benchmarking - squarefootage.nethousekeeping available for download • copy of “slides” •...
TRANSCRIPT
Benchmarking
Moderator:
B. Alan Whitson, RPA
President
Corporate Realty, Design & Management Institute
Seminar Leader
IFMA Health Care Institute’s Educational Workshops and Podcasts
Top Challenges Facing Healthcare Facilities Series
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Speakers
• Ron Kalich, CFM, CMA, SFP National Facilities Director - Kaiser Permanente
Vice President of Research IFMA Health Care Institute
• Steve Rees, CFM Vice President, Capital Management - Alberta Health Services
Representative, Canadian Healthcare Engineering Society
• Todd Wilkening, CHST Director of Facility Services - Ridgeview Medical Center
Chair - Benchmarking 2.0 Committee
• Colby Tuttle Director
Planon
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Housekeeping
Available for Download
• Copy of “slides”
• Questions & Answers
• Continuing Education Credits
• Self Reporting
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Webinar Objectives:
• Why benchmarking is vital for Hospital CEOs & FM
• Benefits of Participating in Benchmarking 2.0 • New online data entry system is fast and easy
• Supported by top healthcare facility organizations • American Society of Healthcare Engineers (ASHE)
• Canadian Healthcare Engineering Society (CHES)
• IFMA Health Care Institute
• Practice Greenhealth
• Understand why Canada is now included?
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Alan Whitson, RPA
Corporate Realty, Design &
Management Institute
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Benchmarking 2.0
Committee • Dennis Smith
Director-Facilities Management
Catholic Health Initiatives
• Steve Rees
Vice Pres., Capital Management
Alberta Health Services
• Ron Kalich
National Facilities Director
Kaiser Permanente
• Todd Wilkening
Director of Facility Services
Ridgeview Medical Center
Committee Chair
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North American Perspective
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Economics of U.S. Healthcare
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Total Annual Medical Cost U.S. - Family of Four
$-
$4,000
$8,000
$12,000
$16,000
$20,000
$24,000
2005 2006 2007 2008 2009 2010 2011 2012
Employer Contribution Employee Contribution Employee Out of Pocket
Data Source: Milliman – Medical Index
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Total U.S. Health Expenditures, Billions
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
Data Source: AHA Trend watch 2011 – Table 1.1
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U.S. Government Healthcare Spending, Billions
$0
$200
$400
$600
$800
$1,000
$1,200
60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10 12
Federal - Net of Transfer Payments State Local
7% of U.S. GDP
Healthcare $1.1 T 17%
Pension $1.0 T 16%
Education $0.9 T 15%
Defense $0.9 T 14%
Welfare $0.7 T 11%
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U.S. Hospital Revenue By Payer Type
1980 2000 2010
Non-patient 2.7% 2.8% 2.1%
Uncompensated 5.1% 6.0% 5.8%
Private Payer 41.8% 38.7% 35.2%
Other Govt 6.1% 1.4% 1.7%
Medicaid 9.6% 12.8% 16.1%
Medicare 34.6% 38.3% 39.1%
50.3% 52.5% 56.9%
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Payment-to-Cost Ratios
70%
80%
90%
100%
110%
120%
130%
140%
88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
Medicare Medicaid Private Payer
Data Source: AHA Trend watch Chart book 2012 Table 4.4
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Payment Shortfall for Medicare & Medicaid
$(40.0)
$(35.0)
$(30.0)
$(25.0)
$(20.0)
$(15.0)
$(10.0)
$(5.0)
$-
$5.0
$10.0
97 '08 99 00 01 02 03 04 05 06 07 08 09 10
Bill
ions
Medicare Medicaid
Data Source: AHA Trend watch Chart book 2012 Table 4.5
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Percentage of U.S. Hospitals that Lost Money
0%
10%
20%
30%
40%
50%
88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
Data Source: AHA Trend watch Chart book 2012 Table 4.1
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Total Operating Margin
Quartile All
Hospitals Investor-Owned
Hospitals Non-Profit Hospitals
1st Quartile 12.32 % 20.03 % 9.60 %
2nd Quartile 2.24 % 10.48 % 1.71 %
3rd Quartile -2.91 % 2.85 % -2.54 %
4th Quartile -11.94 % -11.94 % -10.89 %
Source: Healthcare Management Partners’ HMP Metrics Quarterly Report 2010
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Healthcare Reform
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Payment Reform: Value-Based Purchasing
• CMS payment retention • Applies to base DRG payment
• Total Performance Score
• 70% Process of care (12)
• 30% Patient experience (8)
• Redistribution of payment • Proportional to TPS
• Budget neutrality • ½ of hospitals earn back more
than withheld, others earn less
-1.00%
-1.25%
-1.50%
-1.75%
-2.00%
FY '13 FY '14 FY '15 FY ' 16 FY '17
CMS Payment Withheld
Other Reforms: 30-Day Re-admission Claw Back, 1-Day Observation
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Relationship Between TPS and CMS Incentive
-0.01
-0.005
0
0.005
0.01
0.015
0 10 20 30 40 50 60 70 80 90 100
Ince
ntive
Ra
te
Total Performance Score
Theoretical
Break-Even
Point
37.3
Median Score 37.0
Source: American Hospital Directory:
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Hospital Costs by Expense Type
Data Source: AHA 4Q 2009
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Impact of VBP Withholding on FMs Budgets
• 1% VBP Withholding FY2013 $ 871,933,675
• Average Withholding per Hospital $ 274,366
• Based on 3,178 Hospitals
Data reported to CMS
• Average Operating Costs per Hospital $ 203,800,093
• Average Energy Costs per Hospital (2%) $ 4,076,002
• Reduction in Energy Costs Needed to
