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FM010_PartII_O_Adeleke.pptxCenter for Diabetes Care Business Case
Presented By:
Olufunmilayo Adeleke
Walden University
Strategic plan and business plan for the Center for Diabetes Care
FM010
11/25/2018
1
Center for Diabetes Care:
Short-Term Goals:
Develop community education programs
Advocate for community-based programs that promote health life-style changes
Provide diabetes kitchen classes to encourage healthier meals preparation
Conduct health fairs & community events to provide glucose screening
Long-Term Goals:
Promote & expand diabetes awareness & education to the targeted patient population families
Expand educational outreach programs to all Hispanic Lowertown community population
Short-Term Goals:
The short-term goals for the Center for Diabetes care include:
•To develop tailor-made free diabetes self-management community education series programs and classes offered at various community locations in English and Spanish to increase knowledge and care for diabetes.
•To advocate for community-based diabetes programs that promote health life-style changes that have the prospective to prevent besides delay the onset of diabetes and its complications. Hence, supporting the community members to live better lives and managing diabetes.
•To provide free 6-week diabetes kitchen classes where community members will be able to learn the tasty secrets to preparing healthier meals, hence acquiring skills needed to better control or even prevent diabetes. The classes will be available to those who have pre-diabetes or have already been diagnosed with diabetes, besides any interested community member with the condition of cooking for a diabetic member.
•To collaborate with other kindred groups and community-based organizations that are active in improving outcomes for diabetes and its complications
•To boost and support studies on selected clinical issues in diabetes and its complications, as demarcated by peer-reviewed research protocols.
•To conduct health fairs and community events programs that will provide diabetes education and glucose screenings at local and other community events as allowed by time, the budget, and staffing.
2
Center for Diabetes Care:
Vision:
To achieve appropriate treatment and preventive patient-and family care, centered towards improving patient’s exceptional quality of life and safety outcomes, whereby decreasing hospitalizations from diabetes and its complications.
Mission:
To provide access patients to diabetes education along with ongoing treatment in the language of their choice, in a manner that is culturally appropriate, patient-centered, timely, cost-effective, & high quality, with ultimate aim of community health enhancement.
As stated in the vision and mission, the Center for Diabetes care shall maintain a leadership position in providing education and awareness concerning diabetes and its complications to the Hispanic Lowertown community, health professionals, healthcare systems, and diabetic individuals. Moreover, it will maintain and promote the highest standards of healthcare for diabetic and its complications individuals.
3
Center for Diabetes Care [CDC]:
Goal of the CDC tucked into the:
PPACA Community Health Center Fund: supporting the operations, expansion, & community health centers construction (Dr. Novak, 2014)
IOM goal: improving health quality (ADA, 2018)
Healthy People 2020 Goal: reducing the disease burden of diabetes & improving the quality of life for diabetic/ pre-diabetic individuals (Healthy People.gov, 2010)
The Hispanic Lowertown Community:
Represents the targeted patient population:
Source: Dr. Novak (2014)
The center is targeting the Hispanic population in Lowertown, aged 65 years-old and above, that suffers from type II diabetes. This target patient population represents 39% of the 10,546 lower town population by age, whereas the Hispanic population represents 71% of the Lowertown population by ethnicity (Dr. Novak, 2014) as illustrated in Figure 2 and Figure 1 respectively.
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Population of Lowertown by Ethnicity
Sales Hispanic White African Amer ican 0.71094860857200903 0.15234613040828801 0.13670526101970301
Population of Lowertown by Age
Sales 0–18 years 19–25 years 26–4 5 years 46-64 years 65+ years 0.08 0.09 0.2 0.24 0.39 Column1 0–18 years 19–25 years 26–45 years 46-64 years 65+ years 0.79999999999999993
The Hispanic Lowertown Community:
Hispanics with type II diagnosis face numerous challenges in medication management for diabetes due to complex combination of:
Language barrier
Cultural background
Accessibility to appropriate diabetes & its complications healthcare management & treatment
Inadequate healthcare literacy
Finances/Poverty
(Dr. Novak, 2014)
When patients receive a diagnosis of Type 2 diabetes, they have to navigate a complex and often intimidating healthcare system. They may require treatment by multiple specialists. Managing Type 2 diabetes can be confusing and overwhelming for any patient. In many cases, Hispanics with a diagnosis of Type 2 diabetes face even more challenges than other patients. For many of my patients, there is a language barrier. But the barriers to my Hispanic patients getting proper care for diabetes go beyond a language issue. The issue is a complex combination of culture, accessibility, healthcare literacy, and finances.
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CDC Implementation Timeline:
These time is for the duration of 15 months begin January to April, which will be the month for launching and operationalization of the CDC center.
