Post on 15-Apr-2017
Strategies to Reduce Barriers to
Primary and Specialty Care
FPSC
2015Improving New Patient Access
LORI MACKEY
ELIZABETH HILTON
THE PRESENTERS
Senior Associate Dean for Operations and Finance
University of Cincinnati College of Medicine
Chief Operating Officer
Physician Group, UC Health
Director of Access
Physician Group, UC Health
BACKGROUND
THE BEGINNING
DIAGNOSING THE PROBLEM
ESTABLISHING GOVERNANCE
SETTING STANDARDS
1
2
3
4
5
TOPICS COVERED
UTILIZING TOOLS FOR SUCCESS6
MOVING FORWARD7
BACKGROUND
OUR ORGANIZATION
UC Health
West Chester
HospitalSuburban Outreach
Drake CenterPost Acute Care Facility
College of Medicine University of Cincinnati Faculty Practice Plan
University of
Cincinnati Medical
Center
UC Health Ambulatory
200+
OUTPATIENT SPECIALTY CLINICS
90+
LOCATIONS
760
PHYSICIANS
PHYSICIAN GROUP
18
ACADEMIC CLINICAL DEPARTMENTS
360
MID-LEVEL PROVIDERS
1,500,000
ANNUAL VISITS
1,250
STAFF EMPLOYEES
o Anesthesiao Dermatologyo Emergency Medicineo Environmental Healtho Family Medicineo Internal Medicine
o Cardiologyo Digestive Diseaseso Endocrinologyo General Internal Medicineo Hematology/Oncologyo Infectious Diseaseo Nephrologyo Pulmonary, Critical Care & Sleep
Medicineo Rheumatology/Immunology
o Integrative Medicineo Neurology o OB/GYNo Ophthalmology
CLINICAL PRACTICES
o Otolaryngologyo Paino Pathologyo Primary Care Networko Psychiatryo PM&Ro Radiation Oncologyo Radiologyo Surgery
o Burno Cardiaco Colon & Rectalo General o Oral & Maxillofacialo Plastico Thoracico Transplanto Traumao Urologyo Vascular
THE BEGINNING
BECOMING UC HEALTH
o APPOINTMENT SCHEDULING WAS DECENTRALIZED BY --- DEPT --- DIVISION ---
PHYSICIAN
o SECRETARIES & NURSES WERE THE DRIVERS
o NO CENTRALIZED TELEPHONE NUMBERS (CARDIOLOGY = 21 NUMBERS)
o NO SERVICE STANDARDS
o NO BRAND AWARENESS IN THE COMMUNITY
o HIGH INDIGENT PAYOR MIX
o BUSINESS WAS LARGELY BASED DOWNTOWN
o PATIENTS UNHAPPY & COMPLAINED PRACTICES WERE HARSH AND CONFUSING
o REFERRING PROVIDERS UNHAPPY & COMPLAINED THAT THE COM WAS A “BLACK
HOLE”
o FACULTY PRACTICE PLAN LOST $8 MILLION DOLLARS IN 2008
THE BEGINNING 2008
THE BEGINNING “Logo Soup”
17 CORPORATIONS INDEPENDANTLY FUNCTIONING AS A PHYSICIAN GROUP
DIAGNOSING THE
PROBLEM
IDENTIFYING THE CHALLENGES
HIRED A MARKETING FIRM
INTITIATED PATIENT SATISFACTION SURVEYS
INTITIATED REFERRING PHYSICAN SATISFACTION SURVEYS
A
B
C
DIAGNOSING THE PROBLEM: THE RESEARCH
CONSISTENT BRAND
CENTRAL RECOGNIZABLE TELEPHONE
NUMBER
PROVIDERS APPEAR TO NOT CARE ABOUT PATIENTS
CONSISTENT & RELIABLE
TELEPHONE SYSTEM
A
B
C
D
DIAGNOSING THE PROBLEM: THE FINDINGS
EMORE APPOINTMENT AVAILABILITY
& EASIER PROCESSES
FMD TRIAGE SYSTEM FOR URGENT
APPOINTMENTS
ESTABLISHING
GOVERNANCE
BUILDING THE TEAM TO IMPLEMENT SOLUTIONS
ESTABLISHING GOVERNANCE
2008WORK GROUP
Engaged a consulting firm to developed metrics and accelerate
the move towards CENTRALIZATION
FORMED AN INTERNAL WORKGROUP:
• Developed a single brand
• Implemented standardized telephone verbiage and trees
• Mandated centralized scheduling at the division level
• Standardized scheduling templates
• Discussed developing a centralized scheduling center
• Publically reported 3rd Next Available appointment
2010CONSULTANTS
ESTABLISHING GOVERNANCE
2008WORK GROUP
2010CONSULTANTS
Consultant Recommendations:
• Develop a centralized scheduling center for telephone appointments
• Incorporate indigent and resident scheduling into the Physician
Group
• Develop standardized policies and procedures for the clinics
(blocking, bumping, etc.)
