MASTERS CAPSTONE FM010 APA INTEXT CITATION
cutie123221
FM010PartIO_Adelekefeedback.doc21
2 24
Strategic Plan and Business Plan for the Western Hospital Center for Diabetes Care
Olufunmilayo Adeleke
FM010
Walden University
11/27/2018
Executive Summary
In the Jefferson County, diabetes is a health issue marked by high rates amongst adults, with an 8% county-wide prevalence in comparison to the state average. The CHNA 2013 also reports a 14% county diabetes prevalence amongst the Latino and African-American population. The causative factors of the high diabetes prevalence rates in this county includes but is not limited to inadequate physical exercise, poor nutrition, genetic predisposition, socio-economic conditions such as lack of education, inadequate health insurance, poverty, and physical environment such as fast and fresh foods availability. The Hispanic Lowertown community constitutes of about 71% of the total county’s population. As previously mentioned, Hispanics particularly the Hispanic Lowertown community in Jefferson county bear the burden of type II diabetes and its associated complications. In particular, the burden of diabetes and its complications disproportionately affects the elderly Hispanics in Lowertown, aged 65 years-old and above, are mostly affected by this disease. Sadly, the elder Hispanics of Lowertown and Jefferson county also represent 39% of the population with lower income levels and the least education.
The Center for Diabetes Care must be strategic in its mission and vision statements and its actions when deciding the course of action that will best serve the Hispanic Lowertown community seniors’ diagnosed with type II diabetes. The current diabetes epidemic has drastically affected the population and if neglected could cause other significant health issues and more financial difficulties for the people of Lowertown. Hence, implementation of the Center for Diabetes Care will be a great strategy to preventing prediabetics from becoming diabetic, treating current diabetic patients, and educating current patients to learn to manage diabetes in their everyday life. This will help to significantly reduce hospitalization costs for these targeted patients and would also shorten the time admitted patients spend in the hospital. Indeed, integrating the Center for Diabetes Care will provide diabetes complex cases comprehensive care and preventive management for Hispanics seniors’ with type II diabetes and pre-diabetic conditions. It will provide services in nutrition coaching and counselling, endocrinology, community education, and nursing case management. A collaborative exertion shall be advanced to improve diabetes patient management with multi-specialty care, including mental health, occupational therapy, wound care, nephrology, and vascular surgery.
The goal and objectives of the program are tucked into the PPACA Community Health Center Fund of supporting the operations, expansion, and community health centers construction (Dr. Novak, 2014); the IOM goal of improving health quality; and the Healthy People 2020 goal of reducing the disease burden of diabetes besides improving the quality of life for diabetic or pre-diabetic individuals (Healthy People.gov, 2010). The Center of Diabetes Care intends to achieve these goals through incorporating appropriate treatment and preventive patient-and family care centered towards improving patient’s exceptional quality of life and safety outcomes, whereas decreasing hospitalizations from diabetes and its complications. Furthermore, it intends to develop community education programs, including 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.
The program is not a stand-alone one, as it has ensured strong partnerships with key stakeholders and kindred private and public organizations. The program management unit also comprises of scholars having sound scientific evidence-based diabetic prevention and management background, on top of comprehensive strategies that address most common diabetes and its complications risk factors. Basing on the financial analysis, SWOT analysis, and other non-financial considerations, the Western Hospital board of directors and Chief Executive Officer [CEO] should proceed with establishment of the Center for Diabetes Care. Since, the program financial outlook is superior and stands to yield remarkable profits in a win-win gain situation, since the Center’s cumulative net-income begins to exceed the initial program input by the third year .
Strategic Plan and Business Plan for the Western Hospital Center for Diabetes Care
For the greater part of the last century, Western Hospital has been a momentous and caring part of the Jefferson County community, particularly the Hispanic Lowertown community. The hospital has a proud track record of delivering compassionate healthcare, being in the forefront of healthcare improvement besides innovation, and consistently working to forge resilient, continuous and significant relations with its local community. However, following Dr. Novak (2014) in the recent years, the Hispanic Lowertown community that constitutes 71% of the Lowertown population, has been subjected to the burden of diabetes and its associated complications. In particular, the burden of diabetes and its complications disproportionately affects the elderly Hispanics in Lowertown, aged 65 years-old and above, besides who are the majority, representing 39% of the Lowertown population and with lower levels of education and income.
Basing on Dr. Novak passion concerning prevention besides early interventions of diabetes, he has identified the necessity towards establishing a community-based program to guarantee ongoing diabetes treatment for Hispanic seniors in the Lowertown community. Dr. Novak’s visualization is focused towards patients receiving diabetes education along with ongoing treatment in the language of their choice, besides in a manner that is culturally appropriate. Dr. Novak identifies the strategies towards appropriate treatment and preventive care to improve patient’s quality of life whereas decreasing hospitalizations from diabetes complications.
Through the joint efforts of advisors and Dr. Novak, the importance of applying for funding from the Patient Protection and Affordable Care Act’s (PPACA) Community Health Center Fund to establish the Center for Diabetes Care, have been acknowledged. The funding supports the operations, expansion, and community health centers construction. As a requirement for the Western Hospital board of directors’ approval, this report details the strategic plan and business plan for establishing the community health center.
Demographic Data for the Center of Diabetes Care:
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.
Geographical Location of the Center of Diabetes Care:
The geographic target of the center, is the Lowertown, which has 71% of the Hispanic population as illustrated in Figure 1. Western Hospital has an urgent care center there, which will house the center in the former pharmacy and storage area (Dr. Novak, 2014). The space will be convenient for Lowertown residents, besides being a convenient focal point towards facilitating the community health workers home-visitations for those who can’t or don’t want to visit the clinic.
Figure 1: Population Lowertown by Ethinicity
71%15%14%HispanicWhiteAfrican American
Source: Dr. Novak (2014)
Figure 2: Population of Lowertown by Age
Source: Dr. Novak (2014)
Strategic Plan:
This strategic plan identifies tangible, concrete, and measurable strategies for the prevention and management of diabetes to be implemented at the Center for Diabetes Care through the joint efforts of PPACA Community Health Center Fund, IOM, and Healthy People 2020, along with other numerous public and private kind-red collaborative partners. The process towards development of this strategic plan encompassed a review of Dr. Novak and peer-reviewed articles and journals literatures on epidemiological data on the burden of diabetes, besides relevant evidence-based studies besides best practices in diabetes prevention and management.
These are in line with the Jefferson County Community Benefit coalition prioritized needs that identified and marked diabetes as a number one health need amongst adults in the county. Moreover, an environmental scan was conducted to identify strengths and needs; after which priority strategies were decided. An independent consultant, facilitated the planning process and supported the strategic plan development. This strategic plan, therefore, provides a framework to support the Center for Diabetes Care development and establishment of this important service. The plan has purposefully been developed to closely align with the Western Hospital strategic plan, whereas articulating the particular problem, needs, challenges, and strategies that are vital for the local community, management, and staff of the Center for Diabetes Care.
