Valleywise Community Health Centers Governing Council Finance … · Chairman Benelli noted...

Valleywise Community Health Centers Governing Council

Finance Committee

Meeting

January 2, 2020 4:30 p.m.

Agenda

Agendas are available within 24 hours of each meeting in the office of the Chief Governance Officer, Valleywise Health Medical Center, 2601 East Roosevelt Street, Phoenix, Arizona 85008, Conference and Administration Center, 2nd Floor, Monday through Friday between the hours of 9:00 a.m. and 4:00 p.m. and on the internet at https://valleywisehealth.org/about/governing-council/. Accommodations for Individuals with disabilities, alternative format materials, sign language interpretation, and assistive listening devices are available upon 72 hours advance notice through the office of the Chief Governance Officer, Valleywise Health Medical Center, 2601 East Roosevelt Street, Phoenix, Arizona 85008, Conference and Administration Center, 2nd Floor, (602) 344-5177. To the extent possible, additional reasonable accommodations will be made available within the time constraints of the request. 12/26/2019 12:06 PM

Valleywise Health Medical Center 2601 East Roosevelt Street Phoenix, Arizona 85008

Conference and Administration Center Auditoriums 1 and 2 Office 602-344-5177

Thursday, January 2, 2020

4:30 p.m. One or more of the members of the Finance Committee may participate telephonically. Committee members participating telephonically will be announced at the meeting. Pursuant to A.R.S. § 38-431.03(A)(3), or any applicable and relevant state or federal law, the Finance Committee may vote to recess into an Executive Session for the purpose of obtaining legal advice from the Finance Committee’s attorney or attorneys on any matter listed on the agenda. The Finance Committee also may wish to discuss any items listed for Executive Session discussion in General Session, or the Finance Committee may wish to take action in General Session on any items listed for discussion in Executive Session. To do so, the Finance Committee will recess Executive Session on any particular item and reconvene General Session to discuss that item or to take action on such item. If you are carrying a cell phone, pager, computer, or other sound device, we ask that you silence it at this time to minimize disruption of the meeting.

AGENDA

Finance Committee of the Valleywise Community Health Centers

Governing Council

Committee Members Terry Benelli, Committee Chair Pedro Cons, Committee Vice Chair Melissa Kotrys, Member Isaac Serna, Member Ryan Winkle, Member Barbara Harding, CEO, FQHC, Non-Voting

Member Rich Mutarelli, CFO, Non-Voting Member

Mission Statement of the Valleywise Community Health Centers Governing Council

Serve the population of Maricopa County with excellent, comprehensive health and wellness in a culturally respectful environment.

2

Call to Order Roll Call Call to the Public This is the time for the public to comment. The Finance Committee may not discuss items that are not specifically identified on the agenda. Therefore, pursuant to A.R.S. § 38-431.01(H), action taken as a result of public comment will be limited to directing staff to study the matter, responding to any criticism or scheduling a matter for further consideration and decision at a later date.

ITEMS MAY BE DISCUSSED IN A DIFFERENT SEQUENCE General Session, Presentation, Discussion and Action: 1. Approval of Consent Agenda: 5 min

Any matter on the Consent Agenda will be removed from the Consent Agenda and discussed as a regular agenda item upon the request of any voting Committee member.

a. Minutes:

i. Approve Finance Committee Meeting Minutes Dated December 4, 2019

_________________________End of Consent Agenda____________________________ 2. Discussion and Possible Action on the Federally Qualified Health Center Clinics Ambulatory

Operational Dashboard – Financial Section 15 min Barbara Harding, Chief Executive Officer, Federally Qualified Health Centers

3. Discuss, Review and Possible Action on the following Finance Committee Reports 10 min

a. Monthly Federally Qualified Health Center Clinics Financials and Payer Mix Claire Agnew, Senior Vice President, Financial Services

4. Chair and Committee Member Closing Comments/Announcements 5 min

Terry Benelli, Committee Chair 5. Review Staff Assignments 5 min

Cassandra Santos, Assistant Clerk Old Business: December 4, 2019 Future agenda item: Review Proforma of the Dental Clinic located at the Valleywise Community Health Center-Avondale in February 2020

Beginning FY 2021: Break out behavioral health services from the Valleywise Community Health Centers financials

Adjourn


Finance Committee

Meeting

January 2, 2020

Item 1.a.i.

