Postpartum home
visits
A capital budget Idea
The Who
Venice Family Clinic serves the underserved of Los Angeles
and surrounding towns in California
•Began as a small, after hours, volunteer community
clinic
•Now 19 clinics and growing, including mobile care
•The mission of VFC is to improve the health of people
and communities, including low income and homeless
populations
•They focus on primary care and multiple specialties
such as substance abuse, prenatal, behavioral,
pediatrics, even dental and vision!
(About the Clinic, 2021)
A deeper look at the
state of affairs
To be more accurate, the finances!
•VFC made in revenue: 64,090,604
•Total expenses: 57,889,215
•Their liquidity ratio status: 4.62
•Net assets: 52, 250,669
•Liability: 11,305,742
•Venice Family Clinic presents in good financial
standing. They are able to meet financial demands
expected and unexpected and still pull in a profit
Healthcare trends
•Popularity of home health care and telehealth
•Less time spent fighting transportation,
childcare needs, and stress
•Patients are able to feel more comfortable
within their own environment
What could possibly be
missing?
Despite its top-notch work
with prenatal care, VFC and
the families that receive
care would benefit heavily
from home postpartum care
Benefits of home visits for postpartum follow up
•Home visits are shown to be an effective way of prevention, early detection and management
of post partum depression (Milani et al., 2017)
•Reduced rates of child maltreatment and lowered emergency care use for families (Rosenberg,
2021).
•Increased rates of successful breastfeeding(Amare et al., 2018)
•Reduced infant mortality and increase in mother’s self-perceived confidence(Mokhtari et al.,
2018)
Goals
The VFC claims its main mission is to provide primary health care to
people in need (About the Clinic, 2021).
Postpartum care is an avenue not yet touched upon by VFC, however,
it does offer prenatal care
As shown by the benefits, offering postpartum home care would
create continuity and bridge another piece of healthcare to those in
need
So what are the options….
Option One:
Buy a new van
A new Ford transit van would cost 44,575$
This includes additional safety features, GPS
installed, storage customized, and so on
Basic maintenance can be included through
dealer, will not cover broken parts but basic
things such as oil changes or defective
pieces covered by warranty (ex: GPS
malfunction)
(Ford Motor Company, 2022).
Option Two:
Buy a Used Van
A used Ford Transit cargo van (2017) costs
an average 24,000$
Limited ability to customize from seller,
however company can customize after
market however they would like
Maintenance is up to the buyer
Cheaper option and long term owned
investment
(Kelly blue book, 2022).
Option Three:
Lease a Van
The cost to lease a Ford Transit Van would be
809$/ month
This is based on a 36-month lease and the
ability to drive an average of 100 miles/ day
Annual cost of: 9,708
3 year cost of: 29,124
Covered: Maintenance including but not limited
to all parts on the car, oil changes, basic upkeep
(tire replacement not included)
(Ford Motor Company, 2022).
Additional costs to
understand
•Medical supplies to go in the van for initial inventory
•Minimum 3,000$ will include vitals machine, stethoscope, scale, basic medical
supplies for visits, estimated 1,000$ per month to restock basic medical supplies at
most
•Insurance on Vehicle
•Insurance for this vehicle costs an average of 1704$ a year will depend on plan
selected, coverage, actual model bought, etc. (Insureon, 2021).
•Lettering on Van (lease and buyer friendly)
•Basic lettering that can be removed from vehicle if leased would cost $150 so to
identify the van as company property (Durso, 2020).
•Gas
•$800 Fuel money per month (may change at any given time). This was calculated
based off 100 miles per day estimate x miles traveled in a month estimate divided
by MPG of vehicle (both average the same about), and times the average price of
gas in CA at this time.
•Maintenance
•Will vary based on option selected but general $6,000 should be set aside to cover
maintenance
This Photo by Unknown Author is licensed under CC BY-ND
Strategic Planning
•Additions of services and products within an organization always
bring in the consideration of the long-term financial standing of
the company, mainly within 3-10 years of implementation (Nowicki,
2022).
•The idea for postpartum visits is covered within the VFC’s
mission statement and its goal to deliver high quality primary
health care to people in need (About The Clinic, 2022).
•It should be noted that there are multiple government grants,
including community engagement grants or federal
reimbursement through postpartum programs that may fall into
this category and provides reimbursement and funds to the
company for the adoption of this implementation (Postpartum Support
International, 2022).