• Simplify processes – standardize visit types and durations
• Open up templates – Open Access and slots vs. visits
• Develop standard reports and implement transparent reporting
• Automate referral workflows
• Create a recognizable number for Physician Group
• Implement a new phone system and standardize phone trees and
options
• Separate clinical calls and scheduling calls
• CREATE A SCHEDULING TASK FORCE FOR IMPLEMENTATION
ESTABLISHING GOVERNANCE
2008WORK GROUP
2010CONSULTANTS
2011SCHEDULING
TASK FORCE
EXECUTIVE LEADER: Executive Business Director, Internal Medicine
EXECUTIVE SPONSOR: COO, Physician Group
ATTENDEES: ACCESS
CLINICAL OPERATIONS
IT
PHYSICIAN BILLING
REVENUE CYCLE
Director
VP and Managers
Director and Manager
Director
SVP and Director
STA
KE
HO
LD
ER
S
To provide our customers with an effective process for scheduling appointments for outpatient services across UC Health.
CH
AR
TE
R
ESTABLISHING GOVERNANCE
2008WORK GROUP
2010CONSULTANTS
GO
AL To standardize and consolidate all outpatient clinic appointment telephone scheduling
through one central call center, that is unified and efficient across UC Health.
2011SCHEDULING
TASK FORCE
SCHEDULING STANDARDS • Visit Types• Provider Templates• Preps
TELEPHONE ACCESS • Upgrade Phone System• Standardize Phone Trees• Standardize Phone Message
FO
CU
S
CENTRALIZATION
STANDARDS & STRATEGIES TO TACKLE THE
CHALLENGES OF CENTRALIZATION
SERVICE LEVEL CONSISTENCY
BROADER UNDERSTANDING OF SYSTEM SCHEDULING RULES
ABILITY TO MEASURE PERFORMANCE CONSISTENTLY
STAFF TRAINING AND COVERAGE
AUTOMATION
1
2
3
4
5
LOSS OF AUTONOMY
INABLITY TO CUSTOMIZE SCHEDULES
LACK OF PERSONALIZATION
RELATIONSHIP WITH PATIENT
PROVIDER CONTROL
1
2
3
4
5
CENTRALIZATION: THE PROS AND CONS
COO
Director of Access
Asst. Director of Access
Supervisor
Supervisor
Template Maintenance
Trainer
Questionnaire Builder
IT Manager
Clinical EPIC Builder
WOMENS
HEALTH
Team Lead
Team Lead
ORTHOPAEDICS
INTERNAL MED
PRIMARY CARE
NEUROLOGY
ENT
CENTRALIZATION: ORGANIZATION CHART
ROLE FTE
DIRECTOR: 1.0
ASST DIRECTOR: 1.0
SUPERVISORS: 2.0
TEAM LEADS: 2.0
SCHEDULERS: 36.2
TECHINCAL TEAM: 3.4
AVERAGE # INBOUND CALLS PER DAY: 3,700
CENTRALIZATION: SCHEDULING ALGORITMS
CENTRALIZATION: THE QUESTIONNAIRE
• More appropriate match of provider to patient
• More information obtained prior to the visit
• Provider can see the visit type on the schedule
• Schedulers can be cross-trained
CENTRALIZATION: THE QUESTIONNAIRE
CENTRALIZATION: SCHEDULING BY DIAGNOSIS
Patient: “I have headaches”
Scheduler: uses EPIC questionnaire to determine
severity, onset and previous treatment
Depending on answers patient is scheduled with:
Sub-Specialty: Headache TMJ Facial Pain Trigeminal
Neuralgia
Department: Neurology Dentistry ENT Neurology
CENTRALIZATION: CONSULT SERVICE
A Phone Call AwayPhysician-to-Physician Communication with UCMD
CENTRALIZATION:
• Communicate with your doctor