December 4, 2019 Meeting Minutes

Voting Members Present: Terry Benelli, Committee Chair

Pedro Cons, Committee Vice Chair Isaac Serna, Member Ryan Winkle, Member – arrived at 4:41 p.m.

Voting Members Absent: Melissa Kotrys, Member Non-Voting Members Barbara Harding, Chief Executive Officer, Federally Qualified Health Present: Center Clinics

Rich Mutarelli, Chief Financial Officer Others/Guest Presenters: Claire Agnew, Senior Vice President, Financial Services

Bob Winovich, Dental Services Manager Dr John Chen, D.D.S., Chairman, Department of Dentistry Melanie Talbot, Chief Governance Officer Recorded by: Cassandra Santos, Assistant Clerk Call to Order Chairman Benelli called the meeting to order at 4:30 p.m. Roll Call Ms. Santos called roll. Following roll call, it was noted that three of the five voting members of the Valleywise Community Health Centers Governing Council’s Finance Committee were present, which represented a quorum. Mr. Winkle arrived shortly after roll call. Call to the Public Chairman Benelli called for public comment. There were no comments from the public.

Minutes

Valleywise Community Health Centers Governing Council Finance Committee

Valleywise Health Medical Center Conference and Administration Center, Auditoriums 1 and 2

December 4, 2019 4:30 p.m.

Valleywise Community Health Centers Governing Council – Finance Committee Meeting Minutes – General Session – December 4, 2019

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General Session, Presentation, Discussion and Action: 1. Approval of Consent Agenda:

a. Minutes:

i. Approve Finance Committee Meeting Minutes Dated November 6, 2019

MOTION: Mr. Serna moved to approve the consent agenda. Vice Chairman Cons seconded. VOTE: 3 Ayes: Chairman Benelli, Vice Chairman Cons, Mr. Serna

0 Nays 2 Absent: Ms. Kotrys, Mr. Winkle Motion passed.

2. Make Recommendations to the Valleywise Community Health Centers Governing Council to

Accept the Maricopa County Special Health Care District’s Annual Audit for the Fiscal Year Ending June 30, 2019, Including Information Related to the Federally Qualified Health Center Look-Alike Clinics

Mr. Mutarelli explained that the Health Resources and Services Administration (HRSA) Compliance Manual; Chapter 19; Board Authority, required the Valleywise Community Health Centers Governing Council (VCHCGC) to regularly monitor the financial status of the Federally Qualified Health Centers (FQHC) Clinics, including the review of the annual audit results and ensure appropriate follow-up action taken, if any. The annual audit for the Fiscal Year (FY) ending June 30, 2019 was conducted by Ernst & Young, as approved by the Maricopa County Special Healthcare District (MC SHCD). The audit included Valleywise Health and the FQHC Clinics. The FQHC Clinics operated under the same license and tax identification number as Valleywise Health, therefore were part of the all-inclusive audit. The audit was completed on a consolidated basis of all operating services within Valleywise Health, therefore there was no distinction made regarding the FQHC Clinics. Testing included but was not limited to the audit of cash receipts, revenue, payroll, accounts payable, claims, and inventory. Mr. Mutarelli said that the audit contained Maricopa Integrated Health System (MIHS) nomenclature, throughout, because in was conducted before the name change. He stated that the audit was reviewed and accepted by the MC SHCD Board of Directors at their November 2019 meeting. Mr. Mutarelli gave a brief overview of the auditor’s opinion, which stated there were no concerns, no issues relating to material weaknesses within internal control, and no discrepancies relating to management function, and no difficulties encountered during the audit. A misstatement, relating to the recognition of investments at fair market value, however, it was quickly corrected. In addition, there was one un-corrected misstatement, pertaining to immaterial understatement of revenue. Chairman Benelli commented that she noticed while net assets continued to increase annually, operating loss was shown every year.


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General Session, Presentation, Discussion and Action, cont.: 2. Make Recommendations to the Valleywise Community Health Centers Governing Council to

Accept the Maricopa County Special Health Care District’s Annual Audit for the Fiscal Year Ending June 30, 2019, Including Information Related to the Federally Qualified Health Center Look-Alike Clinics, cont.

