Overview
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Using UDS Feedback Report as a
Management Tool
Susan Friedrich, JSI
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Why is it important?
 National performance
 Program improvement
 Ensuring the health of
your patients
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Focusing Your Efforts
• Too much information and not enough time!
• A Snapshot Approach – focus on a few high
impact measures for initial review to identify
Strengths
Possible areas of improvement
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Snapshot of Performance
•
•
•
•
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?
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Comparison Groups
• Program
 Current year, prior year and 2 year change
 Reported for total patients and AI/AN population
• Averages
 Comparison group – Full Ambulatory, Limited Ambulatory or
Information and Referral
 National average (all UIHP programs)
 BPHC Average (applicable to Full Ambulatory programs)
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Feedback Report
Performance measures
• Access
 Describes patients you serve
• Quality of Care
 Utilization and GPRA measures
• Efficiency
 Evaluates capacity
• Financial Cost/Viability
 Assesses costs and viability
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Patient Profile
Evidence that
program is
serving priority
populations:
• % Growth in patients
 AI/AN patients
 % AI/AN of total patients
 Total patients
 % patients using medical services
• Patient demographics
• Patients with financial, cultural
and linguistic barriers
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
 % Uninsured, Medicaid, other
public
 % < 200% FPL
Patient Profile
Did you
grow?
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Who are
you
serving?
Quality of Care
Evidence that
program is
delivering quality
care:
GPRA Measures
Continuity of care
Prevalence rates
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
• 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
Are you
improving
or getting
worse?
How do
you
compare?
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
What is your
performance?
Efficiency
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
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Efficiency
Did your
visits grow
with
patients?
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
How do you
compare?
Are you at
capacity?
Financial/Cost Viability
Evidence that
program is
financially viable:
• 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
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
 Change in net assets as % of
expense
 Working capital to expense ratio
 Debt to equity ratio
Financial/Cost Viability
Are your
costs
reasonable?
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Do fees cover
costs?
UDS Reference Guide
• 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
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Calculations for Performance
Measures
% Pediatric: (T3A Lines 1-15, Col A+B)
/(T3A L39 CA + T3A L39 CB)
T= Table + = add
- = subtract
L= Line
* = multiply C=
Column
/ = divide
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Averages
Average Defined: The value obtained by dividing the sum of a
set of quantities by the number of quantities in the set.
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Program Type (Full Ambulatory, Limited Ambulatory,
Information and Referral
UIHP National Averages (from all urban programs)
BPHC National (from FQHCs)
Identifying Strengths
& Weaknesses
• Compare your performance with peer groups
How do you compare with similar programs?
• Look at your performance over time
Are things trending in the right direction?
• Identify strengths and weaknesses
• Develop and implement strategy for improvement
URBAN
INDIAN
HEALTH
PROGRAM
CY2012
Contact Information
Susan Friedrich or Priscilla Davis
John Snow, Inc. (JSI)
UDS Helpline: 1-866-698-5976
email: helpuds@uihpdata.net
website: www.uihpdata.net
URBAN
INDIAN
HEALTH
PROGRAM
CY2012