•Even if implementation is not successful the vehicle can be sold
(unless leased, then cancelled) and things such as supplies can
be reused within the clinic or mobile units
What does the company
make back?
•Addition of home health care can raise net profits 12 to 15
percent, and/ or profits up to 248,000 dollars (Fierce Healthcare,
2016).
•Reimbursement profit for a home health care visit can
average 35-36 percent per visit (Grunig, 2021).
•Average profit per visit ranges from 17-72 dollars minimum
(CT.gov, 2022).
•A conservative estimated profit of 4200-18200 dollars per
year based solely on visit profits
•There are multiple government issued grants to help
companies with these programs that can be applied for
•Price to add service would cost 0.28 percent at most based
on revenue earned vs. overall costs last fiscal year .
Organizational
resources
•Budget
•Staff to drive and attend visits
•Training
•Medical supplies
communication
To alert the clinic
-flyers and emails alerting staff of change and
opportunities for training as applicable
-Debriefings following each ‘shift’ especially
within first few weeks of implementation
-Weekly huddles discussing effectiveness and
possible areas of change
For the managers/ supervisors
•Preparation for introductory budget
proposal
•Meetings quarterly to assess revenue vs
expense
•Once implemented, meetings with staff to
analyze benefits and concerns
Statements it will
affect/ budgeting
•The overall fiscal report of the year
•Salaries
•Number of staff
•Medical/ office supplies
•Training
•New budget set aside for emergencies/
maintenance
Reasoning •VFC spent 1,804,224 million on education and outreach to
community 2018. 2,232,926 in 2021.
•Outreach is rising and a goal the clinic stands by. The addition of
telehealth, mobile clinics, and transportation for patients has grown
and been an investment the last few years
•The clinic has stated within its budget it plans to add more mobile
and community outreach vehicles (Venice Family Clinic, 2022).
•This plan will increase revenue by allowing for more visits,
increase the number of patients seen (families can opt in even if
not from clinic before), increases continuity of care which may
lead to families staying with the clinic for pediatric care, and
promotes many benefits for mom and baby
Ratios
Return on Investment Ratio:
Divide the cost of investment by profit and times by 100. The overall
ROI of the company is 0.92 based on last years outreach cost and
revenue (Nowicki, 2022).
Liquidity Ratio:
Total assets divided by total liabilities. Current ratio 4.62, anything
above 1 is considered good. This tells how well the company can pay off unexpected
and planned costs (Nowicki, 2022).
Payback Period Analysis:
To calculate divide the initial cash
outlay of the project by the cash inflow the project makes per
year. Based on all estimated options:
•To buy new: 2.5 years
•To buy used: 1.3 years
•To lease: 0.5 years
Debt to Capitalizing Ratio
: take long term
debt and divide it by long term debt +
net assets (Nowicki, 2022).
THE IMPACTS…
Short term
•Short term large budget impact
•Increase in patient’s seen
•Increase in revenue
Long term
•Required long term costs
•Additional employees
•Less cancellations/ no show appointments
•Continuity of care
•Positive for families
JUSTIFICATION
•Estimated Revenue and utilization of service will outweigh
the short-term cost
•Training that will need to be done, can be done during
office hours and will not require any additional degrees/
certificates
•Increase in patients seen
•Decrease in postpartum health consequences
CONFLICTS
•Despite its well thought-up use, the implementation may be
under-utilized
•Persons outside of travel zones may not benefit from it
•Families may decide to continue with another practice
•Inability to hire suitable staff
references
About the clinic
. Venice Family Clinic. (2021). https://venicefamilyclinic.org/about-the-clinic/#financials
Amare, Y., Scheelbeek, P., Schellenberg, J.
et al.
Early postnatal home visits: a qualitative study of barriers and facilitators to achieving high coverage.
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Milani, H. S., Amiri, P., Mohsey, M., Monfared, E. D., Vaziri, S. M., Malekkhahi, A., & Salmani, F. (2017). Effect of Health Care as the "Home Visiting" on Postpartum Depression. A Controlled Clinical Trial.
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Mokhtari, F., Bahadoran, P., & Baghersad, Z. (2018). Effectiveness of Postpartum Homecare Program as a New Method on Mothers' Knowledge about the Health of the Mothe r and the Infant.
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