• Access your test results
• Request prescription renewals
• View details of your past and upcoming appointments
• Schedule and Cancel Appointments
CENTRALIZATION: GROWTH PLAN
Cardiology, Endocrinology,
Gastroenterology, Haematology/Oncology,
Infectious Disease, Nephology,
Orthopaedics, Primary Care, Pulmonology,
Rheumatology
Neurology, Primary Care
Infectious Disease, Ob/Gyn, Primary Care
Sleep Medicine, Otolaryngology, Primary Care
Dermatology, Primary Care
Student Health, Surgery: Cardiothoracic,
General, Plastics, Podiatry, Oncology,
Transplant, Trauma, Urology, Vascular
GynOncology, Ophthalmology, Pain Medicine,
Perioperative Care, Psychiatry, Radiation
Oncology
FY 12
FY 13
FY 14
FY 15
In
Progress
Planned
for FY 16
SETTING STANDARDS
SHARED EXPECTATIONS
PROVIDER EXPECTATIONS
SLOTS EXPECTED PER CLINIC
NO SHOW
% NEW PATIENTS
BUMP RATE
1
2
4
5
6
SETTING STANDARDS: ACCESS COMMENTATOR
APPOINTMENT LAG7
PHONE METRICS8
PATIENT SATISFACTION9
FILL RATE3
Mar 2015
Patient Access CommentatorMar 2015
Capacity Analysis (MD Only)
Scheduling TelephonePatient
Satisfaction
MeasureOutpatient
Provider Effort
Slots Expected Per Clinic
Expected Slots
Slots FilledSlot Fill
Rate No Show
Rate
Cancelled w/in 24 hrs
of DOS% NPV
Bump Rate
Third Next Available
NEW
NEW Patient Appt Lag Days
NEW MEDICAID Lag Days
Abandoned Call Rate
Queue Time
Ease of Scheduling
Benchmark -- -- -- -- ↑ 90% -- -- -- ↓ 1% ↓ 10 ↓ 14 ↓ 14 ↓ 3% ↓ 0:20 ↑ 90%
↓ 80% ↑ 3% ↑ 13 ↑ 22 ↑ 22 ↑ 5% ↑ 0:30 ↓ 80%
Anesthesia 2.44 12.00 1,005 1,225 122% 3.3% 14.2% 9.9% 0.9% 1.0 8.25 -- -- -- 87%
Dermatology 8.81 16.00 4,830 4,236 88% 5.3% 16.6% 27.2% 1.2% 2.6 20.07 25.07 3.48% 0:43 91%
Family Medicine - UC Student Health 0.00 0.00 0 0 -- 4.4% 9.6% 5.8% 0.9% -- 5.14 -- -- -- 68%
Int. Med. - Cardiology 10.21 11.52 3,592 2,472 69% 8.5% 12.0% 10.5% 7.9% 4.8 16.36 14.67 11.12% 1:22 80%
Int. Med. - Digestive Disease 3.92 11.53 1,543 1,483 96% 13.2% 18.3% 39.6% 4.5% 11.2 22.13 17.97 11.12% 1:22 50%
Int. Med. - Endocrinology 5.05 10.55 1,713 1,263 74% 8.6% 18.0% 18.0% 2.1% 15.8 41.67 30.45 11.12% 1:22 89%
Int. Med. - Gastroenterology North 1.22 13.33 564 390 69% 6.5% 15.7% 38.4% 2.5% 8.0 24.50 23.40 11.12% 1:22 90%
Int. Med. - GIM Faculty Practice 1.78 16.00 1,084 1,695 156% 14.4% 16.4% 11.3% 1.2% 101.8 64.97 74.18 11.12% 1:22 --
METRIC DEFINITION
OUTPATIENT
PROVIDER
EXPECTATIONS
FTE BASED ON CONTRACTUAL
CLINICAL OBLIGATIONS
NUMBER OF SESSIONS
TO BE CONSIDERED
FULL TIME
FTE SESSION REQUIREMENTS ARE
SET BY DEPARTMENT AND ARE USUALLY EITHER 9 OR 10 PER
WEEK
FTE ADJUSTEDSESSIONS REQUIRED PER
CONTRACT
NUMBER OF WEEKS WORKED
52 WEEKS LESS 7 FOR VACATION AND CME
SESSION DURATION 4 HOURS
OUTPATIENT PROVIDER EXPECTATIONS1
CENTRALIZATION: SETTING STANDARDS
METRIC DEFINITION
SLOT
DURATION
THE LENGTH OF THE PROVIDERS
SHORTEST VISIT TYPE
NUMBER OF
SLOTS PER
YEAR
ANNUAL HOURS
SLOT DURATION
DAILY SLOTS
SCHEDULABLE