Vision Statement:
To achieve appropriate treatment and preventive patient-and family care centered towards improving patient’s exceptional quality of life and safety outcomes, whereas decreasing hospitalizations from diabetes and its complications.
Mission Statement:
To provide pre-diabetic and diabetic patients 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.
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. The Center for Diabetes Care will:
· 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.
· 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.
· 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.
· Collaborate with other kindred groups and community-based organizations that are active in improving outcomes for diabetes and its complications
· Boost and support studies on selected clinical issues in diabetes and its complications, as demarcated by peer-reviewed research protocols.
· 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 .
Values Statement:
To achieve the vision and mission, necessitates clear priorities setting, supportive staff and team leadership, and community collaboration, reinforced by the Center of Diabetes Care healthcare service values of:
· Collaboration: Cultivating and maintaining performance depends on all team members
· Openness: Transparent performance monitoring, follow-up and reporting is important towards guaranteeing information sharing
· Respect: Team members roles and efforts in performance improvement shall be valued
· Empowerment: A mutual trust at all levels towards sustainable performance improvement
SWOT Analysis:
This SWOT analysis provides the strategic planning tool that have been used to evaluate the Strengths, Weaknesses, opportunities, and threats of the intervention. Its major aim is to offer insights on what makes the intervention applicable, sustainable, and effective from a public health and stakeholder’s perspective (Nathan, 2015). Furthermore, it presents the necessary preconditions for the intervention implementation.
Table 1: SWOT Analysis
|
Strengths: · A dynamic, bottom-up, flexible, integrated, multi-intersectoral, and equity oriented intervention · Strong partnerships with key stakeholders and kindred private and public organizations · Sound scientific evidence-based background · Comprehensive strategies that address most common diabetes and its complications risk factors · Sound and efficient leadership · Strong educational models and healthcare strategies · Broad participatory approach that will ensure effective multi and transectoral collaboration · Availability of funds from PPACA |
Opportunities: · Increasing awareness by healthcare systems on actions to address diabetes and its complications prevention and health promotion. · Increased diabetes and its complications management and integrated care information sharing and exchange of best practices at national and international level · Increased community sensitive towards diabetes prevention as a health problem and societal issue · Advancement in ICT and social media to facilitate diabetes preventive strategies dissemination · Existence of established policies within the health system and various sectors that allows harmonized and target-oriented interventions |
|
Weaknesses: · Focused on single-disease treatment · Focus on only Hispanic seniors in the Jefferson County community |
Threats: · Increased prevalence of diabetes and pre-diabetes in the Jefferson County community · Persistent social inequalities in community health · Challenges due to current economic crisis · Lack of political commitment that might challenge the interventions effective implementation, policies, and activities due to political changes and absence of long-term endorsement. |
Strategies for Launching and Operationalizing the Center for Diabetes Care:
The Center for Diabetes Care Launching Strategies:
Marketing Strategy :
Launching the program right shall be the initial step to the success of this initiative as a whole. As a consequence, to ensure that the right team is gathered together for the launch, the marketing strategy shall be used to promote awareness within the target market; which will ascertain that team leaders and the donor agency representatives are available during the launch. Besides showcasing to the targeted audience that the program is supported by a strong team and backed by senior management. Hence, increasing the targeted-audience buy-in and motivating them towards participating in the program, besides increasing sustainability even after the donor withdrawal.
Services to be offered will be developed in two stages. The first stage will be to institute the fundamental endocrinology specialty besides community patient education diabetes care components, in addition to establishing collaboration between ancillary support services, including pharmacy, laboratory services, behavioral health, orthotics, and podiatry. Pricing shall be dictated by prevailing reimbursement rates, with outpatient clinical visits being consistently billed plus reimbursed.
The Center for Diabetes Care shall be located in Lowertown that has 71% Hispanics, specifically at the former Western Hospital pharmacy and storage area. Hence, it will make the space convenient for the targeted patient population. Besides, those do not want or who cannot visit the clinic, shall be visited at their homes by community health workers.
Marketing Budget:
A multifaceted marketing strategy with a budget of US$40,000 shall be applied to promote the Center for Diabetes Care. The goals of the marketing strategy that will be the success measurements are:
· Established Center for Diabetes Care recognition
· Increased market to Hispanic seniors’ Lowertown population
· Increased Hispanic Lowertown community awareness and involvement with diabetes
· Increased number of referrals and clinical patient visitations
· Increased market to Hispanic seniors’ pre-diabetic and diabetic patients
Target Market:
The Center for Diabetes care will target two groups, comprising the healthcare providers in the Hispanic Lowertown community who will refer the patients to the Center for Diabetes Care. Besides the Hispanic Lowertown population, aged 65 years-old and above who account for 39% of the Hispanic population and who have been diagnosed with type II diabetes along with their primary caregivers. Moreover, have lower incomes, less education, have language barrier to access appropriate treatment and preventative care for type II diabetes, a complex amalgamation of healthcare literacy, finances, culture to navigate through a complex and often unapproachable healthcare system.
Marketing Tactics:
Two promotional strategies have been identified. First, is the marketing tactic for healthcare providers that will involve hosting a lunch for key general practitioners and specialists at Bobby Fly’s , a local celebrity chef restaurant, whereby the audience will be served with a healthy Mexican lunch. At this juncture, Dr. Novak will be highlighting to the audience the program goal and objectives, besides the program timelines and milestones. In addition, the Center for Diabetes Care brochures shall be delivered to the general practitioners and specialists likely to refer patients.
The second marketing tactic, is for diabetes patients and their families and will encompass hosting ribbon cutting by Rosa Sanchez, the State Senator, then followed by press release and news stories in the local papers. Furthermore, a luncheon shall be arranged and hosted by Rosa Sanchez for church leaders and other key influencers. These will be followed by conducting radio spots on Spanish language radio, besides printing adverts in the local Spanish paper.
Basing on the fact that there is an existence of a fundamental strategy, therefore, to foster an authentic relationship with the target market, the market strategies that the team will employ to create awareness and promote the Center for Diabetes Care include using social media platforms to post clear illustrations of the project goal and objectives by presenting them in their point of view. Besides utilizing direct messages on social media platforms such as Facebook, Snapchat, Twitter, and Instagram to reach out and communicate with potential primary caregivers’ population who could be looking for the centers products and services. Indeed, this will be a very powerful marketing strategy.
Creating video tutorials, will be another effective marketing strategy to get the word out concerning the center’s activities. These tutorials will be informative towards walking the targeted market through step-by-step tutorials concerning the center activities. Furthermore, to boost visibility on social media platforms without taking all the efforts and time towards building the audience, certainly the team can certainly leverage micro-influencers with thousands of followers (Menke, Casagrande, Geiss, & Cowie, 2015). This can be accomplished, through locating the right influencer in the Hispanic Lowertown community niche, with the intention of targeting the right audience. Furthermore, there will be marketing strategies to build the brand to the community through sponsoring diabetes screening events, workplace partnerships, and fundraising events.