Offset VBP Withholding 6.7%
VBP Data Source: Paul Shoemaker, Pres. - American Hospital Directory:
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Ron Kalich, CFM, CMA, SFP
Kaiser Permanente
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Benchmarking
• What is benchmarking?
• “A standard by which something can be measured or
judged”
• Measuring operations using standardized metrics and
comparing to others
• Why benchmark?
• To learn about and improve your business
• How do you measure your operations today?
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First Things First
1. Measure performance
2. Then, match to available comparative metrics
• Effectiveness metrics measure quality
• Efficiency metrics are readily comparable
• Inputs Outputs
• Cost metrics may be comparable, within ranges
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Utilities Efficiency
Better
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Utility Comparison
}
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Cost versus Intensity Efficiency
Blue - Energy Intensity Down
Red - Energy Intensity Up
$4.60
$4.80
$5.00
$5.20
$5.40
$5.60
2010 2011 2012
Energy Cost ($)/sqft
CN5810 CS2451
150
170
190
210
230
2010 2011 2012
Energy Intensity kBTU/sqft
CN5810 CS2451
Blue - Energy Cost Down
Red - Energy Cost Up
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Cost versus Intensity Efficiency
Blue - Energy Cost Up
Red - Energy Cost Down
Blue - Energy Intensity Down
Red - Energy Intensity Up
$3.50
$3.55 $3.60
$3.65
$3.70
$3.75 $3.80
$3.85
$3.90
2010 2011 2012
Energy Cost ($)/sqft
CS2251 CS3851
120
130
140
150
160
170
2010 2011 2012
Energy Intensity kBTU/sqft
CS2251 CS3851
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Utilities Benchmarking Example
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Utilities Benchmarking example
•Is this good performance?
•Why?
•Can or should I make changes to
operations to target “better”
performance?
•How?
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Avoid Benchmarking Mistakes
• Arbitrarily targeting industry averages
• Not understanding benchmark composition
• Not investigating drivers of your measures
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Achieving Operational Excellence
• “You can’t manage what you don’t measure”
• Compare – Benchmark • External
• Internal
• Time based
• Learn and understand drivers
• Set goals
• Review progress
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Steve Rees, CFM
Alberta Healthcare Services
Todd Wilkening, CHST
Ridgeview Medical Center
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Benefits of Participating in Benchmarking 2.0
• Compare your performance with other organizations
using the most widely accepted facility management
metrics
• Uncover costs, which by comparison, may be excessive
in relation to performance
• Identify ways to improve your organization’s
performance and contribute to the bottom line
• Determine opportunities for improvement and uncover
best practice
• Locate hidden opportunities to assist you in
demonstrating your departments value
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Expanded Coverage
Benchmarking 1.0 • Region
• Facility Description
• Utilities
• Maintenance
• Clinical Engineering
• Environmental Services
• Waste
• Linen Services
• Cost of Operations
Benchmarking 2.0 • Region • Facility Description • Facility Condition Index • Current Replacement Value • RE & Property Mgmt. • Construction • Utilities • Maintenance • Clinical Engineering • Environmental Services • Waste • Linen Services • Risk Management • Cost of Operations
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Benchmarking 2.0 Where Do We Go From Here
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Your Next Steps
• Accessible now on CHES.org and IFMA’s BEX
• Must be completed by September 30
• All information submitted is strictly confidential and is
documented as anonymous
• Report on one facility per survey
• But report on all facilities within your organization
• Data should be from most recent completed fiscal year
(12 months)
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Benchmark II Report
• Will be available in November 2012
• Geographic location and climate zones will be utilized
• Facility size, age and type
• Utility cost / sq ft - sq metre
• Customized Reports
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Benchmark II Report
• Staff Size
• Operating Budget Size
• Energy Management Tactics
• Maintenance Costs / sq ft - sq metre
• PM vs. DM Ratio
• Contracted vs. In-house Service
• Current Replacement Value Index
• Maintenance Management Systems
• Charge Backs / Internal Invoicing
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Online Inputs & Reports
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Building Exchange (BEX)
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Contact Information
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Organizational Account
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Locating Your Organization
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Creating/Adding Facilities
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Reporting
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Parameter of the Data Set
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Desired Report
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Report Generation
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Link to Benchmarking 2.0 Survey
https://healthcarefacilities.gallup.com
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Colby Tuttle Director Integrated Workplace Management Systems
Planon
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It’s all about the data.
