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9/25/2018 1 2018 Capital Link 1 www.caplink.org Assessing Your Market Session 1 of 2 Jonathan Chapman Director CHC Advisory Services October 3, 2018 2018 Capital Link 2 www.caplink.org Capital Link Launched in 1995, nonprofit, HRSA national cooperative partner Offices in CA, CO, FL, LA, MA, MO, and WV Over $1.1 billion in financing for over 230 capital projects Direct assistance to health centers and complementary nonprofit organizations in planning for and financing operational growth and capital needs Industry vision and leadership in the development of strategies for organizational, facilities, operational and financial improvements Metrics and analytical services for measuring health center impact, evaluating financial and operating trends and promoting performance improvement

Assessing Your Market Session of...2010/03/18  · • Tetanus, Diphtheria, and Pertussis • Not being vaccinated results in approximately 5,320 cases per 100,000 children • $17,000

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Page 1: Assessing Your Market Session of...2010/03/18  · • Tetanus, Diphtheria, and Pertussis • Not being vaccinated results in approximately 5,320 cases per 100,000 children • $17,000

9/25/2018

1

2018 Capital Link 1www.caplink.org

Assessing Your MarketSession 1 of 2

Jonathan Chapman

Director CHC Advisory Services

October 3, 2018

2018 Capital Link 2www.caplink.org

Capital Link

• Launched in 1995, nonprofit, HRSA national cooperative partner

• Offices in CA, CO, FL, LA, MA, MO, and WV

• Over $1.1 billion in financing for over 230 capital projects

‐ Direct assistance to health centers and complementary nonprofit organizations in planning for and financing operational growth and capital needs

‐ Industry vision and leadership in the development of strategies for organizational, facilities, operational and financial improvements

‐ Metrics and analytical services for measuring health center impact, evaluating financial and operating trends and promoting performance improvement

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2018 Capital Link 3www.caplink.org

Assessing “at the Edges”

2018 Capital Link 4www.caplink.org

Assessing Risks and Opportunities

You can’t manage what you don’t know and…

You can’t know what you don’t measure

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2018 Capital Link 5www.caplink.org

Specific and Targeted Outreach

2018 Capital Link 6www.caplink.org

Things to Consider

• HRSA’s Compliance Manual, Chapter 3: Needs Assessment

• What is your perceivedMarket?

• Market can = geography, specific population, service type, etc.

• The findings will likely inform & expand any ‘gut instinct’

• There is A LOT of data out there

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2018 Capital Link 7www.caplink.org

Assessing Your Market

2018 Capital Link 8www.caplink.org

Geographical Service Area Identification

• Examine and map patient origins

• Approximately 75% (or other natural break) is considered Primary

• Next 10‐15% is Secondary

• Similar to HRSA UDS Service Area Map and UDSMAPPER

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2018 Capital Link 9www.caplink.org

Zip Code 37129 ‐ UDSMAPPER

2018 Capital Link 10www.caplink.org

Market Assessment ‐ UDSMAPPER

20 Minutes Drive Time from Health Center Admin Location

WITH TRAFFIC CONSIDERATION

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2018 Capital Link 11www.caplink.org

Market Assessment ‐ UDSMAPPER

2018 Capital Link 12www.caplink.org

Demographics and Economic Indicators

• Compare state, county, metropolitan areas, cities, zip codes, etc.‐ Populations‐ Race‐ Income Ratios‐ Education‐ Language‐ Business Establishments and Employees by Industry‐ Disabilities‐ Many more, usually according to health center specifics

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2018 Capital Link 13www.caplink.org

Data Table – UDSMAPPER Data

2018 Capital Link 14www.caplink.org

Data.gov 

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2018 Capital Link 15www.caplink.org

US Census FactFinder

• Geographies by census block, tract, zip code, county, state, etc.

2018 Capital Link 16www.caplink.org

US Census FactFinder

• Veterans, SNAP, family structure, poverty, language, housing, transportation, businesses (county and zip code business patterns), disability, origins, etc.

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2018 Capital Link 17www.caplink.org

US Census FactFinder ‐ Veterans

2018 Capital Link 18www.caplink.org

Medical Needs of Service Area

• Compare state, county, metropolitan areas, cities, zip codes, etc.‐ General health indicators

• Other health providers and facilities

• Health Professional Shortage Areas (HPSA) and MUA/Ps

• Health Disparities

• Selected Workforce Considerations

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2018 Capital Link 19www.caplink.org

US Census FactFinder – Health Care Establishments

2018 Capital Link 20www.caplink.org

Data Table – UDSMAPPER Data

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2018 Capital Link 21www.caplink.org

HRSA Data (formerly Data Warehouse)

2018 Capital Link 22www.caplink.org

County Health Rankings

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2018 Capital Link 23www.caplink.org

County Health Rankings

2018 Capital Link 24www.caplink.org

Policy Map

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2018 Capital Link 25www.caplink.org