Operationalizing of the Center for Diabetes Care:
To operationalize the Center for Diabetes Care, Dr. Novak in conjunction with the Western Hospital Human Resources have created an organizational management structure that includes a description of roles and responsibilities as illustrated in Table 2. The structure comprises of a nurse practitioner who will oversee a team of four community health workers. These executive committee will be overseen by a steering committee that comprises of a pharmacist, two endocrinologists, a nurse practitioner, and a nutritionist.
The former Western Hospital urgent care pharmacy in Lowertown shall be renovated to accommodate four small consultation rooms, waiting room, classroom, a kitchen for cooking practical, a receptionist space, an administrative area for the program director, a billing office. Besides, an in-house laboratory to provide convenient critical lab values testing, including urinalysis, blood glucose, lipid panels, and HbA1C. The Center shall utilize the same Western Hospital patient scheduling and electronic medical record system. Likewise, the program will not its individual human resource management, e-mail software, accounting, and time clocks. Therefore, plans will be made for the successful integration of the Western Hospital systems into the Center for Diabetes Care operations.
Table 2: Roles and Responsibilities of Executive Committee at the Center for Diabetes Care
|
Designation |
Roles and Responsibilities |
|
1. Dr. Chris Novak, MD, Program Director. |
Shall: · Provide organizational leadership. · Define strategy and goals. · Consult on complex clinical issues. · Establish and refine policies and procedures. · Represent the Center for Diabetes Care to the medical community and the patient community. · Collaborate with the board of Western Hospital and the Center for Diabetes Care’s steering committee. |
|
2. Nurse Practitioner |
Shall: · Provide clinical support for less complex cases. · Supervise community educators. · Lead the community education program. · Drive the creation of the best practices database |
|
3. Four Community Health Workers |
Shall: · Serve as bridges between the healthcare system and people living with and at risk for diabetes. · Provide support for diabetes control programs, community-based organizations, and other agencies instrumental in establishing these links. · Promote actions that enable community members to access care that meets standard recommendations for diabetes care and prevention (e.g., annual eye exams and foot exams, regular A1C testing). · Develop and communicate culturally and linguistically appropriate messages on diabetes self-care and community action. · Provide social support to community members as they adapt their lifestyles, through counseling and motivational interviewing. · Mobilize their communities for social action to address diabetes. |
|
4. Receptionist |
Shall: · Schedule appointments. · Welcome patients. · Manage the office. · Bill insurance for services rendered. |
Source: Dr. Novak (2014)
Staffing Needs :
The Western Hospital Human Resources, shall be tasked with the overseeing of the recruitment process of the right community health workers and the nurse practitioner.
The requirements of the community health workers include having a combination of language skills, the ability to collaborate with the entire care team, cultural competency, besides having appropriate clinical knowledge and presentation skills. Whereas the nurse practitioner shall be required to have the same skills as the community health workers, but, be flexible and innovative (Adashi, Geiger, & Fine, 2010). Crystal clear organizational policies and procedures shall be developed and availed to all successful recruited staff, however, the nurse practitioner shall support the community health workers in addressing any ambiguity encountered along their line of duty . The success of the Center for Diabetes Care hinges on the teamwork performance and productivity instigated by appropriate staffing.
Operating Model :
The Center for Diabetes Care operating model shall be based on community health workers, since they act as a bridge to healthcare providers and a dependable source of education for patients. Therefore, incorporating community health workers is an effective methodology towards improving knowledge related to diabetes and its complications, besides facilitating monitoring, and follow-up at the community level (Krug, 2016). They are uniquely qualified because they do live in the communities that they will serve, know what is meaningful, besides bridge the cultural gap between the community and healthcare providers, and speak the language of their community. Hence, following ADA (2018) they have a high inclination of connecting the targeted patient population to the Center for Diabetes Care services, and informing the center about the unique needs of the community by overcoming the communication barrier that impacts the patients’ abilities to follow through with their treatments.
The community health workers are expected to have healthcare or nursing education background with language skills in order to relate with the patients more efficiently. All staffs will undergo an intensive three-week training program so as to be equipped with cultural competency, besides diabetes and prevention hands-on skills and knowledge, as well as being equipped with basic first aid skills. Furthermore, a formal weeklong intensive training for the staff shall be conducted at an off-site location on an annual basis.
The Center for Diabetes Care, shall also create a learning culture for the staff through conducting on every Monday a two-hour morning meetings sessions. These shall be facilitated by an expert speaker every other week such as a community health worker, a pharmacist, besides a nutritionist from a different organization (Dr. Novak, 2014). These learning culture sessions, shall be collaborative in a manner that fosters learning from each other’s achievements and failures. Every single community health worker shall have an equal opportunity of presenting and sharing an achievement from the last week’s experience, a case, as well as an issue that could have been challenging. In this way, the community health workers will be able to improve and develop progressively their patient care skills and knowledge of diabetes using the lesson learnt from these sessions.
The Center for Diabetes Care shall also embrace the advance in technology to communicate with patients and the broader care time. Hence, the community health workers shall be issued with IPads to create informative video tutorials so as to walk the targeted patient population through step-by-step treatment plan and significant health and lifestyle information such as getting to know diabetes, basic nutrition and goal setting, staying well with diabetes, medication management for diabetes, and physical activities. Furthermore, the center shall embrace electronic medical records [EMRs] as a tool to foster effective collaboration in patient information documentation, reporting, and sharing.
Short-and Long-Term Goals:
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.
Long-Term Goals:
The long-term goals for the Center for Diabetes care include:
· To promote and expand diabetes awareness and education to the targeted patients population families
· To expand the Center for Diabetes care educational outreach programs to the entire Hispanic Lowertown community population
Business Plan:
This business plan ascertains the feasibility of implementing the Center for Diabetes Care. It details the implementation timeline for key activities, and an analysis of financial data, including a chart summarizing the financial data.