Mr. Mutarelli said that it was largely in part due to the April 2019 openings of the Valleywise Emergency-Maryvale and Valleywise Behavioral Health Center-Maryvale, which resulted in the addition of over 400 Full Time Equivalents (FTEs) and other associated cost. MOTION: Vice Chairman Cons moved to make recommendations to the Valleywise Community

Health Centers Governing Council to accept the Maricopa County Special Health Care District’s annual audit for the fiscal year ending June 30, 2019, including information related to the Federally Qualified Health Center Look-Alike Clinics. Mr. Serna seconded.

VOTE: 3 Ayes: Chairman Benelli, Vice Chairman Cons, Mr. Serna

0 Nays 2 Absent: Ms. Kotrys, Mr. Winkle Motion passed.

3. Discussion and Possible Action on the Federally Qualified Health Center Clinics Ambulatory

Operational Dashboard – Financial Section Ms. Harding reviewed actual visits compared to budget for fiscal-year-to-date (FYTD) as of October 2019 for select Valleywise Community Health Centers. She said that visits at the Valleywise Community Health Centers-Avondale, El Mirage, Glendale, Guadalupe, Mesa, maintained positive variances above target and indicated consistent improvement. Current challenges existed with the Valleywise Community Health Centers-Chandler and Maryvale, for with negative variances of within five percent less than the target. Valleywise Community Health Centers-McDowell, 7th Avenue, South Central, and Sunnyslope had a negative variances for actual visits compared to budget. She reviewed actual visits compared to budget for clinics located at the Valleywise Comprehensive Health Center-Phoenix. Visits at the Pediatric Primary Care Clinic had a 1.2% negative variance. The Internal Medicine Clinic had a positive variance of 1.1 percent. The Women’s Clinic had a negative 16.5% variance and the Antepartum Testing Service Line had negative 10.6% negative variance. NOTE: Mr. Winkle arrived. Ms. Harding reviewed visits for select clinics, month-to-date (MTD). She pointed out that the Women’s Clinic located at the Valleywise Comprehensive Health Center-Phoenix had a negative 17% variance. An error was uncovered pertaining to the Women’s Clinic located at the Valleywise Comprehensive Health Center-Phoenix regarding the number of provider positions actually held at the clinic. An additional Nurse Practitioner (NP) position, which did not exist, was inadvertently counted when the budget was created. She noted that the error would continue to result in a higher negative variance of actual visits compared to budget for the remainder of the fiscal year. The Antepartum testing service line located at the Valleywise Comprehensive Health Center-Phoenix had a negative 20.5% variance, attributed to inadequate staffing coverage.


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General Session, Presentation, Discussion and Action, cont.: 3. Discussion and Possible Action on the Federally Qualified Health Center Clinics Ambulatory

Operational Dashboard – Financial Section, cont. Chairman Benelli noted improvement was shown at the Valleywise Community Health Center-McDowell. Ms. Harding agreed but there was still room for improvement and challenges still existed. Ms. Harding said that that there were over 678 influenza vaccinations given out during the Curbside Care, the campaign. She said that each case of an influenza vaccine given was disbursed toward the participating clinic and likely a contributor to an increase in visits. She pointed out that the Valleywise Community Health Center-7th Avenue continued to indicate negative variances, pertaining to visits compared to actual budget, on a monthly basis. This was likely attributed to an over aggressive prediction of patient migration from the now closed 7th Avenue Walk-In Clinic. Chairman Benelli asked whether that was a guess or based on actual figures. Ms. Harding said that the number of patients projected to migrate from the 7th Avenue Walk-In Clinic to the Valleywise Community Health Center-7th Avenue was negatively assumed. Chairman Benelli commented that there were potential learning lessons to gain. Ms. Harding mentioned she would not review details about visits to the Dental Clinics located at the Valleywise Community Health Centers and the Valleywise Comprehensive Health Center-Phoenix, however, she said that the dental clinics had a negative variance of 2.3 percent FYTD overall. Behavioral health services visits had a FYTD positive variance of 22.5 percent. Overall, the FQHC Clinic visits had a negative variance of 2.8%, FYTD, as of October 2019. Referring to ambulatory network specialty services referrals, Ms. Harding said that challenges existed in relation to keepage opportunities. She said that she and Dr. Lopez were working with process flow work groups to address ways to increase keepage opportunities. Ms. Harding also mentioned that the Ambulatory Operational Dashboard was currently under evaluation and there may be changes on reported measures. She said that she would soon update the committee about potential changes in reporting style and would ask for valuable feedback at that time. 4. Discuss, Review and Possible Action on the following Finance Committee Reports