Policy Map ‐ Health

2018 Capital Link 26www.caplink.org

Aunt Bertha

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2018 Capital Link 27www.caplink.org

Aunt Bertha

2018 Capital Link 28www.caplink.org

Aunt Bertha

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2018 Capital Link 29www.caplink.org

Market Assessment – Selected National Resources

• UDSMAPPER and HealthLandscape: www.UDSMAPPER.org

• US Census FactFinder: https://factfinder.census.gov

• US Census QuickFacts: https://www.census.gov/quickfacts

• County Health Rankings: http://www.countyhealthrankings.org/

• HRSA Data: https://data.hrsa.gov/ (formerly Data Warehouse)

• Aunt Bertha: https://www.auntbertha.com/

• CDC/Nat’l Center for Health Statistics (FastStats): https://www.cdc.gov/nchs/index.htm

• Policy Map: https://www.policymap.com/

• US Datasets: https://catalog.data.gov/dataset

• US SBA’s Market Analysis: https://www.sba.gov/tools/sba‐learning‐center/training/market‐research

2018 Capital Link 30www.caplink.org

Data

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2018 Capital Link 31www.caplink.org

Identifying Service Area Opportunities

• Evaluate service area market share‐ Total population and low income population‐ Payor mix

• Population Projections‐ Anticipate changing demographics and their effect

• Estimating potential patients, visits, providers, capital needs

• https://www.tn.gov/content/dam/tn/tacir/documents/Population2010.pdf

• http://cber.bus.utk.edu/popproj.htm

2018 Capital Link 32www.caplink.org

Back of the Envelope

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2018 Capital Link 33www.caplink.org

Service Area – UDSMAPPER Data

2018 Capital Link 34www.caplink.org

Thinking of Expanding?

An organization wants to consider increasing its low income population market share by 10%.  

How many more patients, 

visits, and providers 

would that mean?

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2018 Capital Link 35www.caplink.org

Expansion Considerations

• Market Share – Current and Projected• Number of Patients from specific population divided by that total population• Service Area FQHC Patients = 9,226• Service Area General Population = 230,000; Low Income Population = 70,000• 4% market share General Population; 13% market share Low Income Population

• Estimating Encounters/Visits• Historic/Realistic visits per patient times expected patients• FQHC Visits = 32,000• 32,000 / 9,226 = 3.5 visits per patient

• Projecting Workforce Needs• Historic/Realistic Provider Productivity divided by expected visits/patients• FQHC Provider FTE = 25 • FQHC Visits = 32,000• 32,000 / 25 = 1,280 visits per FTE

2018 Capital Link 36www.caplink.org

Expansion Considerations

• An organization wants to increase its low income population market share by 10%; how many more patients, visits, providers?

• 13% x 1.10 = 14.3%• 14.3% x 70,000 = 10,010 patients                                                

(increase of 784 patients)

• 784 * 3.5 visits per patient = 2,744 additional visits

• 2,744 / 1,280 visits per Provider FTE = 2.1 additional Provider FTEs 

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2018 Capital Link 37www.caplink.org

Expansion Considerations

• Estimated Square Footage/Funding Needed to Treat New Patients – HYPOTHETICAL

• Using estimated square feet per provider as basis…1,500

• 2.1 FTE x 1,500 sq ft per = 3,210 total sq ft

• Estimated construction cost per square foot as basis…$145*

• 3,210 sq ft * $145/sq ft = $465,000 estimated cost

*http://www.buildingjournal.com/construction‐estimating.html

2018 Capital Link 38www.caplink.org

Expansion Considerations

Hard Costs: 70%Equipment:  15%Soft Costs: 15%

Total Project Cost  100%

+ Land/Building Acquisition

Typical Breakdown of Project Costs for Health Centers:

$465,000$100,000$100,000

$665,000

??

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2018 Capital Link 39www.caplink.org

Service Expansion ‐ Immunization Rates and Costs

• Tetanus, Diphtheria, and Pertussis

• Not being vaccinated results in approximately 5,320 cases per 100,000 children

• $17,000 in hospitalization costs per case

• Dtap Vaccine = $80/child

• 74,000 children under 5 years of age in service area

• Current Immunization Rate =  70% 30% = $20 million in costs

• Spend $1.6 million to increase the Immunization Rate to 80%            

• New Immunization Rate = 77% 23% = $15 million in costs

Reduction of Hospitalization Costs of $5 Million

2018 Capital Link 40www.caplink.org

Information

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2018 Capital Link 41www.caplink.org

Contact

Visit us Online: www.caplink.org

• Learn more about our products and services

• Download our free publications and resources

• Register for upcoming webinars

• Sign up for our e‐newsletter, Capital Ink

• Subscribe to our blog at capitallinksblog.blogspot.com

Jonathan ChapmanDirector of CHC Advisory Services970‐833‐[email protected]