7
CDC Program Milestones:
Reduction/mitigation diabetes progression and optimizing risk factors reduction related to micro-& macro-vascular diabetes complications
Reduction in average HbA1xc levels from the current 10.5 to 8.5 within 2 years
35 percent reduction in cardiovascular complications
Reduction in mortality, heart, & stroke rates related with diabetes complications
Increased diabetes prevention & management awareness & number of targeted population involved in these activities
Increased number of diabetic diagnosed and pre-diabetic targeted population in medication management for diabetes
Over 4,882 benefitting from the program
These milestones will be used to measure success of the Center for Diabetes Care, including Increased diabetes prevention and management awareness & number of targeted population involved in physical activities, basic nutrition & goal setting, besides engaging in health and lifestyles that support them to live better and managing diabetes.
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CDC Financial Analysis:
Approximated number of patient visitations per year
| Year | Patients Visitations |
| 1 | 4,882 |
| 2 | 4,882*1.05 = 5,126 |
| 3 | 5,126*1.05 = 5,382 |
Capital Requirements:
| Description | Year 1 | Year 2 | Year 3 |
| Server | $ 15,000 | ||
| Remodel of Office Space | $ 98,550 | ||
| Security System | $ 2,654 | ||
| Furniture | $ 12,281 | $ 1,000 | $ 1,000 |
| Practice Management System | $ 5,000 | $ 2,500 | $ 2,500 |
| Computers & Cabling | $ 41,696 | ||
| Total | $ 175,181 | $ 3,500 | $ 3,500 |
The probable patient visits is approximated to increase annually by 5 percent. Therefore, the projection for the subsequent years are as illustrated in the first Table. The second table illustrates the capital requirements needed to operationalize the program
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CDC Financial Analysis:
Non-Staffing Costs
| Year 1 | Year 2 | Year 3 | |
| Fringe Benefits | $ 59,609 | $ 60,802 | $ 62,018 |
| Travel | $ 5,000 | $ 5,000 | $ 10,000 |
| Training | $ 35,000 | $ 10,000 | $ 15,000 |
| Equipment | $ 5,000 | $ 2,000 | $ 2,000 |
| Supplies | $ 15,000 | $ 15,300 | $ 15,606 |
| Contractual | $ 8,000 | $ 8,160 | $ 8,323 |
| Allocated Rent | $ 23,418 | $ 23,769 | $ 24,126 |
| Depreciation | $ 26,277 | $ 35,036 | $ 35,036 |
| Insurance | $ 4,004 | $ 4,204 | $ 4,414 |
| Overhead Allocation | $ 9,167 | $ 9,442 | $ 9,725 |
| Uncollectible Income | $ 21,281 | $ 39,865 | $ 55,177 |
| Marketing | $ 45,000 | $ 15,000 | $ 15,000 |
| Indirect Charges | $ 54,764 | $ 56,955 | $ 59,233 |
| Total | $ 311,520 | $ 285,533 | $ 315,659 |
This table illustrates the non-staffing costs needed to operationalize the program
10
CDC Financial Analysis:
Staffing Costs
| Designation | FTE | Year 1 | Year 2 | Year 3 |
| Endocrinologist | 0.93 | $146,940 | $154,287 | $162,001.35 |
| Contract Specialists | 0.30 | $22,500 | $23,625 | $24,806.25 |
| Nurse Practitioner | 0.95 | $79,889.3 | $82,285.979 | $84,754.5584 |
| Community Health Workers | 4.00 | $976,000 | $1,00,5280 | $1,035,438.4 |
| Reception/Office Management | 1.00 | $35,000 | $35,700 | $36,414 |
| Total | $1,260,329.3 | $1,301,177.98 | $1,343,414.56 |
Every patient visitation will be charged a base value of US$450. However, certain incentives will be allowed to certain patients basing on their economic stratification. The insurance will be 30 percent of every patient visit gross revenue. The staff salaries will increase by 5 percent per year and the total salary will be based on FTE as illustrated in Table
11
CDC Financial Analysis: Proforma Statement:
| Particulars | Year 1 | Year 2 | Year 3 |
| Patients Visits Revenue | |||
| Patient Visits | 4882 | 5126 | 5382 |
| Revenue Per Visit | $450 | $450 | $450 |
| Gross Patient Visits Revenue | $2,196,900 | $2,306,745 | $2,422,084.50 |
| Deduction from Patient Revenue | $65,907.00 | $69,202.35 | $72,662.54 |
| Net Patient Visits Revenue | $2,130,993.00 | $2,237,542.65 | $2,349,421.97 |
| Operating Expenses | |||
| Staffing Salaries | $1,260,329.30 | $1,301,177.98 | $1,343,414.56 |
| Fringe Benefits | $ 59,609 | $ 60,802 | $ 62,018 |
| Travel | $ 5,000 | $ 5,000 | $ 10,000 |
| Training | $ 35,000 | $ 10,000 | $ 15,000 |
| Equipment | $ 5,000 | $ 2,000 | $ 2,000 |
| Supplies | $ 15,000 | $ 15,300 | $ 15,606 |
| Contractual | $ 8,000 | $ 8,160 | $ 8,323 |
| Allocated Rent | $ 23,418 | $ 23,769 | $ 24,126 |
| Depreciation | $ 26,277 | $ 35,036 | $ 35,036 |
| Insurance | $ 4,004 | $ 4,204 | $ 4,414 |
| Overhead Allocation | $ 9,167 | $ 9,442 | $ 9,725 |
| Uncollectible Income | $ 21,281 | $ 39,865 | $ 55,177 |
| Marketing | $ 45,000 | $ 15,000 | $ 15,000 |
| Indirect Charges | $ 54,764 | $ 56,955 | $ 59,233 |
| Capital Costs | $175,181 | $3,500 | $3,500 |
| Net Operating Expenses | $1,747,030.30 | $1,590,210.98 | $1,662,572.56 |
| Excess of Revenue Over Expenses | $383,962.70 | $647,331.67 | $686,849.40 |
| Cumulative Income | $383,962.70 | $1,031,294.37 | $1,718,143.77 |
| Net Cash From Excess Revenue | $410,239.70 | $1,066,330.37 | $1,753,179.77 |
| Cumulative Income/Net Cash | $410,239.70 | $1,476,570.07 | $3,229,749.84 |
Basing on the financial analysis, the program stands to yield remarkable profits in a win-win gain situation. Therefore, it has the ability to sustain itself even after the donor withdrawal, whereas providing pre-diabetic and diabetic patients with the much-needed access to education along with ongoing treatment in the language of their choice, besides in a manner that is culturally appropriate, patient-centered, timely, cost-effective, and high quality, with ultimate aim of community health enhancement.
