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Taking a Fresh Look at the AAMC Faculty Practice Plan Survey (FPPS)
Mary Patton WheatleyHershel Alexander
November 4, 2011
OverviewBrief description of the annual faculty
practice plan survey Highlight a few key data pointsDiscuss practice needs moving
forward
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FPPS: Why another survey?
To answer questions from members: “What are other practices doing?” “Who is similar to me?”
To answer questions from policy makers “What’s different about faculty practices?”
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Data collectionFY2010 Survey
Organizational characteristics– Governance structure– Organizational structure– Degree of centralization– Locus of control
Basic financial data Size of practice (encounters, faculty, etc)
No FY2011 Survey Assess data collection and reporting needs
Note: Group on Faculty Practice also administers an executive compensation survey which is currently being collected for FY2011
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OwnershipPopulation
NPopulation
%
Response Rate
N
Response Rate %
Public 72 58% 24 33%
Private 53 42% 36 68%
Total 125 100% 60 48%
Source: FPPS, 2010
FPPS Response Rates
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Governance
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Source: Q4b, FPPS, 2010. Practices were asked to indicate number of positions on Board for the given categories.
Typical Practice Plan Board Composition
11%
47%14%
7%
7%
14%
Executive Positions (Dean, FPP, Hospital/Health System CEO)Department ChairsFaculty At LargeCommunity MembersOther Department AppointeeOther
N=58
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Executive Members 2010
Dean of SOM 21
Clinical Department Chair 7
Hospital, Medical Center or Health System
4
Practice Plan CEO 2
Faculty at Large 2
Community Member 1
Other 5
Total Respondents 42
Source: Q4b, FPPS, 2010. Practices where asked to check which board position was chair. 42 out of 58 practices uniquely identified who their chair was.
Who is the Chair of the Practice Plan Board?
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Position
Number of Practices with Position
Percent of Total Practices that Have the Position on the Board
Percent of Positions that Have Voting Privileges
Dean 54 93% 80%
Clinical Department Chair 51 88% 100%
Practice Plan CEO 47 81% 49%
Faculty at Large 42 72% 95%
Other 41 71% 86%
Hospital CEO 31 53% 54%
Other FPP Execs 24 41% 45%
Other University Reps 20 34% 61%
Community Members 17 29% 93%
Dept Appointee 14 24% 100%
Basic Science Rep 9 16% 100%
Hospital Board Members 7 12% 83%
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How Often a Given Position is on the Practice Plan Governing Board and Has Voting Rights
Source: Q4b, FPPS, 2010. Practices were asked to indicate number of positions on Board for the given categories and whether the positions had voting privileges. N=58
Revenues and Outflows
10
77%
6%
1%
9%
6%
Professional BillingContracted Clinician TimeContracted Administrative TimeHospital SupportOther
Source: Q8f, FPPS, 2010. Responses indicated are self-reported.
N=50
Average Percent of Revenue Derived from Various Sources
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Practice Outflows
Categories Average25th
Percentile 50th Percentile
75th Percentile
Physician Compensation (Percentage of Total Practice Plan Revenue used towards Physician Salaries) 47%
38%
48% 52%
Institutional Taxes and Transfers(Percentage of Total Practice Plan Revenue used towards Taxes and Support)
9% 4% 8% 10%
Operational Expenses(Percentage of Total Practice Plan Revenue used towards Operational Expenses)
43% 34% 45% 54%
12Source: Derived from Revenues and Expenses in Q8 and Q9, FPPS, 2010, N=56
Control Across Academic Entities
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Revenue Cycle ActivitiesFaculty practices have much more control of the back-end revenue cycle processes than front end processes:
Scheduling (62% have complete or partial control)Registration (68% have complete or partial control)Coding (80% have complete or partial control)Credentialing (88% have complete or partial control)Back-end billing (92% have complete or partial control)
Source: Q3, FPPS, 2010. Practices were asked to select which academic entities have complete or partial control of a function. Practices could select more than one entity for each function. N=60
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Details for Scheduling
Entities that Control Scheduling N % Cumulative %
Practice and Department 16 27% 27%
Hospital/Health System Only 10 17% 43%
Practice, Department, and Hospital/Health System 8 13% 57%
Department Only 8 13% 70%
Practice and Hospital/Health System 5 8% 78%
Department and Hospital/Health System 5 8% 87%
Practice only 4 7% 93%Practice, School of Medicine, Department, and Hospital/Health System 2 3% 97%
Practice, School of Medicine, and Department 1 2% 98%
Practice and School of Medicine 1 2% 100%
Source: Q3, FPPS, 2010. Practices were asked to select which academic entities have complete or partial control of a function. Practices could select more than one entity for each function. N=60
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Other Parts of the Academic Enterprise
Most Involvement(at least 50% have complete or partial control)
Least Involvement(85% or more have no control)
Clinical Departments
Revenue cycle (scheduling, registration, coding) Practice development Clinical care functions (Patient care, Clinic operations) Compensation/Benefits for MDs/Providers
Information systems Compliance Audits Investments Managed care/contracting
Hospital/ Health System
Revenue Cycle (scheduling and registration) Business development
o Marketing/Public Relationso Strategic planning
Clinical care functions o Patient careo Patient safety o Professional practiceso Quality improvement
Infrastructureo Information Systemso Risk management/liabilityo Space
Compensation/benefits for MDs/Providers
Source: Q3, FPPS, 2010. Practices were asked to select which academic entities have complete or partial control of a function. Practices could select more than one entity for each function. N=60 16
Most Involvement(at least 50% have complete or partial control)
Least Involvement(85% or more have no control)
School of Medicine
Compensation/benefits for MD/Providers Strategic planning
Budget/Finance Space
Revenue cycle functions (Scheduling, Registration, Coding, Credentialing, Billing and Collections)
Managed care and contracting Investments
Parent University Audit Investments Personnel/HR
Very little involvement in revenue cycle, clinical care, practice development
Other Parts of the Academic Enterprise
Source: Q3, FPPS, 2010. Practices were asked to select which academic entities have complete or partial control of a function. Practices could select more than one entity for each function. N=60
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2012 Survey
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Assessment/Feedback Can the FPPS answer the crucial questions?
What do you need to know (that you cannot get from current data sources)?
How does the AAMC need to report the data? Other feedback?
What do we need to know about tomorrow’s practice? What is practice’s role within the larger academic
clinical enterprise?
Round table this afternoon to consider these questions
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Next Steps Transition survey administration to Data
Operations and Services Hershel Alexander, Director Kajal Nayyar, Sr. Research Analyst
Implement a process for survey revision Round table discussion Additional steps forthcoming
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Contact Information Kajal Nayyar
Sr. Research Analyst, Data Operations and [email protected], (202) 478-9913
Hershel AlexanderDirector, Data Operations and [email protected], (202) 828-0649
Mary WheatleyManager, Health Care [email protected], (202) 862-6297
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