a. Monthly Federally Qualified Health Center Clinics Financials and Payer Mix b. Quarterly Valleywise Community Health Centers Governing Council Expenditures

Compared to Budget c. Quarterly Federally Qualified Health Center Clinics Routine Capital Purchases Report d. Quarterly Federally Qualified Health Center Clinics Care Reimagined Capital Purchases

Report Ms. Agnew reviewed MTD financials as of October 2019. Actual visits to the Valleywise Community Health Centers including behavioral health service visits met budget, with a positive variance of two percent. Behavioral health service visits were better than expected, however, the deficit was present within the Valleywise Community Health Centers.


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General Session, Presentation, Discussion and Action, cont.: 4. Discuss, Review and Possible Action on the following Finance Committee, cont. Total operating revenues were five percent less than budget and total operating expenses were over budget by two percent. Other operating revenue had a negative variance of 34% due to grant program FTE position vacancies at the Valleywise Community Health Center-McDowell. Ms. Agnew noted that contract labor costs had a 74% negative variance which was attributed to a large part of contract labor coverage needed within the scheduling department at the Patient Assistance Center (PAC). Medical service fees expenses were better than budget with a 15% positive variance. Ms. Agnew explained that supplies were over budget, due to an overage of pharmaceutical expenses. Influenza vaccines were purchased from a different vendor for FY 2020, and that the purchase rate was not accounted for correctly, also attributing to the higher than usual supply expense. Purchase service fees exceeded budget due to consulting fees related to the New Access Point (NAP) application. She added that the expense would eventually be offset, by the NAP funding received. Salaries and wages and employee benefits were better than budget with a positive variance of four percent. Ms. Agnew stated that total operating expenses were better than budget, by two percent. Ms. Talbot asked whether the curbside care campaign events counted toward visits for the Valleywise Community Health Centers. Ms. Agnew said that was true. She went on to point out the that total operating expenses had a margin before overhead allocation had a negative variance of $127,835. Ms. Agnew pointed out that visits at the Valleywise Comprehensive Health Center-Phoenix did not meet budget by 12 percent. She said that it was largely due to the Women’s Clinic and Antepartum Testing service line located at the Valleywise Comprehensive Health Center-Phoenix, and their struggle to reach volume targets, although other clinics also faced challenges. Total operating revenues were ten percent lower than expected, while total operating expenses were less than budget by 12 percent. She pointed out that supplies were better than budget, due to an adjustment that was posted from the Valleywise Health pharmacy to the Pediatric Primary Care Clinic located at the Valleywise Comprehensive Health Center-Phoenix. Total operating expenses were better than budget, by 12 percent with a margin before overhead allocation had a positive variance of $16,366. Ms. Agnew said that visits at the FQHC Dental Clinics had a negative variance of five percent. Total operating revenue did not meet budget, while total operating expenses had a positive variance of four percent, even though purchase services exceeded budget. The margin before overhead allocation had a negative variance of negative $49,879.


