making the case: fellowship financials
TRANSCRIPT
Making the Case: Fellowship Financials
Britney Broyhill, DNP, ACNP-BC
CHS NP Fellowship Director
Objectives
• Participants will name 5 key motives for creating a post-graduate education program for Nurse Practitioners for healthcare administrators.
• Participants will create a business model to provide financial support for a NP post-graduate education program
• Participants will calculate a potential ROI for a NP post-graduate education program.
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Current State of Post Graduate
Programs
Subspecialty Break-out
….to create value for patients.
Objective Problem/Opportunity @ CHS
Clinical Outcomes
● ACPs in acute care settings are often hired from non-acute settings
● ACPs receive on-the-job training with their supervising physicians
● ACPs often find themselves ill prepared for many clinical situations
The Need for Advanced Clinical Practitioners…
Satisfaction
● CHS lacks strong reputation as a best place to work for ACPs
● Fragmented communication with ACPs across the System
● Provider dissatisfaction with ACP/MD clinical partnerships
● Underutilization leads to ACP disengagement (not practicing at top of license)
● Physician frustration with increasing work load and patient demands
Costs
● High MD/ACP ratio = Higher cost provider workforce
● Vacant ACP positions yield lost revenue, decreased patient satisfaction & decreased access to care
● Length of time to recruit skilled providers contributing to increased costs
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Key Drivers
• Employee Engagement Scores
• Turnover Rates
• Recruitment Costs
• Lower Workforce Costs
• ACP Productivity Differential
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Components of Business Plan
• Executive Summary
• Project Overview
• Situation Assessment
• Management and Operations
• Alternatives and Recommendations
• Financial Projections
• Management Action Plan
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Costs to Consider
• Administrative costs
– Licensure
– Interview Expenses
– Food/Beverage
– Marketing
• Salaries and Benefits
– CE
– Directors/Staff
– Mentors/Lecturers
– Simulation Costs
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Leadership Approval & Funding
• Management Company
– Business Plan
– ROI
• Executive Vice President Sponsorship
• Funding Approval
• Board approval
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Return on Investment
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Value CreatedImproved clinical outcomes with ACPs obtaining the clinical knowledge and
expertise needed to practice at top of license,
Increased physician & patient satisfaction
Higher ACP satisfaction = leads to increased retention; decreased vacancies
Lower turnover cost, including recruitment, training/orientation, lost productivity, new hire costs
Lower recruitment costs = due to fewer vacancies; enhanced pipeline shortens recruitment cycle
Lower provider workforce cost = sufficient quality and quantity of providers allows shift of the ACP to MD ratio
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The “Ask”• $14.1 million over 5 years ($18.4 m with expan.)
– Included CAP, Fellowship and Collaborative
– Did not include expansion (32 Fellows v. 56 Fellows)
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ROI
• Proj. BE 18 mo. ($27.4 million in 12 mo.)
– Lower provider workforce cost ($18.2 m) (141 ACPs)
– Revenue generated by Fellows ($3.5 m)
– Decreased Open Position time ($2.1 m) 141 – 92 days
– Decreased turnover rate ($2.9 m) (18 ACPs) 12 – 8%
– Lower recruitment costs ($0.7 m) (218 ACPs)
– Increased patient access (days to first new patient appt. and days to established patient appt.)
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Other ROIs?
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How is this scalable?
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Benefits to Fellowship Programs
• Protected time to learn
• Social support during transformative year
• Ease into independence
• Organized approach to key topics to be successful in a specialty
• Proctoring for procedures completed
• Ready to be productive on day 1 of permanent practice when being compensated at full salary
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Questions
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