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Analyzing Your KeyPerformance Measures
Gina Mazza RN, BSNTotal Performance Director
March 2011
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Insights from Fazzis work with hundreds ofhome health and hospice agencies
Benchmark comparisons fromOperational/Financial Service: BestWorks
Insights from current realities for homehealth care
Foundation for this Presentation
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Quality and Financial Matrix
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Strategic Management Model
Whats GoingTo Happen?
What Should WeDo About It?
What Are TheImplications?
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Two Approaches to Benchmarking
Internal Benchmarking: Identifying,
measuring and tracking over a period of
time.
Comparative Benchmarking: Tracking
performance indicatorsAND comparing
them to national standards and best
practice standards, i.e. top 20%.
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Home Health Compare
Hospitalization Rate
Home Health Process Measures
Patient Satisfaction Measures
Quality Performance Measures
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81%
82%
85%
85%
89%
Likelihood of
Recommending
Specific Care Issues
Communications Btwn
Providers and Patients
Overall Rating of Care
Care of Patients
Fazzi National Database
HHCAHPS: Initial Results
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91%
89%
91%
93%
94%
Likelihood of
Recommending
Specific Care Issues
Communications Btwn
Providers and Patients
Overall Rating of Care
Care of Patients
Fazzi National Database
HHCAHPS: Best Practice Results
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Profit Margin
Case Mix Weight
Cost per Visit
Staffing Ratio
Key Financial Performance Measures
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Profit Margin
National
AverageTop Performers
Medicare Profit 11.6% 29%
Home Health
All Payers 3.85% 13.2%
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2011
Impact of Underscoring and Revenue
Average Case
Mix Weight
Revenue/Episode
$2,192.97*
500 SOC
Net Revenue
What it Would
Mean
National1.31**
$2,872.79 $1,436,395 N/A
1.25 $2,741.21 $1,370,606 ($65,789)
1.20 $2,631.56 $1,315,782 ($120,613)
1.15 $2,521.92 $1,260,958 ($175,438)
1.10 $2,412.27 $1,206,134 ($230,262)
1.05 $2,302.62 $1,151,309 ($285,086)
1.00 $2,192.97 $1,096,485 ($339,910)
.95 $2,083.32 $1,041,661 ($394,735)
*Current CMS Standardized 60 Day Rate for Episodes as of Jan. 1, 2011**MedPAC, Re ort to the Con ress: Medicare Pa ment Polic , June 2010
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Medicare Episode Drivers
Medicare
Profit
Case Mix
Weight
All
Visits
Cost/Nsg
Visit
National
Average11.6% 1.2 16 $157
TopPerformers 29% 1.26 15 $138
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Home Health All Payers Drivers
Profit
Margin
Nsg
Visits/
Day
Cost/
Nsg Visit
Non
Visiting
Staff
National
Average3.85% 4.2
$157 6.8/
100 ADC
TopPerformers
13.2% 5 $138 6.6/100ADC
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How Should
We Approach Change?
Never change things by fighting
the existing reality.
Instead, build a NEW model that
makes the existing model
obsolete."
Buckminster Fuller
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New Options That Are Now Being Initiated
1. Accountable Care Organizations (ACOs): Work together,lower costs and improve quality.
2. Bundled Payments: One payment to cover the services for
the patient across health sectors.
3. Value Based Contracting: Rewards and penalties.
4. Patient Centered Medical Home Program: Physician
manages cases and share in savings.
5. Care Transition Programs: Improve quality and improve
patient experience during transitions of care.
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What Are the
Goals of All These Initiatives?
1. Save money.
2. Improve quality outcomes.
3. Improve patient experience.
4. Address patients with chronic disease.
5. Reduce unplanned hospitalization.
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What Should the Goals of Every
Home Care Agency Be?
1. Save money Reduce cost/visit and cost/episode.
2. Improve quality outcomes Top 1/3 of Home Health
Compare measures.
3. Improve patient experience Top 1/3 of HHCAHPS.
4. Address patients with chronic disease
Create ateach back/chronic disease education program.
5. Reduce unplanned hospitalization Be in top 10% of
lowest hospitalization rates in the country.
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To Be a Success, Remember
If all you do
Is all you did.
Then all youll get
Is all you got.
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Questions and Answers
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Fazzi Associates
413-584-5300
www.fazzi.com
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