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General Session, Presentation, Discussion and Action, cont.: 4. Discuss, Review and Possible Action on the following Finance Committee, cont. For all clinics combined, total overall visits were below budget by two percent and total operating revenues had a negative variance of seven percent. Total operating expenses exceeded budget with a negative variance of five percent. The margin before overhead allocation had a negative variance of $161,339. Pertaining to a Year to Date (YTD) analysis, Ms. Agnew reported that for all clinics combined, visits were under budget by three percent. Total operating revenues were less than budget, with a negative six percent variance, while total operating expenses had a positive one percent variance, better than budget. The margin before overhead allocation was negative $979,566. Referencing the FQHC Clinics visits by payor, Ms. Agnew said that a six-month trend indicated a very slight decrease for Medicaid insurance payments from 48.8% in September 2019, compared to 48.6% in October 2019. She noted a minor increase in self-pay payments from 25.8% in September 2019 to 25.9% in October 2019. A four-year payor mix trend did not show significant change FYTD as of October 2019, compared to FY 2018, but noted the slight decrease in Medicaid insurance payments and self-pay payments as well. Chairman Benelli noticed a decrease in the commercial insurance payments but noted that payments from that source were higher payment amounts, for the most part. Ms. Agnew said that was a correct statement. Ms. Agnew reviewed VCHCGC’s actual expenses compared to budget for the FYTD as of October and noted that the budget was positive by 371.00 dollars. She pointed out that that travel reimbursement costs from the National Association of Community Health Centers (NACHC) conference September and spoke about a $4,400 total cost for audio visual (AV) Equipment, of which half would be a VCHCGC expense. In relation to actual visits to the Valleywise Community Health Centers, Vice Chairman Cons asked if behavioral health services would eventually break out into its own and separate financial report. Ms. Agnew said that if the committee requested a separate report, that could be obliged. Vice Chairman Cons suggested that the break out take affect beginning FY 2021. Ms. Agnew made note of the request. With respect to routine capital, Ms. Agnew highlighted purchase of replacement of ambulatory tablets pertaining to the FQHC Clinics, however, there were no other notable changes to report. Pertaining to Care Reimagined capital purchases, Ms. Agnew stated that there were no changes to report.

She added that the report only represented the first trench of Care Reimagined project costs. 5. Discuss the Future of Dental Services at the Federally Qualified Health Center Clinics Valleywise Dr. Chen explained that significant disparities existed in the receipt of dental health and oral health care services, nationwide. He explained that oral health was directly correlated to a patients overall medical and systemic health.


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General Session, Presentation, Discussion and Action, cont.: 5. Discuss the Future of Dental Services at the Federally Qualified Health Center Clinics Valleywise,

cont. Studies suggested that oral bacteria and inflammation associated with forms of gum disease played a role in a patients overall general medical health. There were many conditions and disease that could be linked to oral health. He gave a brief over view of the history of the linkage between medicine and dentistry. He explained the evolution of medicine and the stages of its critical connection to dentistry and oral health. He spoke about the father of modern dentistry, a French physician named Pierre Fauchard, and his impact on the world of oral health. Dr. Chen spoke about the differences of medical health care insurance coverage compared to dental and oral health care insurance coverage. He pointed out the importance of integrating medical health care and oral health care. He said that Maricopa County was the fifth largest city in the United States and that the at-risk and vulnerable patient population’s oral health needs were largely unmet. Dental residency programs were critical. He spoke briefly about how challenging it was to recruit dentists. Mr. Winovich presented a list of Dental Clinics located at the Valleywise Community Health Centers-Avondale, Mesa, McDowell, South Central, and Chandler. There was also a Dental Clinic located at the Valleywise Comprehensive Health Center-Phoenix. He reviewed visits of all dental clinics combined compared to actual budget from FY 2018 through FYTD as of October 2020. He pointed out new revenue and actual budget comparisons for the same time frame. FYTD 2020 had revenues of $1,570,550 in comparison to FY 2019 with a total revenue of $1,655,171. Comparisons indicated some areas of positive trending, but challenges still existed pertaining to visits and net revenues.

Dr. Chen added that coverage challenges also were due to New York University Lutheran Medical Center officially terminating the Valleywise Health dental residency and pediatric primary care programs.

Mr. Winovich added that the main contributing factors for low volumes were unplanned and uncovered provider sessions, planned paid time off (PTO), and unexpected military training leave.

Other barriers to the achievement of volume goals were provider illness, family emergencies, maternity leave, reduced full time hours to part-time hours, unexpected affiliated training agreement terminations, and a limited availability of qualified dental provider candidates to recruit.

Mr. Winovich gave highlighted short-term dental clinic closure mitigation strategies, which included various resource outlets and challenges. He explained that job openings for the recruitment of dental providers and hygienists were posted on the throughout the year. He mentioned that two new dental hygienists were recently hired, which attributed to seven total additional visits per day overall. He gave a list of issues that would prevent dental clinic closures including the challenge to recruit dental providers and dental hygienists due to the highly competitive market, mostly pertaining to compensation.