• Completing the Benchmark Survey is “as easy as
possible”… but there is still a lot of data required.
• Property
• Operations
• Financial
• And more...
• The imperative is clear
• The potential benefits can be measured in $$
• 2-4 man-hours per survey (site, campus, network?)
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Planon’s IWMS Philosophy
Real Estate
Management
Maintenance
Management
Integrated
Services
Management
Space &
Workplace
Management
Core Functions
Project Management, Budgets, Notifications, Workflow, Reporting
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Visibility through Integration
Today
Contracts
PPM Work Orders
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Visibility through Integration
Today
Contracts
PPM Work Orders
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Visibility through Integration
Today
Contracts
PPM Work Orders
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How IWMS Supports Benchmarking in Healthcare
Real Estate
Management
Maintenance &
Asset
Management
Integrated
Services
Management
Space &
Workplace
Management
Core Functions
Project Management, Budgets, Notifications, Workflow, Reporting
• Portfolio hierarchy creates location-context for all metrics
• Provides complete repository building/property/construction data
• Easily assimilates new properties from M&A
• Manage all Planned, Reactive and Compliance related activity
• Complete Asset registry with lifecycle and capital/lifecycle history
• “Meter” assets record all utility, waste and CO2 metrics
• Accurately account for space allocation by entity and/or CIP code
• Correctly allocate Sustainability and Operations metrics to sqft
• Provide detailed “location awareness” to all operations & functions
• Support Environmental Services practices and goals
• Support EH&S and Risk Management process and reporting
• Answer all those “CAFM” questions YES!
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Achieving Operational Excellence
• “You can’t manage what you don’t measure”
• Compare – Benchmark • External
• Internal
• Time based
• Learn and understand drivers
• Set goals
• Review progress
Ron Kalich
Kaiser Permanente
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How IWMS Supports Benchmarking in Healthcare
Energy and Utilities
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How IWMS Supports Benchmarking in Healthcare
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How IWMS Supports Benchmarking in Healthcare
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How IWMS Supports Benchmarking in Healthcare
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How to Achieve a Successful IWMS
The Software
▪ Integrated Platform
- Corporate RE and Leasing
- “Smart Workplace” Space, MAC, Reservations…
- Maintenance & Asset Management, including PPM
- Integrated Services
▪ Customer–specified Integrations via Planon Enterprise Talk
The Implementation
- Planon Implementation Method
- Accelerator best-practice reference database
- Gap Analysis to define additional configuration requirements
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Questions & Answers
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Question and Answer
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Webinar Information
• A recorded version of this webinar will be available at
www.planonsoftware.com
• Whitepapers available for download on
www.planonsoftware.com
• Contact Planon for a QuickScan assessment
• Identify the major areas of improvement
• Understand the ROI impact
• Email [email protected]
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Benchmarking 2.0 Information & Help Line
Link to Survey
https://healthcarefacilities.gallup.com
Questions about Completing Benchmark Survey?
Please contact Survey Support at
+1-281-974-5665
or
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Contact Information
Ron Kalich, CFM,CMA, SFP
National Facilities Director - Kaiser Permanente
Vice President of Research IFMA Health Care Institute
Steve Rees, CFM
Vice President, Capital Management - Alberta Health Services
Representative, Canadian Healthcare Engineering Society
Todd Wilkening, CHST
Director of Facility Services - Ridgeview Medical Center
Chair - Benchmarking 2.0 Committee
Colby Tuttle
Director - Planon
B. Alan Whitson, RPA
President - Corporate Realty, Design & Management Institute
IFMA Health Care Institute Advisory Board
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