analyzing your key performance measures

8/3/2019 Analyzing Your Key Performance Measures

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Analyzing Your KeyPerformance Measures

Gina Mazza RN, BSNTotal Performance Director

March 2011


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2011

Insights from Fazzis work with hundreds ofhome health and hospice agencies

Benchmark comparisons fromOperational/Financial Service: BestWorks

Insights from current realities for homehealth care

Foundation for this Presentation


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2011

Quality and Financial Matrix


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2011

Strategic Management Model

Whats GoingTo Happen?

What Should WeDo About It?

What Are TheImplications?


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2011

Two Approaches to Benchmarking

Internal Benchmarking: Identifying,

measuring and tracking over a period of

time.

Comparative Benchmarking: Tracking

performance indicatorsAND comparing

them to national standards and best

practice standards, i.e. top 20%.


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2011

Home Health Compare

Hospitalization Rate

Home Health Process Measures

Patient Satisfaction Measures

Quality Performance Measures


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2011

81%

82%

85%

85%

89%

Likelihood of

Recommending

Specific Care Issues

Communications Btwn

Providers and Patients

Overall Rating of Care

Care of Patients

Fazzi National Database

HHCAHPS: Initial Results


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2011

91%

89%

91%

93%

94%

Likelihood of

Recommending

Specific Care Issues

Communications Btwn

Providers and Patients

Overall Rating of Care

Care of Patients

Fazzi National Database

HHCAHPS: Best Practice Results


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2011

Profit Margin

Case Mix Weight

Cost per Visit

Staffing Ratio

Key Financial Performance Measures


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Profit Margin

National

AverageTop Performers

Medicare Profit 11.6% 29%

Home Health

All Payers 3.85% 13.2%


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2011

Impact of Underscoring and Revenue

Average Case

Mix Weight

Revenue/Episode

$2,192.97*

500 SOC

Net Revenue

What it Would

Mean

National1.31**

$2,872.79 $1,436,395 N/A

1.25 $2,741.21 $1,370,606 ($65,789)

1.20 $2,631.56 $1,315,782 ($120,613)

1.15 $2,521.92 $1,260,958 ($175,438)

1.10 $2,412.27 $1,206,134 ($230,262)

1.05 $2,302.62 $1,151,309 ($285,086)

1.00 $2,192.97 $1,096,485 ($339,910)

.95 $2,083.32 $1,041,661 ($394,735)

*Current CMS Standardized 60 Day Rate for Episodes as of Jan. 1, 2011**MedPAC, Re ort to the Con ress: Medicare Pa ment Polic , June 2010


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2011

Medicare Episode Drivers

Medicare

Profit

Case Mix

Weight

All

Visits

Cost/Nsg

Visit

National

Average11.6% 1.2 16 $157

TopPerformers 29% 1.26 15 $138


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2011

Home Health All Payers Drivers

Profit

Margin

Nsg

Visits/

Day

Cost/

Nsg Visit

Non

Visiting

Staff

National

Average3.85% 4.2

$157 6.8/

100 ADC

TopPerformers

13.2% 5 $138 6.6/100ADC


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2011

How Should

We Approach Change?

Never change things by fighting

the existing reality.

Instead, build a NEW model that

makes the existing model

obsolete."

Buckminster Fuller


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2011

New Options That Are Now Being Initiated

1. Accountable Care Organizations (ACOs): Work together,lower costs and improve quality.

2. Bundled Payments: One payment to cover the services for

the patient across health sectors.

3. Value Based Contracting: Rewards and penalties.

4. Patient Centered Medical Home Program: Physician

manages cases and share in savings.

5. Care Transition Programs: Improve quality and improve

patient experience during transitions of care.


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What Are the

Goals of All These Initiatives?

1. Save money.

2. Improve quality outcomes.

3. Improve patient experience.

4. Address patients with chronic disease.

5. Reduce unplanned hospitalization.


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2011

What Should the Goals of Every

Home Care Agency Be?

1. Save money Reduce cost/visit and cost/episode.

2. Improve quality outcomes Top 1/3 of Home Health

Compare measures.

3. Improve patient experience Top 1/3 of HHCAHPS.

4. Address patients with chronic disease

Create ateach back/chronic disease education program.

5. Reduce unplanned hospitalization Be in top 10% of

lowest hospitalization rates in the country.


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2011

To Be a Success, Remember

If all you do

Is all you did.

Then all youll get

Is all you got.


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Questions and Answers


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2011

Fazzi Associates

413-584-5300

www.fazzi.com

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