# SLOTS PER YEAR
BUSINESS DAYS
SLOTS EXPECTED PER CLINIC2
CENTRALIZATION: SETTING STANDARDS
OUTPATIENT EXPECTATIONS – OFFER LETTERS1
Based on our mutual understanding, your initial allocation of effort will be as follows:
Clinical: 80%Clinical Trials 10%Education 10%Total: 100%
Clinical Practice:We look forward to helping you develop your ongoing interest and expertise in the area of Interventional Cardiology. This will include developing a multidisciplinary valve clinic as well as fostering relationships with local health networks.
Your estimated clinical efforts will include twelve (12) weeks of inpatient service at the University of Cincinnati Medical Center (UCMC) as assigned by the division, including CCU, 6 South, and consult service; FOUR 4-HOUR SESSIONS OF OUTPATIENT CLINICS at the Medical Arts Building (MAB) or other locations as assigned; and one (1) full day of procedures at UCMC per week, plus participation in call coverage. It is important to know that your clinical effort can change based on the needs of the department.
In an effort to enhance and monitor adherence to our patient care mission, we expect patient referrals to be made to FPP specialties and UC Health facilities, subject to patient choice, third party payor requirements and your judgment as to the best medical interests of the patient. In addition, all FPP physicians participate in the care of indigent patients and in teaching activities for our students, residents and fellows.
CENTRALIZATION: SETTING STANDARDS
OUTPATIENT EXPECTATIONS - CARDIOLOGIST1
UNIVERSITY OF CINCINNATI - FPP
DEPARTMENT OF INTERNAL MEDICINE - CARDIOLGY
Outpatient Clinic Effort Allocation for Provider: 100.0% Patients /Slots % Number
New 29% 4.0
Assumptions: Based on Full-Time Effort Est. 71% 10.0
Number of Sessions Per Week 9.0 (A)
Hours Per Session 4.0 (B) Total 100% 14.0
No. Sessions Scheduled Annually 100% O/P Provider (A * 52 weeks) 468 (C) Show Rate 85%
% Clinics Expected to Attend (7 weeks Out of Office) 86.5% (D) Patients Seen 11.9 229.5
No. 4hr Sessions Year Expected to Attend (C * D) 405 (E) Slots Seen 15.3 229.5
No Clinic Cancellations Allowed - Prior to Mandated Make Ups (C - E) 63 (F)
Annual Visits 4,869
Target Hrs for 100% O/P Provider (A * B* 52 weeks) 1,872 (G) Annual wRVUs 9,099
Target Hrs Attended 1,620 (H) wRVU % 74%
Slots Per Session (240 minutes/Shortest Slot Durartion) 16 Annual Charges $966,190
Duration New Slot 30 Annual Payments $434,786
Duration F/Up Slot 15 Collection % 45%
Procedures Per session 5
Established Overbooks 2
wRVU FPSC
25th percentile 5,237
50th percentile 7,112
75th percentile 9,156
minutes used 4 hr session
minutes used 4 hr session
CENTRALIZATION: SETTING STANDARDS
OUTPATIENT EXPECTATIONS - CARDIOLOGIST1
CENTRALIZATION: SETTING STANDARDS
Effort Allocation for Faculty: Year 1 Expectations for Clinical Effort:
Outpatient 40% Target Weekly 4 Attended Clin Equiv.