Implementation Timeline for Key Activities:
The implementation timeline is as illustrated in Figure 3. The key performance indicators that will be used to measure success of the Center for Diabetes Care include:
Table 3: The Center for Diabetes Care Key Performance Indicators
|
Key Performance Indicators [KPIs] |
Goal |
|
Clinical: |
|
|
· Reduction or mitigation diabetes progression and optimizing risk factors reduction related to micro-and macro-vascular diabetes complications |
70% |
|
· Percentage targeted population tested for diabetes |
75% |
|
· Reduction in mortality, heart, and stroke rates related with diabetes complications |
27% |
|
· Diabetics percentage necessitating emergency care and re-hospitalization within a month of discharge |
30% |
|
· Reduction in average HbA1C levels within 2 years |
10.5 to 8.5 |
|
· Reduction in cardiovascular complications |
35% |
|
· Diabetics percentage receiving screenings: |
|
|
Blood Pressure Examinations |
82% |
|
Cholesterol Examinations |
82% |
|
Two HbA1C tests |
82% |
|
Foot Examinations |
82% |
|
Eye Examinations |
82% |
|
Operational: |
|
|
· Workload Capacity by Community Health Worker |
Yr 1: 80%; Yr2: 100% |
|
· Recruitment & Turnover of Personnel |
100%/10% |
|
· Volume Indicator: Initial Annualized |
935/678 |
|
· Volume Indicator: Follow-Up Annualized |
4,882/3,896 |
|
Services: |
|
|
· Targeted Patient Satisfaction |
96% |
|
· Referring Healthcare Providers Satisfaction |
96% |
|
· Employee Satisfaction |
96% |
Figure 3: Implementation Timeline
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
Financial Analysis:
The proposed Center for Diabetes Care will operate as a division of Western Hospital. The aim of this financial analysis is to determine if the Western Hospital BODs and CEO should approve the establishment of the Center. Along with the financial projections, other aspects shall be evaluated in the final recommendation including SWOT analysis and risk fulfillment of the Center’s mission. First, the probable patient visits is approximated to increase annually by 5 percent. Therefore, the projection for the subsequent years are as illustrated in Table 3
Table 4: Projected Number of Patient Visitations per Annum
|
Year |
Patients Visitations |
|
1 |
4,882 |
|
2 |
4,882*1.05 = 5,126 |
|
3 |
5,126*1.05 = 5,382 |
Capital Requirements:
The start-up resources through PPACA Community Health Center Funding are projected to total US$182,181, with the majority of these costs, US$98,500 being involved in the remodeling of the office space to meet the requirements of the Center for Diabetes Care.
Table 5: Capital Requirements for the Center for Diabetes Care
|
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 |
Reimbursement Model:
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 in Table 6 .
Table 6: 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 |
Non-Staffing/Operating Costs:
Table 6: Non-Staffing/Operating Costs for Center for Diabetes Care
|
|
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 |
Proforma Statement:
Table 8: Proforma Statement for the Center for Diabetes Care
|
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 Net-Income |
$410,239.70 |
$1,476,570.07 |
$3,229,749.84 |
Recommendation:
Basing on the financial analysis, SWOT analysis, and other non-financial considerations, the Western Hospital board of directors and Chief Executive Officer [CEO] should proceed with establishment of the Center for Diabetes Care. This is because the program financial outlook is superior and stands to yield remarkable profits in a win-win gain situation, since the Center’s cumulative net-income begins to exceed the initial program input by the third year.
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. Partnering with an international renowned PPACA Community Health Center Fund, IOM, and Healthy People 2020 would give the Center for Diabetes Care a competitive advantage throughout the County and State.
References
Adashi, E., Geiger, J., & Fine, M. (2010). Health care reform and primary health care: The growing importance of the community health center. The New England Journal of Medicine, 362: 2047-2050.
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
Krug, E. G. (2016). Trends in diabetes: Sounding the alarm. The Lancet, 387(10027), 1485-1486.
Menke, A., Casagrande, S., Geiss, L., & Cowie, C.C. (2015). Prevalence of and trends in diabetes among adults in the United States, 1988-2012. The Journal of the American Medical Association, 314(10):1021-9.
Nathan, D.M. (2015). Diabetes: Advances in diagnosis and treatment. The Journal of the American Medical Association, 314(10):1052-62
�Good intro. Executive summary would be even better with brief overview of the supporting data in 1 paragraph and then emphasis on specific goals and planned actions for the Center. Often bullet points are useful. The more succinct the summary is the better keeping the audience in mind- typically board or CEO level audience or external stakeholders.
�Based
�Good vision statement summary. This would have been good to include in an abbreviated version in your executive summary
�Good observation!
�This is a key threat – glad you identified this. Some mention of workforce limitations may also be important here. Are there enough employees who are bi-lingual? What about integration of community health workers into the team- where might that be placed in the SWOT?
�Better than “right” or “wrong” use more specific terms …would it successfully, timely, what other terms would be more specific and avoid bias?
�Flay
�Good!
�Good point and good example of support for effective integration of CHWs into the healthcare team
�Is this realistic? Based on target population, many are uninsured and low income. I would recommend building in more realistic revenue sources. It can also not be assumed that these individuals are automatically eligible for Medicare if they did not pay into the system during employment years. This is also state specific- what factors come into play in the Texas Medicaid system? This section needs more evidence based research and support to ensure you are presenting a realistic model.
�You are proposing significant increase in patient visits- does the cost and staffing plan support that growth adequately? Add in details about decisions to expand CHW staff much more than others- why?. Be clear on how CHWs will address expanded patient volume.
�This conclusion does not seem realistic if you look at realistic financial picture for this community. Need to review this more carefully and base it on realistic data for Texas and for this population from what is presented in the case.
