serious Safety Events Precursor Safety Events Near Miss Safety Events Medication errors Financial ($) Revenue per patient Labor cost per patient Net revenue per FTE Op expense per FTE NOI per FTE July August September October November December January February March April May June 39
Program assessment: what has changed / what s the trend annually? Operational Dashboard Volume New pt visits Return pt visits Admissions Discharges Acuity Nurse : pt ratio Pt Satisfaction (%) Physician Midlevel Nurse Care Manager Clinic Wait Time Quality Falls / pt days Serious Safety Events Precursor Safety Events Near Miss Safety Events Medication errors Financial ($) Revenue per patient Labor cost per patient Net revenue per FTE Op expense per FTE NOI per FTE FY12 FY13 FY14 FY15 40
Demand data: what is the demand for program services? AML DX & TRANSPLANT DEMAND ESTIMATES Midwestern Regional Medical Center 1 AML potential AML SCT 20-54 55-74 Totals tx vol 2 potential Midwestern Adult Adult Population 25,365,969 9,128,054 34,494,023 MRMC financials Transplant Demand / 100,000 population 5.5 12.3 Avg Charge Transplant Demand = pop x (demand / 100,000) 1,395 1,123 2,518 $$ 2012 Allogeneic Transplants (related + unrelated) 566 543 1,109 Reimb% Market Potential = demand - actual 829 580 1,409 % NOI AML prevelance, 2014 SEER 3 36% $$ AML estimated volume potential 508 NOI% SCT conversion rate 4 15% % AML estimated SCT volume potential 75 Notes: Sources: NMDP, CIBMTR, SEER 1 2012 Census data: The NMDP provided population and estimated SCT demand data related to existing CTCA SCT program markets. The above estimates do not factor in volume driven by Western and Southeastern populations. 2 The above also assumes capacity to care for 100% of the estimated potential AML patient volume and subsequent SCT volume. In addition, timing for AML volume increases will depend on marketing, outreach, and changes in referral/practice patterns. 3 SEER: 52,280 new luekemia cases, 2014; 18,860 new AML cases, 2014 4 SCT converstion rate: # SCTs per CIBMTR / #New AML cases 2014 per SEER 5 MRMC experience, 82 cases between 2012-2014 y-t-d 41
Program assessment: can current staffing address the change? MIDWESTERN REGIONAL MEDICAL CENTER ACTUAL PROCEDURE VS ACTUAL FTE ANALYSIS FISCAL YEAR 2014 JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE REQUIRED PROCEDURE TIME (AMPFM) PROCEDURES HOURS 1,228.4 1,296.2 1,158.5 1,211.9 1,190.0 701.7 934.2 1,054.0 1,177.8 *NON - ALLOCATED PRODUCTIVE TIME 528.3 489.4 493.4 513.7 531.5 491.7 476.8 536.1 541.7 TOTAL PROCEDURE HOURS 1,756.7 1,785.6 1,651.9 1,725.6 1,721.5 1,193.4 1,411.0 1,590.1 1,719.5 PROCEDURE FTE EQUIV 10.98 11.16 10.32 10.78 10.76 7.46 8.82 9.94 7.16 ACTUAL TIME (LAWSON) REGULAR FTE HOURS (Incl Contract Labor) 1,599.75 1,666.00 2,520.18 1,605.95 1,588.25 1,574.31 1,581.50 1,575.75 2,521.50 REGULAR TIME FTE EQUIV 10.00 10.41 10.50 10.04 9.93 9.84 9.88 9.85 10.51 OVERTIME FTE HOURS 96.3 174.3 213.3 117.8 156.5 115.3 131.8 123.8 246.8 OVERTIME FTE EQUIV 0.60 1.09 0.89 0.74 0.98 0.72 0.82 0.77 1.03 TOTAL ACTUAL HOURS (LAWSON) 1,696.00 1,840.25 2,733.43 1,723.70 1,744.75 1,689.56 1,713.25 1,699.50 2,768.25 TOTAL ACTUAL FTE EQUIV (LAWSON) 10.60 11.50 11.39 10.77 10.90 10.56 10.71 10.62 11.53 ACTUAL/REQUIRED VARIANCE (IN EQUIV) -0.4 0.3 1.1-1.2 0.0 3.1 1.9 0.7 4.4 42
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