12
Reference
American Diabetes Association [ADA]. (2018). Standards of Medical Care in Diabetes 2018. http://care.diabetesjournals.org/content/diacare/suppl/2017/12/08/41.Supplement_1.DC1/DC_41_S1_Combined.pdf
Dr. Novak, S. (2014). Excerpts from Dr. Novak’s presentation to Center for Diabetes Care Steering Committee.
Healthy People.gov. (2010). Healthy People 2020: Diabetes. https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes
JFMAMJJASONDJMA
Designing of Detailed Strategic
Plan & Business Plan, PowerPoint
Business Case Presentation, &
Risk Management Report
Healthcare Consultant
Dr. Novak CDC-Steering
Committee Presentation,
Relevant Peer-Reviewed
Journals, Interview with Dr.
Novak, & Excperts from CNHA
30 Days
Submission of the Detailed
Strategic Plan & Business Plan to
the Western Hospital Board of
Directors and Chief Executive
Officer for Approval
Dr. Novak
Detailed Strategic Plan &
Business Plan
3 Weeks
Business case Presentation to the
Western Hospital Board of
Directors and Chief executive
Officer
Dr. NovakBusiness case Presentation1 day
Upon Approval by the BOD & CEO,
design the Center for Diabetes
Care Proposal
Dr. Novak &
Healthcare Consultant
Detailed Strategic Plan &
Business Plan &
2 Weeks
Submission/Application of the
Center for Diabetes Care Proposal
to PPACA
Dr. NovakTthe Center for Diabetes Care
Proposal
1 Day
Designing of the Center for
Diabetes Care Organizational
Policies & Procedures
Dr. Novak & Western
Hospital HRM
Western Hospital
Recruitment Policies &
Procedures
30 days
Renovation of the Westen Hospital
Urgent Care Centre to
Accommodate the Center for
Diabetes Care
Dr. Novak &
Construction
Contractor
Construction Equipment &
Contracted Competent
Supplier
90 days
Advertisement & Staffing of the
Center for Diabetes Care
Dr. Novak & Western
Hospital HRM
Recruitment Policies &
Procedures
30 days
Procurement & Transportation of
Equipments , Furniture, & Fittings
Dr. Novak, Contract
Specialists & Supplier
Contracted Competent
Supplier
30 days
Procurement & Transportation of
Supplies
Dr. Novak, Contract
Specialists & Supplier
Contracted Competent
Supplier
30 Days
Instillation & Testing of
Equipments, Furniture, & Fittings,
plus supplies
Dr. Novak, Contract
Specialists & Supplier
Instillation Manuals60 Days
Intensive Training of the Recruited
Staff
Dr. Novak, Western
Hospital HRM, &
Healthcare Consultant
Training Manual on Center of
Diabetes Care Goals &
Objectives
30 Days
Marketing of the Center of
Diabetes Care
Marketing Team
Marketing Startegy of the
Center of Diabetes Care
30 Days
Insuring the Center for Diabetes
Care
Dr. Novak, Contract
Specialists & Insurance
Company
Insurance Policy2 weeks
Designing of the Center for
Diabetes Care Community
Education Programs
Dr. Novak, Contract
Specialists & Nurse
Paractitioner
Diabetes Management Best
Practices
60 days
Intensive Training of the
Community Health Workers
Dr. Novak, Contract
Specialists & Nurse
Paractitioner
Community Education
Programs Manuals
60 days
Monitoring & Follow-up of
Activities
Center for Diabetes
Care TeamMonitoring Reports
Continious
Launching & Operationalizing of
the Center for Diabetes Care
Dr. Novak, Western
Hospital CEO, PPACA
Representatives, &
State Senator
Luncheon Session2 Days
Activity(s)Responsible Person (s)Resources
Duration in Months
Duration
