A Dental Incentive System
that Works
Juris M. Svarcbergs,DMD,MPH
Dental Director
CAMcare Health Corporation
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Background
The early years
‘Do gooders’
Focus on ‘ideal service’
Dedication to cause or philosophy
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Background
Traditional professional ‘formula’
Work in itself a reward
(a non-monetary incentive)
Salary adequate compensation
(your paycheck is the reward)
Administration outlook
(we’re not the private sector)
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Background
The Changing Times
Burdened with debt Graduates
Business oriented Dentists
MBA Administrators
The realization:“To do Good,
we must do Well!”
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Driving Forces in today’s
environment
Decreased grant funding opportunities
Mainstreamed care delivery
Competition for patients
Competition for revenue
Increased opportunity for Revenue
generation
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The New Environment
200,000
180,000
160,000
140,000
120,000
100,000
80,000
60,000
40,000
20,000
0
Goal
Actual
Profitability
Cost Center Analysis
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DENTAL PRODUCTIVITY
Target is 2,400/DDS
Annualized Rate:
2,639 enc/DDS
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Improvements in MIS, CIS
Enable accurate dental data collection
RVU capabilty for correlation of amount
of care with visit info
Provider profiles
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Why not become ……
competitive
in today’s environment with
MOTIVATED and
EFFICIENT PROVIDERS!?!
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Let’s Try an Incentive System!
Money always
works!
Should we Increase
salary?
Should we consider
commissions?
How do we tie work
produced to
paycheck?
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The Dilemma(s)
Increased Revenue can only be
generated with
Administrators don’t want to lose
over expenditures
Providers don’t
administrators to
share income or ‘commission's’ fairly
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Available Incentive Systems
% of Provider generated charges
% of collections of Provider’s production
“x” % of Medicaid income
“y” % of Self Pay income
$’s per R.V.U. generated
The ‘mathematician's dream’ formula
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Satisfaction
Can you really be happy if you
 Can’t figure out your take home
pay or bonus
 Can’t ‘trust’ the figures of billing
or admin people
 You have to treat some patients
in ways to benefit your income
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Real Life
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How to Build an Effective
Incentive Program:
The “5 Commandments”
Simple and easy to understand
Allay administration fears
Empower providers
Make the reward memorable
Relate the incentive directly to the
organization’s income level
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The CAMcare Incentive Plan
Guaranteed base
salary: Reasonable and
contractual
Security
Budgeting
Good fringe benefits
Health coverage,
malpractice,CME time &
coverage, pension
Goodwill and
competitive edge
Only one concernPRODUCTIVITY
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The CAMcare Incentive Plan
Quarterly Goals
600 visits/ FTE
(not 599!!) (individual
provider not group
average)
Quarterly Payout
10% of base salary in
contract-exactly
(prorated for quarter i.e
2.5% of annual base
salary)
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‘Bonus Payout’ Example
Dr. XYZ had 645
patient visits this
quarter
At $80K contract/yr,
Dr.XYZ rec’d $20,000
in base salary
Reaching/Goal gets
$2,000 Bonus
CHC submitted bill
for approx. $64,500
to all payors
CHC expects to get
min. 2.5 times what
pays out docs
CHC gets
$42,500
(Doc gets $22,000)
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Special Request for Payout!
Goal Achievers:
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Bonus is Recognition of
Achievement
Bonus checks are separate and usually
presented by CEO
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And it’s part of total Package
Professional Compensation Package:
1. Base Salary
$ 80,000
2. Health Coverage
5,604
3. Soc.Security Taxes
4,142
4. CME Allowance
1,500
5. Vacation,CME,Personal,
Holidays,Sick, time
8,941
6. Malpractice Coverage
3,800
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Add up Total Package
Total Value………………$ 103,987
If Loan Repayment-add 25,000
TOTAL Package without Bonus:
$128,987 !!!
Is another $ 8,000 worth the effort???
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Results: Avg.Encounters/DDS
3,000
2,800
2,600
2,400
2,200
2,000
1,800
1,600
1,400
1,200
1,000
1998
1999
2000
2001
Visits/DDS
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Results: RVU’s per DDS/yr.
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Results: DDS’s reaching goal
90.00%
80.00%
70.00%
60.00%
1998
1999
50.00%
2000
40.00%
2001
30.00%
20.00%
10.00%
0.00%
1998
1999
2000
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2001
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DENTAL VISITS by Year
14500
14000
13500
13000
1998
1999
2000
2001
12500
12000
11500
11000
10500
10000
1998
1999
2000
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2001
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The Bottom Line: Dental Cost
Center $ EPI (profitability)
60,000
50,000
40,000
30,000
EPI/DDS
20,000
10,000
0
1998
1999
2000
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CAMcare
Revenue & Expenses
CAMcare Health Corporation
A n nu a l R e v e n ue v s E xpe nse
Millions
$
11
10
Revenue
Expenses
9
8
1997
1998
1999
2000
2001
Year
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S = R/E
Choose a ‘goal’ that directly influences
the organization’s income level
Offer a definite bonus amount that is
‘BIG’ yet ‘small’
Support providers in achieving goal
at every level
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S = R/E
Make the reward memorable
(timing, amount, presentation)
Report to Board as a “Dental
Department defining” event!
(Dental exceeds expectations)
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Who are the ‘Satisfied
Customers’?
Providers
Board
(and support staff)
CEO
Patients
CFO
Community
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Simply
Satisfying!
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