_1603730459.xls
Chart1
| 0–18 years | 0–18 years |
| 19–25 years | 19–25 years |
| 26–45 years | 26–45 years |
| 46–64 years | 46–64 years |
| 65+ years | 65+ years |
Sheet1
| Sales | Column1 | |||||
| 0–18 years | 8% | |||||
| 19–25 years | 9% | |||||
| 26–45 years | 20% | |||||
| 46–64 years | 24% | |||||
| 65+ years | 39% | 80% | ||||
| To update the chart, enter data into this table. The data is automatically saved in the chart. | ||||||
| ` | ||||||
| 3839.55 | 9845 | |||||
| 20 | ||||||
| 17 | ||||||
| 24 | ||||||
| 39 | ||||||
| 100 |
_1603884043.xls
Chart1
| Year 1 | Year 1 |
| Year 2 | Year 2 |
| Year 3 | Year 3 |
Sheet1
| Adapted from | |||||||||||||
| http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | |||||||||||||
| Patient-Generated Revenue by Payer | |||||||||||||
| Fiscal year from April 1 to March 31 | |||||||||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,250 | $133.04 | $166,300 | -67.61 | $ 250,812 | 98% | $245,796 | ||||||
| Medicare | 2,000 | $132.70 | $265,396 | -10.48 | $ 286,356 | 95% | $272,038 | ||||||
| Private Insurance | 100 | $137.08 | $13,708 | $72.44 | $ 6,464 | 80% | $5,172 | Year 3 assumes CHW are at their capactiy of 7200 patient visits, or 4 CHW FTEs see 10 patients per day 4 days per week, 45 weeks a year | |||||
| Self Pay (sliding fee) | 50 | $111.68 | $5,584 | $89.89 | $ 1,090 | 40% | $436 | ||||||
| 3,400 | $ 544,722 | $523,441 | |||||||||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,750 | $133.04 | $232,820 | -67.61 | $ 351,137 | 98% | $344,115 | ||||||
| Medicare | 3,500 | $132.70 | $464,442 | -10.48 | $ 501,122 | 95% | $476,066 | $171.04 | 133.04 | 133.04 | |||
| Private Insurance | 400 | $137.08 | $54,834 | $72.44 | $ 25,858 | 80% | $20,686 | $170.60 | 132.6977549111 | ||||
| Self Pay (sliding fee) | 200 | $111.68 | $22,336 | $89.89 | $ 4,358 | 40% | $1,743 | $176.24 | 137.0847146866 | ||||
| 5,850 | $ 882,476 | $842,610 | $143.58 | 111.6807951356 | |||||||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 2,000 | $135.70 | $271,402 | -67.61 | $ 406,622 | 98% | $398,489 | ||||||
| Medicare | 3,800 | $135.35 | $514,336 | -10.48 | $ 554,160 | 95% | $526,452 | ||||||
| Private Insurance | 900 | $139.83 | $125,844 | $72.44 | $ 60,648 | 80% | $48,518 | ||||||
| Self Pay (sliding fee) | 500 | $113.91 | $56,957 | $89.89 | $ 12,012 | 40% | $4,805 | ||||||
| 7,200 | $ 1,033,442 | $978,265 | |||||||||||
| Grant Funding by Source | Year 1 | Year 2 | Year 3 | ||||||||||
| PPHF Grant | $100,000 | $100,000 | $100,000 | ||||||||||
| Foundation Grants | $75,000 | $ 50,000 | |||||||||||
| Total | $175,000 | $150,000 | $100,000 | ||||||||||
| 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 | $ - 0 | $ - 0 | $ - 0 | ||||||||||
| Marketing | $ 45,000 | $ 15,000 | $ 15,000 | ||||||||||
| Indirect Charges | $ 54,764 | $ 56,955 | $ 59,233 | ||||||||||
| Total Non-Staffing Costs | $ 290,240 | $ 245,668 | $ 260,481 | ||||||||||
| Staffing costs | |||||||||||||
| Annual Salary | FTE | Year 1 | Year 2 | Year 3 | |||||||||
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 | |||||||||
| Contract Specialists | 0.3 | $ 75,000 | $ 78,750 | $ 82,688 | |||||||||
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 | |||||||||
| Community Health Workers | 4 | $ 244,000 | $ 251,320 | $ 258,860 | |||||||||
| Reception/office management | 1 | $ 35,000 | $ 35,700 | $ 36,414 | |||||||||
| $ 596,094 | $ 618,287 | $ 641,371 | |||||||||||
| Capital Costs | Year 1 | Year 2 | Year 3 | ||||||||||
| Server | $15,000 | ||||||||||||
| Remodel of office space | $98,550 | ||||||||||||
| Security System | $2,654 | ||||||||||||
| Furniture | $12,281 | 1000 | 1000 | ||||||||||
| Practice Management System | $5,000 | 2500 | 2500 | ||||||||||
| Computers & Cabling | $41,696 | ||||||||||||
| $175,181 | $3,500 | $3,500 |
patient-generated revenue
| Projected Patient-Generated Revenue by Payer | |||||||
| Fiscal year from April 1 to March 31 | |||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,250 | $0.00 | $0 | -67.61 | $ 84,513 | 98% | $82,822 |
| Medicare | 2,000 | $0.00 | $0 | -10.48 | $ 20,960 | 95% | $19,912 |
| Private Insurance | 100 | $0.00 | $0 | $72.44 | $ (7,244) | 80% | ($5,795) |
| Self Pay (sliding fee) | 50 | $0.00 | $0 | $89.89 | $ (4,495) | 40% | ($1,798) |
| 3,400 | $ 93,734 | $95,141 | |||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,750 | $0.00 | $0 | -67.61 | $ 118,318 | 98% | $115,951 |
| Medicare | 3,500 | $0.00 | $0 | -10.48 | $ 36,680 | 95% | $34,846 |
| Private Insurance | 400 | $0.00 | $0 | $72.44 | $ (28,976) | 80% | ($23,181) |
| Self Pay (sliding fee) | 200 | $0.00 | $0 | $89.89 | $ (17,978) | 40% | ($7,191) |
| 5,850 | $ 108,044 | $120,425 | |||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 2,000 | $0.00 | $0 | -67.61 | $ 135,220 | 98% | $132,516 |
| Medicare | 3,800 | $0.00 | $0 | -10.48 | $ 39,824 | 95% | $37,833 |
| Private Insurance | 900 | $0.00 | $0 | $72.44 | $ (65,196) | 80% | ($52,157) |
| Self Pay (sliding fee) | 500 | $0.00 | $0 | $89.89 | $ (44,945) | 40% | ($17,978) |
| 7,200 | $ 64,903 | $100,214 | |||||
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf |
grant funding
| Projected Grant Funding by Source | ||||
| Year 1 | Year 2 | Year 3 | ||
| PPHF Grant | $100,000 | $100,000 | $100,000 | |
| Foundation Grants | $75,000 | $ 50,000 | ||
| Total | $175,000 | $150,000 | $100,000 | $425,000 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
non-staffing costs
| Projected 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 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
staffing costs
| Projected Staffing Costs | ||||
| Annual Salary | ||||
| FTE | Year 1 | Year 2 | Year 3 | |
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 |
| Contract Specialists | 0.30 | $ 75,000 | $ 78,750 | $ 82,688 |
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 |
| Community Health Workers | 4.00 | $ 244,000 | $ 251,320 | $ 258,860 |
| Reception/Office Management | 1.00 | $ 35,000 | $ 35,700 | $ 36,414 |
| Total | $ 596,094 | $ 618,287 | $ 641,371 | |
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf | ||||
| Designation | FTE | Year 1 | Year 2 | Year 3 |
| Endocronologist | 0.93 | 146940 | 154287 | 162001.35 |