Inpatient Services 20% Hours Hr Sessions Hours FTE wRVUs
Procedures/US-FNA 20% Outpatient 749 3.60 636 9,703
Teaching 10% Inpatient 416 2.00 416 9,650
Academic 10% Procedures 416 2.00 354 0
Research 0% Total 1,581 7.60 1,406 19,353
Total 100%
UNIVERSITY OF CINCINNATI - FPP
DEPARTMENT OF INTERNAL MEDICINE - CARDIOLGY
Assistant Professor 1 2 3 4 5
FUNDING:
External Funding:
Clinical Revenue 339,619 484,230 569,902 620,053 751,039 $2,764,843
Clinical Trial Revenue - - 50,000 75,000 100,000 $225,000
Total External Funding 339,619 484,230 619,902 695,053 851,039 $2,989,843
System Support
Sustaining Support - 95,146 97,049 98,989 100,969 $392,153
Total Hospital Support - 95,146 97,049 98,989 100,969 $392,153
Department/Division Funding
Division Funds Teaching - 4,500 4,500 4,500 4,500 $18,000
Total IM Funding - 4,500 4,500 4,500 4,500 $18,000
TOTAL FUNDING 339,619 583,876 721,450 798,543 956,509 $3,399,996
METRIC DEFINITION
FILL RATE
ACTUAL SLOTS WHEN A PATIENT IS
SEEN
EXPECTED SLOTS BASED ON
CONTRACTUAL OBLIGATIONS
PROVIDER MONTHLY FILL RATE3
CENTRALIZATION: SETTING STANDARDS
George, F Orthopedics 274%
Mizeres, S Pulmonary 243%Phillips, S Hematology Oncology 172%Shah, M Dermatology 169%Song, C Cardiology 165%
Oncology 21%Ferry, G Women's Health WC 20%Allen, J Oncology 15%Kahn, F Orthopedics 13%Lopez, P Infectious Diseases 8%
Top 5
Bottom 5
**Only physicians with either 200 expected or filled slots were included
Department Physician**
Bottom 5
Top 5
PC Union Centre 40%Psychology 34%PC Redbank 31%Oncology 30%Infectious Diseases 21%
Pain Center 134%Plastic Surgery 119%Bone Marrow 119%Otolaryngology 101%PC Internal Med WCS 99%
Information was presented at Quarterly Chairs Meetings:
PROVIDER MONTHLY FILL RATE - TRANSPARENCY3
CENTRALIZATION: SETTING STANDARDS
FILL RATE – RESULTS3
CENTRALIZATION: DEVELOPING STRATEGIES
71.0%
75.0%76.0% 76.0%
0
50
100
150
200
250
300
350
400
450
500
60%
65%
70%
75%
80%
85%
90%
FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER O
F P
RO
VID
ERS
MEA
SUR
ED
# of Providers Measured Fill Rate
MEASUREMENT DEFINITION
NO SHOW RATE
PATIENTS WHO NO SHOWED
PATIENTS WHO ARRIVED +
CANCELLED WITHIN 24 HOURS + NO
SHOWED
CANCELLATIONS
WITHIN 24
HOURS
PATIENTS WHO CANCELLED WITHIN 24
HOURS
PATIENTS WHO ARRIVED +
CANCELLED WITHIN 24 HOURS + NO
SHOWED
NO SHOWS / 24 HOUR CANCELLATIONS4
CENTRALIZATION: SETTING STANDARDS
How and When??• Upon Scheduling
• 3 Days before appointment
• 2 Days before appointment
• VOICE or TEXT
CENTRALIZATION: DEVELOPING STRATEGIES
4 NO SHOWS / 24 HOUR CANCELS – REMINDER CALLS
CENTRALIZATION: SETTING STANDARDS
4 NO SHOWS / 24 HOUR CANCELLATIONS-
PERFORMANCE
7.0% 6.7% 6.9%7.6%
14.0%13.5%
14.1%13.6%
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
0%
2%
4%
6%
8%
10%
12%
14%
16%
FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER O
F O
UTP
ATI
ENT
VIS
ITS
O/P Visits No Show 24 Hour Cancellation
MEASUREMENT DEFINITION
% NEW PATIENTS
NUMBER OF NEW PATIENTS ARRIVED
PATIENTS WHO ARRIVED +
CANCELLED WITHIN 24 HOURS + NO
SHOWED
% NEW PATIENTS5
CENTRALIZATION: SETTING STANDARDS
% NEW PATIENTS - BENCHMARKING5
CENTRALIZATION: SETTING STANDARDS
Faculty Practice Solutions Center
New Patient Visit
November 2014
MEASURESas values
UC HEALTH
FPSC 25th Percentile
FPSC 50th Percentile
FPSC 75th Percentile
FPSC 90th Percentile
Department of Dermatology Dermatology 31.8% 27.07% 31.64% 35.47% 38.56%
MOHS Surgery 24.26% 14.26% 23.44% 28.08% 40.59%
Department of Medicine
Allergy / Immunology 34.69% 27.69% 32.72% 38.95% 48.32%
Cardiology: Electrophysiology 19.84% 13.98% 18.72% 22.84% 29.01%
Cardiology: Invasive 17.72% 12.87% 15.58% 21.58% 27.74%
Cardiology: Invasive Interventional 17.58% 11.64% 16.61% 21.71% 26.70%
Cardiology: Noninvasive 16.62% 13.64% 15.50% 19.30% 21.68%
Endocrinology / Metabolism 20.39% 17.20% 19.31% 23.14% 27.23%
Gastroenterology 31.99% 26.63% 30.50% 37.03% 41.40%
CENTRALIZATION: SETTING STANDARDS
5 % NEW PATIENTS - PERFORMANCE
19%19%
16%
13% 13%14% 14%
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
0%
5%
10%
15%
20%
25%
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER O
F O
UTP
ATI
ENT
VIS
ITS
Number New Patients O/P Visits % New
METRIC DEFINITION
BUMP RATE
NUMBER OF APPOINTMENTS
TOTAL NUMBER OF APPOINTMENTS
SCHEDULED FOR THE MONTH
BUMP RATE6
CENTRALIZATION: SETTING STANDARDS
CENTRALIZATION: SETTING STANDARDS
BUMP RATE – POLICY IMPLEMENTATION6
BUMP RATE - TRANSPARENCY6
CENTRALIZATION: SETTING STANDARDS
225 of 577 providers had a bump rate of 0%175 providers had a bump rate of over 3%
8,114 Total Patients Bumped
Physicians with the highest bump rates (> 20 patients):
Physician DepartmentPatients Bumped
Percent of Total
Scheduled
On List Q1 FY 14
Gallagher, K Cardiology 34 57.63% XFreer, G Neurology 179 33.00%George, C Digestive 35 22.01% X
Shah, A Hem/Onc 95 20.13% XHelfrich, P P, M & R 59 18.85%Morris, K Surgery 59 17.99%Mathis, B Surgery 36 17.65%Aring, P Neurology 47 17.03%Korning, J Nephrology 61 16.00%
Information was presented at Quarterly Chairs Meetings:
BUMP RATE - RESULTS
CENTRALIZATION: SETTING STANDARDS
5.7%
4.4%4.6%
4.2%
3.5%
0
200000
400000
600000
800000
1000000
1200000
0
0.01
0.02
0.03
0.04
0.05
0.06
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER O
F V
ISIT
S
Bumped Visits O/P Visits Bump Rate
9
NEW PATIENT 3RD NEXT & APPOINTMENT LAG7
CENTRALIZATION: SETTING STANDARDS
METRIC DEFINITION
3RD NEXT
AVAILABLE NEW
PATIENT
APPOINTMENT
AVERAGE LENGTH OF TIME IN DAYS
NETWEEN THE DAY A NEW PATIENT
MAKES A REQUEST FOR AN
APPOINTMENT WITH A PHYSICIAN
AND THE 3RD AVAILABLE
APPOINTMENT FOR A VISIT.
