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URBAN INDIAN HEALTH PROGRAMCY2012
Overview
URBAN INDIAN HEALTH PROGRAMCY2012
Using UDS Feedback Report as a Management Tool
Susan Friedrich, JSI
URBAN INDIAN HEALTH PROGRAMCY2012
National performance Program
improvement Ensuring the health
of your patients
Why is it important?
URBAN INDIAN HEALTH PROGRAMCY2012
• Too much information and not enough time!• A Snapshot Approach – focus on a few high
impact measures for initial review to identifyStrengthsPossible areas of improvement
Focusing Your Efforts
URBAN INDIAN HEALTH PROGRAMCY2012
• Patient profile – who are you serving?• Quality of care – are standards of care high?• Efficiency – are we maximizing our resources?• Financial security - are we in a good financial
position?
Snapshot of Performance
URBAN INDIAN HEALTH PROGRAMCY2012
Comparison Groups• Program
Current year, prior year and 2 year changeReported for total patients and AI/AN population
• AveragesComparison group – Full Ambulatory, Limited Ambulatory or
Information and ReferralNational average (all UIHP programs)BPHC Average (applicable to Full Ambulatory programs)
URBAN INDIAN HEALTH PROGRAMCY2012
Performance measures
• Access Describes patients you serve
• Quality of Care Utilization and GPRA measures
• Efficiency Evaluates capacity
• Financial Cost/Viability Assesses costs and viability
Feedback Report
URBAN INDIAN HEALTH PROGRAMCY2012
Evidence that program is serving priority populations:
• % Growth in patientsAI/AN patients% AI/AN of total patientsTotal patients% patients using medical services
• Patient demographics• Patients with financial, cultural and
linguistic barriers% Uninsured, Medicaid, other
public% < 200% FPL
Patient Profile
URBAN INDIAN HEALTH PROGRAMCY2012
Patient Profile
Did you grow?
Who are you
serving?
URBAN INDIAN HEALTH PROGRAMCY2012
Evidence that program is delivering quality care:
GPRA MeasuresContinuity of carePrevalence rates
• Visits per patient (continuity)• Rates of service use• GPRA
Chronic Disease (diabetes control)
Routine and Preventive care (screenings, immunizations and assessments)
Behavioral health (tobacco, mental health and domestic violence)
Quality of Care
URBAN INDIAN HEALTH PROGRAMCY2012
Quality of Care
How do you
compare?
What is your performance?
Are you improving or getting
worse?
URBAN INDIAN HEALTH PROGRAMCY2012
Evidence that program is operating a cost effective services delivery model:
• Growth in visits• Provider FTEs• Panel size
(patients/provider FTE)• Visits per provider
(productivity)• Medical Team Ratio >1
• Staff Ratios
Efficiency
URBAN INDIAN HEALTH PROGRAMCY2012
EfficiencyDid your
visits grow with patients?
Are you at capacity?
How do you
compare?
Are you at capacity?
URBAN INDIAN HEALTH PROGRAMCY2012
• Cost Cost per patient and visit % administrative costs Charge to cost ratio Surplus/deficit as % of total
costs• Diversification of Funding
% income from IHS % income from patient service IHS funding per AI/AN patient
• Financial Viability Change in net assets as % of
expense Working capital to expense ratio Debt to equity ratio
Financial/Cost Viability
Evidence that program is financially viable:
URBAN INDIAN HEALTH PROGRAMCY2012
Financial/Cost ViabilityAre your
costs reasonable
?
Do fees cover costs?
URBAN INDIAN HEALTH PROGRAMCY2012
• Provides formulas for all measures• Format “replicates” the report format• In the formula section, each measure
is identified with: A number A name, corresponding to the name
on the report A formula for calculating the
measure
UDS Reference Guide
URBAN INDIAN HEALTH PROGRAMCY2012
% Pediatric: (T3A Lines 1-15, Col A+B) /(T3A L39 CA + T3A L39 CB)
T= Table + = add - = subtractL= Line * = multiply C=
Column / = divide
Calculations for Performance Measures
URBAN INDIAN HEALTH PROGRAMCY2012
Average Defined: The value obtained by dividing the sum of a set of quantities by the number of quantities in the set.
Program Type (Full Ambulatory, Limited Ambulatory, Information and Referral
UIHP National Averages (from all urban programs)BPHC National (from FQHCs)
Averages
URBAN INDIAN HEALTH PROGRAMCY2012
• Compare your performance with peer groupsHow do you compare with similar programs?
• Look at your performance over timeAre things trending in the right direction?
• Identify strengths and weaknesses• Develop and implement strategy for improvement
Identifying Strengths & Weaknesses
URBAN INDIAN HEALTH PROGRAMCY2012
Susan Friedrich or Priscilla DavisJohn Snow, Inc. (JSI)
UDS Helpline: 1-866-698-5976email: [email protected]: www.uihpdata.net
Contact Information