| Contract Specialists | 0.30 | 22500 | 23625 | 24806.25 |
| Nurse Practitioner | 0.95 | 79889.3 | 82285.979 | 84754.55837 |
| Community Health Workers | 4.00 | 976000 | 1005280 | 1035438.4 |
| Reception/Office Management | 1.00 | 35000 | 35700 | 36414 |
| Total | 1260329.3 | 1301177.979 | 1343414.55837 |
capital costs
| Projected Capital Costs | |||||||||
| Year 1 | Year 2 | Year 3 | |||||||
| Server | $ 15,000 | Year 1 | 4882 | ||||||
| Remodel of Office Space | $ 98,550 | Year 2 | 5126 | ||||||
| Security System | $ 2,654 | Year 3 | 5386 | ||||||
| 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 | ||||||
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | |||||||||
| Particulars | Year 1 | Year 2 | Year 3 | ||||||
| Patients Visits Revenue | |||||||||
| Patient Visists | 4882 | 5126 | 5382 | ||||||
| Revenue Per Visit | $450 | $450 | $450 | Staffing Costs | Non-Staffing Costs | ||||
| Gross Patient Visits Revenue | $2,196,900 | $2,306,745 | $2,422,084.50 | Year 1 | $1,260,329.30 | $ 311,520 | |||
| Deduction from Patient Revenue | $65,907.00 | $69,202.35 | $72,662.54 | Year 2 | $1,301,177.98 | $ 285,533 | |||
| Net Patient Visits Revenue | $2,130,993.00 | $2,237,542.65 | $2,349,421.97 | Year 3 | $1,343,414.56 | $ 315,659 | |||
| 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 Opereating 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 | ||||||
| Cummulative 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 | ||||||
| Cummulative Income/Net Cash | $410,239.70 | $1,476,570.07 | $3,229,749.84 |
capital costs
Implementation Plan
| Activity(s) | Responsible Person (s) | Resources | Duration | Duration in Months | ||||||||||||||
| J | F | M | A | M | J | J | A | S | O | N | D | J | M | A | ||||
| 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. Novak | Business case Presentation | 1 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. Novak | Tthe 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 Manuals | 60 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 Policy | 2 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 Team | Monitoring Reports | Continious | |||||||||||||||
| Launching & Operationalizing of the Center for Diabetes Care | Dr. Novak, Western Hospital CEO, PPACA Representatives, & State Senator | Luncheon Session | 2 Days |
_1603884593.xls
Chart1
| Year 1 |
| Year 2 |
| Year 3 |
Sheet1
| Adapted from | |||||||||||||
| http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | |||||||||||||
| Patient-Generated Revenue by Payer | |||||||||||||
| Fiscal year from April 1 to March 31 | |||||||||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,250 | $133.04 | $166,300 | -67.61 | $ 250,812 | 98% | $245,796 | ||||||
| Medicare | 2,000 | $132.70 | $265,396 | -10.48 | $ 286,356 | 95% | $272,038 | ||||||
| Private Insurance | 100 | $137.08 | $13,708 | $72.44 | $ 6,464 | 80% | $5,172 | Year 3 assumes CHW are at their capactiy of 7200 patient visits, or 4 CHW FTEs see 10 patients per day 4 days per week, 45 weeks a year | |||||
| Self Pay (sliding fee) | 50 | $111.68 | $5,584 | $89.89 | $ 1,090 | 40% | $436 | ||||||
| 3,400 | $ 544,722 | $523,441 | |||||||||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,750 | $133.04 | $232,820 | -67.61 | $ 351,137 | 98% | $344,115 | ||||||
| Medicare | 3,500 | $132.70 | $464,442 | -10.48 | $ 501,122 | 95% | $476,066 | $171.04 | 133.04 | 133.04 | |||
| Private Insurance | 400 | $137.08 | $54,834 | $72.44 | $ 25,858 | 80% | $20,686 | $170.60 | 132.6977549111 | ||||
| Self Pay (sliding fee) | 200 | $111.68 | $22,336 | $89.89 | $ 4,358 | 40% | $1,743 | $176.24 | 137.0847146866 | ||||
| 5,850 | $ 882,476 | $842,610 | $143.58 | 111.6807951356 | |||||||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 2,000 | $135.70 | $271,402 | -67.61 | $ 406,622 | 98% | $398,489 | ||||||
| Medicare | 3,800 | $135.35 | $514,336 | -10.48 | $ 554,160 | 95% | $526,452 | ||||||
| Private Insurance | 900 | $139.83 | $125,844 | $72.44 | $ 60,648 | 80% | $48,518 | ||||||
| Self Pay (sliding fee) | 500 | $113.91 | $56,957 | $89.89 | $ 12,012 | 40% | $4,805 | ||||||
| 7,200 | $ 1,033,442 | $978,265 | |||||||||||
| Grant Funding by Source | Year 1 | Year 2 | Year 3 | ||||||||||
| PPHF Grant | $100,000 | $100,000 | $100,000 | ||||||||||
| Foundation Grants | $75,000 | $ 50,000 | |||||||||||
| Total | $175,000 | $150,000 | $100,000 | ||||||||||
| 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 | $ - 0 | $ - 0 | $ - 0 | ||||||||||
| Marketing | $ 45,000 | $ 15,000 | $ 15,000 | ||||||||||
| Indirect Charges | $ 54,764 | $ 56,955 | $ 59,233 | ||||||||||
| Total Non-Staffing Costs | $ 290,240 | $ 245,668 | $ 260,481 | ||||||||||
| Staffing costs | |||||||||||||
| Annual Salary | FTE | Year 1 | Year 2 | Year 3 | |||||||||
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 | |||||||||
| Contract Specialists | 0.3 | $ 75,000 | $ 78,750 | $ 82,688 | |||||||||
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 | |||||||||
| Community Health Workers | 4 | $ 244,000 | $ 251,320 | $ 258,860 | |||||||||
| Reception/office management | 1 | $ 35,000 | $ 35,700 | $ 36,414 | |||||||||
| $ 596,094 | $ 618,287 | $ 641,371 | |||||||||||
| Capital Costs | Year 1 | Year 2 | Year 3 | ||||||||||
| Server | $15,000 | ||||||||||||
| Remodel of office space | $98,550 | ||||||||||||
| Security System | $2,654 | ||||||||||||
| Furniture | $12,281 | 1000 | 1000 | ||||||||||
| Practice Management System | $5,000 | 2500 | 2500 | ||||||||||
| Computers & Cabling | $41,696 | ||||||||||||
| $175,181 | $3,500 | $3,500 |
patient-generated revenue
| Projected Patient-Generated Revenue by Payer | |||||||
| Fiscal year from April 1 to March 31 | |||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,250 | $0.00 | $0 | -67.61 | $ 84,513 | 98% | $82,822 |
| Medicare | 2,000 | $0.00 | $0 | -10.48 | $ 20,960 | 95% | $19,912 |
| Private Insurance | 100 | $0.00 | $0 | $72.44 | $ (7,244) | 80% | ($5,795) |
| Self Pay (sliding fee) | 50 | $0.00 | $0 | $89.89 | $ (4,495) | 40% | ($1,798) |
| 3,400 | $ 93,734 | $95,141 | |||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,750 | $0.00 | $0 | -67.61 | $ 118,318 | 98% | $115,951 |
| Medicare | 3,500 | $0.00 | $0 | -10.48 | $ 36,680 | 95% | $34,846 |