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cont. Long term strategies, which aligned with Care Reimagined initiatives, included a proforma of the Dental Clinic located at the Valleywise Community Health Center-Avondale. He explained that consultants recommended the closure of that particular dental clinic, yet a proforma would potentially indicate the need to keep the dental clinic at that location open. Active recruitment and hiring for dental providers and dental hygienists for the Valleywise Comprehensive Health Center-Peoria were ongoing. The evaluation of the number of operatories at the Dental Clinic located at the Valleywise Community Health Center-Mesa were monitored. Chairman Benelli asked what an operatory was. Mr. Winovich said that it was a dental exam room. He went on the describe various opportunities that would possibility prevent dental clinic closures. He reiterated that the New York University Lutheran Medical Center terminated the Valleywise Health dental residency and pediatric primary care programs and the dental clinics that were negatively impacted. Maximizing the opportunity associated with new alliances such as the Delta Dental Network of Arizona and others.

Mr. Winovich mentioned that the Arizona Alliance for Community Health Centers (AACHC) initiated a lawsuit pertaining to AHCCCS adult dental coverage. If the AACHC prevailed it would positively impact Valleywise Health reimbursable dental services in the future.

Vice Chairman Cons said that the State of Arizona recently approved the practice of dental therapists, which was a new class of dental care provision, under the oversight of a dental provider, intended to increase access in underserved or unserved area. He asked whether dental schools have begun to enroll dental therapists and if so, would Valleywise Health be able accept a dental therapist training in the residency program.

Dr. Chen said that was a possibly, however the educational requirement was intense.

Ms. Harding said that United Healthcare was the only entity that paid for dental therapist services currently. Ms. Harding said that within the coming months, evaluations and decisions would be made about future dental clinic moves and closures. Vice Chairman Cons asked when the proforma of the Dental Clinic located at the Valleywise Community Health Center-Avondale would be completed. Ms. Harding said that it would be completed by February 2020. Vice Chairman Cons asked if there was idea of the potential loss of visits if the Dental Clinic located at the Valleywise Community Health Center-Avondale moved its services to the Valleywise Comprehensive Health Center-Peoria. Ms. Harding said that ongoing random survey questionnaires were given to patients at the Dental Clinic located at the Valleywise Community Health Center-Avondale inquiring whether patients were likely to utilize services at the Dental Clinic located at the Valleywise Comprehensive Health Center-Peoria. She said that most responses were no.


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cont. Ms. Talbot asked if the proforma review should be placed on the February 2020 Finance Committee agenda. Ms. Harding said to add the item to the agenda. Chairman Benelli reminded the committee and staff to be cognizant how much time it would potentially take to review and discuss the proforma. Ms. Talbot said that it the committee agreed, the February 2020 meeting could begin at 4:00 p.m. to allow more time. The committee agreed. 6. Chair and Committee Member Closing Comments/Announcements

There were no closing comments or announcements. 7. Review Staff Assignments Ms. Santos reviewed staff assignments and reiterated outstanding old business. Adjourn MOTION: Mr. Winkle moved to adjourn the December 4, 2019 Finance Committee meeting.

Mr. Serna seconded. VOTE: 4 Ayes: Chairman Benelli, Vice Chairman Cons, Mr. Serna, Mr. Winkle

0 Nays 1 Absent: Ms. Kotrys Motion passed.

Meeting adjourned at 5:38 p.m. ______________________________ Cassandra Santos, Assistant Clerk


Finance Committee

Meeting

January 2, 2020

Item 2.

Ambulatory Dashboard Financial Section

*** ***

Avondale Chandler El Mirage Glendale Guadalupe Maryvale McDowell Mesa 7th Ave

S. Central

Phoenix Sunnyslope VCHCs Overall FYTDWomen's

Clinic

Antepartum

TestingDiabetes Ed

Internal

Medicine PPeds Primary

Other FQHC

Total

Other FQHC

FYTD

Grand Total

FQHCFYTD FQHC

10,572 7,794 5,460 7,883 3,700 8,533 7,064 7,196 9,813 7,070 6,625 81,710 9,288 3,170 345 5,592 7,944 26,339 120,343