NEW PATIENT
APPOINTMENT
LAG DAYS
AVERAGE LENGTH OF TIME IN DAYS
BETWEEN THE DAY A NEW PATIENT
APPOINTMENT WAS SCHEDULED AND
THE APPOINTMENT DATE.
CENTRALIZATION: SETTING STANDARDS
16
8
5 5 5 5
7
25
23 24
22
18
22
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
0
5
10
15
20
25
30
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER
OF
NE
W A
PP
OIN
TM
EN
TS
3rd Next Available Average Lag Days Average Lag Days Mcaid
7 NEW PATIENT 3RD NEXT & APPOINTMENT LAG -
RESULTS
QUEUE TIME (ASA) / ABANDONNED CALL RATE8
CENTRALIZATION: SETTING STANDARDS
METRIC DEFINITION
QUEUE TIMETHE AVERAGE AMOUNT OF TIME IT
TOOK A CALL TO BE ANSWERED.
ABANDONNED
CALL RATE
CALLS THAT WERE DISCONECTED
BEFORE BEING ANSWERED
ALL CALLS
• REAL TIME monitoring
• QUEUE calls based on agent availability
• FORECAST high volume periods
• RECORD all calls
CENTRALIZATION: DEVELOPING STRATEGIES
QUEUE TIME / ABANDONNED CALLS8
CENTRALIZATION: SETTING STANDARDS
QUEUE TIME / ABANDONNED CALLS – PHONE TREES8
Thank you for choosing UC Health. To help us serve you better, please listen to
the following options:
If this is an emergency, please hang up and call 911.
• If you’re calling to schedule, reschedule or cancel an appointment, please press 1
• If you’re calling for a prescription refill, please press 2Please contact your pharmacy directly for prescription refills. If you are encountering any
issues with refilling a prescription or need a prescription for a controlled substance, please
press 1
• If you’re calling to speak with a member of our medical staff, please press 3
• If you’re calling about medical records, please press 4
• If you’re calling about your bill, please press 5
Again, thank you for choosing UC Health. We look forward to providing all of your health
care needs.
To repeat these options, please press #
CENTRALIZATION: SETTING STANDARDS
QUEUE TIME / ABANDONNED CALLS – RESULTS8
7.29%
6.75%
4.89%
6.67%0:43 0:42
0:31
0:46
0:00
0:09
0:17
0:26
0:35
0:43
0:52
0%
1%
2%
3%
4%
5%
6%
7%
8%
FY 2012 FY 2013 FY 2014 YTD FY 2015
QU
EU
ET
IME
AB
AN
DO
NN
ED
CA
LL
RA
TE
Abandonned Call Rate Queue Time
PATIENT SATISFACTION9
CENTRALIZATION: SETTING STANDARDS
METRIC DEFINITION
SCHEDULING
SATISFACTION
ANSWER TO PRESS GANEY QUESTION
– “”
PROVIDER
SATISFACTION
ANSWER TO PRESS GANEY QUESTION
– “”
PATIENT SATISFACTION (Ease of Scheduling) -
RESULTS
CENTRALIZATION: SETTING STANDARDS
67%
76%
68%
74%
80%
88% 88%
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
60%
65%
70%
75%
80%
85%
90%
95%
100%
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 YTD FY 2015
NU
MB
ER O
F O
UTP
ATI
ENT
VIS
ITS
O/P Visits Ease of Scheduling Ease of Scheduling Goal
9
PATIENT SATISFACTION (Likelihood to refer)
- RESULTS
CENTRALIZATION: SETTING STANDARDS
77%78%
84%83%
86%
89% 89%
81%82% 83%
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
75%
80%
85%
90%
95%
100%
FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 YTD FY 2015
TOTA
L N
UM
BER
OF
VIS
ITS
Likely to Refer Likely to Refer Goal Provider Rating Provider Rating Goal
9
IN THE BEGINNING – WE WERE ….
17 CORPORATIONS INDEPENDANTLY FUNCTIONING AS A PHYSICIAN GROUP
NOW …..
We are