| Private Insurance | 400 | $0.00 | $0 | $72.44 | $ (28,976) | 80% | ($23,181) |
| Self Pay (sliding fee) | 200 | $0.00 | $0 | $89.89 | $ (17,978) | 40% | ($7,191) |
| 5,850 | $ 108,044 | $120,425 | |||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 2,000 | $0.00 | $0 | -67.61 | $ 135,220 | 98% | $132,516 |
| Medicare | 3,800 | $0.00 | $0 | -10.48 | $ 39,824 | 95% | $37,833 |
| Private Insurance | 900 | $0.00 | $0 | $72.44 | $ (65,196) | 80% | ($52,157) |
| Self Pay (sliding fee) | 500 | $0.00 | $0 | $89.89 | $ (44,945) | 40% | ($17,978) |
| 7,200 | $ 64,903 | $100,214 | |||||
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf |
grant funding
| Projected Grant Funding by Source | ||||
| Year 1 | Year 2 | Year 3 | ||
| PPHF Grant | $100,000 | $100,000 | $100,000 | |
| Foundation Grants | $75,000 | $ 50,000 | ||
| Total | $175,000 | $150,000 | $100,000 | $425,000 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
non-staffing costs
| Projected 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 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
staffing costs
| Projected Staffing Costs | ||||
| Annual Salary | ||||
| FTE | Year 1 | Year 2 | Year 3 | |
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 |
| Contract Specialists | 0.30 | $ 75,000 | $ 78,750 | $ 82,688 |
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 |
| Community Health Workers | 4.00 | $ 244,000 | $ 251,320 | $ 258,860 |
| Reception/Office Management | 1.00 | $ 35,000 | $ 35,700 | $ 36,414 |
| Total | $ 596,094 | $ 618,287 | $ 641,371 | |
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf | ||||
| Designation | FTE | Year 1 | Year 2 | Year 3 |
| Endocronologist | 0.93 | 146940 | 154287 | 162001.35 |
| Contract Specialists | 0.30 | 22500 | 23625 | 24806.25 |
| Nurse Practitioner | 0.95 | 79889.3 | 82285.979 | 84754.55837 |
| Community Health Workers | 4.00 | 976000 | 1005280 | 1035438.4 |
| Reception/Office Management | 1.00 | 35000 | 35700 | 36414 |
| Total | 1260329.3 | 1301177.979 | 1343414.55837 |
capital costs
| Projected Capital Costs | ||||||||||
| Year 1 | Year 2 | Year 3 | ||||||||
| Server | $ 15,000 | Year 1 | 4882 | |||||||
| Remodel of Office Space | $ 98,550 | Year 2 | 5126 | |||||||
| Security System | $ 2,654 | Year 3 | 5386 | |||||||
| 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 | |||||||
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | ||||||||||
| Particulars | Year 1 | Year 2 | Year 3 | |||||||
| Patients Visits Revenue | ||||||||||
| Patient Visists | 4882 | 5126 | 5382 | |||||||
| Revenue Per Visit | $450 | $450 | $450 | Staffing Costs | Non-Staffing Costs | |||||
| Gross Patient Visits Revenue | $2,196,900 | $2,306,745 | $2,422,084.50 | Year 1 | $1,260,329.30 | $ 311,520 | ||||
| Deduction from Patient Revenue | $65,907.00 | $69,202.35 | $72,662.54 | Year 2 | $1,301,177.98 | $ 285,533 | ||||
| Net Patient Visits Revenue | $2,130,993.00 | $2,237,542.65 | $2,349,421.97 | Year 3 | $1,343,414.56 | $ 315,659 | ||||
| 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 | Year 1 | $410,239.70 | |||||
| Capital Costs | $175,181 | $3,500 | $3,500 | Year 2 | $1,476,570.07 | |||||
| Net Opereating Expenses | $1,747,030.30 | $1,590,210.98 | $1,662,572.56 | Year 3 | $3,229,749.84 | |||||
| Excess of Revenue Over Expenses | $383,962.70 | $647,331.67 | $686,849.40 | |||||||
| Cummulative 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 | |||||||
| Cummulative Income/Net Cash | $410,239.70 | $1,476,570.07 | $3,229,749.84 |
capital costs
Implementation Plan
| Activity(s) | Responsible Person (s) | Resources | Duration | Duration in Months | ||||||||||||||
| J | F | M | A | M | J | J | A | S | O | N | D | J | M | A | ||||
| 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. Novak | Business case Presentation | 1 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. Novak | Tthe 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 Manuals | 60 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 Policy | 2 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 Team | Monitoring Reports | Continious | |||||||||||||||
| Launching & Operationalizing of the Center for Diabetes Care | Dr. Novak, Western Hospital CEO, PPACA Representatives, & State Senator | Luncheon Session | 2 Days |
_1603882674.xls
Chart1
| Year 1 |
| Year 2 |
| Year 3 |
Sheet1
| Adapted from | |||||||||||||
| http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | |||||||||||||
| Patient-Generated Revenue by Payer | |||||||||||||
| Fiscal year from April 1 to March 31 | |||||||||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,250 | $133.04 | $166,300 | -67.61 | $ 250,812 | 98% | $245,796 | ||||||
| Medicare | 2,000 | $132.70 | $265,396 | -10.48 | $ 286,356 | 95% | $272,038 | ||||||
| Private Insurance | 100 | $137.08 | $13,708 | $72.44 | $ 6,464 | 80% | $5,172 | Year 3 assumes CHW are at their capactiy of 7200 patient visits, or 4 CHW FTEs see 10 patients per day 4 days per week, 45 weeks a year | |||||
| Self Pay (sliding fee) | 50 | $111.68 | $5,584 | $89.89 | $ 1,090 | 40% | $436 | ||||||
| 3,400 | $ 544,722 | $523,441 | |||||||||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 1,750 | $133.04 | $232,820 | -67.61 | $ 351,137 | 98% | $344,115 | ||||||
| Medicare | 3,500 | $132.70 | $464,442 | -10.48 | $ 501,122 | 95% | $476,066 | $171.04 | 133.04 | 133.04 | |||
| Private Insurance | 400 | $137.08 | $54,834 | $72.44 | $ 25,858 | 80% | $20,686 | $170.60 | 132.6977549111 | ||||
| Self Pay (sliding fee) | 200 | $111.68 | $22,336 | $89.89 | $ 4,358 | 40% | $1,743 | $176.24 | 137.0847146866 | ||||
| 5,850 | $ 882,476 | $842,610 | $143.58 | 111.6807951356 | |||||||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income | ||||||
| Medicaid | 2,000 | $135.70 | $271,402 | -67.61 | $ 406,622 | 98% | $398,489 | ||||||
| Medicare | 3,800 | $135.35 | $514,336 | -10.48 | $ 554,160 | 95% | $526,452 | ||||||
| Private Insurance | 900 | $139.83 | $125,844 | $72.44 | $ 60,648 | 80% | $48,518 | ||||||
| Self Pay (sliding fee) | 500 | $113.91 | $56,957 | $89.89 | $ 12,012 | 40% | $4,805 | ||||||
| 7,200 | $ 1,033,442 | $978,265 | |||||||||||
| Grant Funding by Source | Year 1 | Year 2 | Year 3 | ||||||||||
| PPHF Grant | $100,000 | $100,000 | $100,000 | ||||||||||
| Foundation Grants | $75,000 | $ 50,000 | |||||||||||
| Total | $175,000 | $150,000 | $100,000 | ||||||||||
| 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 | $ - 0 | $ - 0 | $ - 0 | ||||||||||
| Marketing | $ 45,000 | $ 15,000 | $ 15,000 | ||||||||||
| Indirect Charges | $ 54,764 | $ 56,955 | $ 59,233 | ||||||||||
| Total Non-Staffing Costs | $ 290,240 | $ 245,668 | $ 260,481 | ||||||||||
| Staffing costs | |||||||||||||
| Annual Salary | FTE | Year 1 | Year 2 | Year 3 | |||||||||
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 | |||||||||
| Contract Specialists | 0.3 | $ 75,000 | $ 78,750 | $ 82,688 | |||||||||
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 | |||||||||
| Community Health Workers | 4 | $ 244,000 | $ 251,320 | $ 258,860 | |||||||||
| Reception/office management | 1 | $ 35,000 | $ 35,700 | $ 36,414 | |||||||||
| $ 596,094 | $ 618,287 | $ 641,371 | |||||||||||
| Capital Costs | Year 1 | Year 2 | Year 3 | ||||||||||
| Server | $15,000 | ||||||||||||
| Remodel of office space | $98,550 | ||||||||||||
| Security System | $2,654 | ||||||||||||
| Furniture | $12,281 | 1000 | 1000 | ||||||||||
| Practice Management System | $5,000 | 2500 | 2500 | ||||||||||
| Computers & Cabling | $41,696 | ||||||||||||
| $175,181 | $3,500 | $3,500 |
patient-generated revenue
| Projected Patient-Generated Revenue by Payer | |||||||
| Fiscal year from April 1 to March 31 | |||||||
| Year 1 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,250 | $0.00 | $0 | -67.61 | $ 84,513 | 98% | $82,822 |
| Medicare | 2,000 | $0.00 | $0 | -10.48 | $ 20,960 | 95% | $19,912 |
| Private Insurance | 100 | $0.00 | $0 | $72.44 | $ (7,244) | 80% | ($5,795) |
| Self Pay (sliding fee) | 50 | $0.00 | $0 | $89.89 | $ (4,495) | 40% | ($1,798) |
| 3,400 | $ 93,734 | $95,141 | |||||
| Year 2 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 1,750 | $0.00 | $0 | -67.61 | $ 118,318 | 98% | $115,951 |
| Medicare | 3,500 | $0.00 | $0 | -10.48 | $ 36,680 | 95% | $34,846 |
| Private Insurance | 400 | $0.00 | $0 | $72.44 | $ (28,976) | 80% | ($23,181) |
| Self Pay (sliding fee) | 200 | $0.00 | $0 | $89.89 | $ (17,978) | 40% | ($7,191) |
| 5,850 | $ 108,044 | $120,425 | |||||
| Year 3 | number of visits | average charge per visit | total charges | average adjustment per visit | amount billed | collection rate | income |
| Medicaid | 2,000 | $0.00 | $0 | -67.61 | $ 135,220 | 98% | $132,516 |
| Medicare | 3,800 | $0.00 | $0 | -10.48 | $ 39,824 | 95% | $37,833 |
| Private Insurance | 900 | $0.00 | $0 | $72.44 | $ (65,196) | 80% | ($52,157) |
| Self Pay (sliding fee) | 500 | $0.00 | $0 | $89.89 | $ (44,945) | 40% | ($17,978) |
| 7,200 | $ 64,903 | $100,214 | |||||
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf |
grant funding
| Projected Grant Funding by Source | ||||
| Year 1 | Year 2 | Year 3 | ||
| PPHF Grant | $100,000 | $100,000 | $100,000 | |
| Foundation Grants | $75,000 | $ 50,000 | ||
| Total | $175,000 | $150,000 | $100,000 | $425,000 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
non-staffing costs
| Projected 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 |
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf |
staffing costs
| Projected Staffing Costs | ||||
| Annual Salary | ||||
| FTE | Year 1 | Year 2 | Year 3 | |
| Endocronologist | 0.93 | $ 158,000 | $ 165,900 | $ 174,195 |
| Contract Specialists | 0.30 | $ 75,000 | $ 78,750 | $ 82,688 |
| Nurse Practitioner | 0.95 | $ 84,094 | $ 86,617 | $ 89,215 |
| Community Health Workers | 4.00 | $ 244,000 | $ 251,320 | $ 258,860 |
| Reception/Office Management | 1.00 | $ 35,000 | $ 35,700 | $ 36,414 |
| Total | $ 596,094 | $ 618,287 | $ 641,371 | |
| Adapted from: Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20O/PDF%20OpenDoorFinancialAnalysis.pdf | ||||
| Designation | FTE | Year 1 | Year 2 | Year 3 |
| Endocronologist | 0.93 | 146940 | 154287 | 162001.35 |
| Contract Specialists | 0.30 | 22500 | 23625 | 24806.25 |
| Nurse Practitioner | 0.95 | 79889.3 | 82285.979 | 84754.55837 |
| Community Health Workers | 4.00 | 976000 | 1005280 | 1035438.4 |
| Reception/Office Management | 1.00 | 35000 | 35700 | 36414 |
| Total | 1260329.3 | 1301177.979 | 1343414.55837 |
capital costs
| Projected Capital Costs | ||||||
| Year 1 | Year 2 | Year 3 | ||||
| Server | $ 15,000 | Year 1 | 4882 | |||
| Remodel of Office Space | $ 98,550 | Year 2 | 5126 | |||
| Security System | $ 2,654 | Year 3 | 5386 | |||
| 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 | |||
| Adapted from Chelius, L., Hook, J., & Rodriguez, M. (2010). Financial analysis of Open Door Community Health Centers’ telehealth experience. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/O/PDF%20OpenDoorFinancialAnalysis.pdf | ||||||
| Particulars | Year 1 | Year 2 | Year 3 | |||
| Patients Visits Revenue | ||||||
| Patient Visists | 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 Opereating 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 | |||
| Cummulative 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 | |||
| Cummulative Income/Net Cash | $410,239.70 | $1,476,570.07 | $3,229,749.84 |
capital costs
Implementation Plan
| Activity(s) | Responsible Person (s) | Resources | Duration | Duration in Months | ||||||||||||||
| J | F | M | A | M | J | J | A | S | O | N | D | J | M | A | ||||
| 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. Novak | Business case Presentation | 1 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. Novak | Tthe 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 Manuals | 60 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 Policy | 2 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 Team | Monitoring Reports | Continious | |||||||||||||||
| Launching & Operationalizing of the Center for Diabetes Care | Dr. Novak, Western Hospital CEO, PPACA Representatives, & State Senator | Luncheon Session | 2 Days |
_1603730388.xls
Chart1
| Hispanic |
| White |
| African American |
Sheet1
| Sales | |
| Hispanic | 71% |
| White | 15% |
| African American | 14% |
| To update the chart, enter data into this table. The data is automatically saved in the chart. | |
| 7000 | |
| 1500 | |
| 1346 | |
| 9846 |