10,181 7,953 4,795 7,809 3,238 8,829 7,740 6,672 10,743 8,443 7,034 83,437 11,037 3,604 0 5,670 8,031 28,342 123,912

391 (159) 665 74 462 (296) (676) 524 (930) (1,373) (409) (1,727) (1,749) (434) 345 (78) (87) (2,003) (3,569)

3.8% -2.0% 13.9% 0.9% 14.3% -3.4% -8.7% 7.9% -8.7% -16.3% -5.8% -2.1% -15.8% -12.0% -1.4% -1.1% -7.1% -2.9%

1,904 1,390 1,045 1,394 606 1,585 1,304 1,358 1,774 1,215 1,300 14,875 1,666 510 57 1,018 1,506 4,757 21,949

1,944 1,440 834 1,397 543 1,617 1,393 1,284 1,976 1,581 1,260 15,269 1,904 629 0 1,148 1,515 5,196 22,659

(40) (50) 211 (3) 63 (32) (89) 74 (202) (366) 40 (394) (238) (119) 57 (130) (9) (439) (710)

-2.1% -3.5% 25.3% -0.2% 11.6% -2.0% -6.4% 5.8% -10.2% -23.1% 3.2% -2.6% -12.5% -18.9% -11.3% -0.6% -8.4% -3.1%

1,602 1,321 996 1,315 548 1,361 1,152 1,263 1,648 1,148 1,228 13,582 76,708 1,568 996 1,390 3,954 21,878 17,536

7.93 7.89 6.07 7.24 6.44 7.15 4.40 6.29 7.27 7.35 7.73 6.83 6.83 8.23 6.99 7.88 7.76 7.76 7.02

8.31 7.24 6.99 6.72 6.41 6.82 4.15 6.85 6.01 5.96 7.00 6.46 6.72 8.04 7.09 8.32 7.87 7.64 6.73

230.32 177.30 130.22 172.11 76.75 203.26 296.50 184.50 262.29 193.93 161.10 2,088.29 11,914.77 218.86 162.54 179.97 561.37 3,202.89 2,649.66

192.70 182.50 142.50 195.70 85.50 199.65 277.50 184.50 274.25 192.51 175.40 2,102.71 11,419.91 195.00 140.50 167.00 502.50 2,864.69 2,605.21

(37.62) 5.20 12.28 23.59 8.75 (3.61) (19.00) (0.00) 11.96 (1.42) 14.30 14.42 (494.87) (23.86) (22.04) (12.97) (58.87) (338.20) (44.45)

(1.16) 0.16 0.38 0.73 0.27 (0.11) (0.59) (0.00) 0.37 (0.04) 0.44 0.44 (2.67) (0.73) (0.68) (0.40) (1.81) (1.83) (1.37)

8.06 7.43 6.86 7.13 6.44 6.98 4.50 6.86 6.49 6.72 6.95 6.72 7.61 7.50 7.78 7.64 6.90

1,314.12 1,011.59 742.97 981.98 437.92 1,159.68 1,691.70 1,052.67 1,496.49 1,106.49 919.17 11,914.77 1,248.71 927.35 1,026.84 3,202.89 15,117.67

1,206.29 1,007.23 769.41 1,048.43 528.75 1,110.25 1,375.39 1,001.75 1,450.13 994.57 927.71 11,419.91 1,151.00 741.69 972.00 2,864.69 14,284.60

(107.83) (4.36) 26.44 66.45 90.83 (49.43) (316.32) (50.92) (46.36) (111.92) 8.54 (494.87) (97.71) (185.66) (54.84) (338.20) (833.07)

(0.58) (0.02) 0.14 0.36 0.49 (0.27) (1.71) (0.27) (0.25) (0.60) 0.05 (2.67) (0.53) (1.00) (0.30) (1.83) (4.50)

*100%-115% 127.9% 136.4% 117.8% 126.3% 111.7% 129.3% 148.7% 142.3% 114.1% 105.9% 107.1% 125.5% 119.3% 109.2% 97.1% 111.6% 105.5% 107.2%

Target Avondale Maryvale Mesa 7th Ave Total FYTD

344 359 675 386 1,764

241 361 482 241 1,325

103 (2) 193 145 439

42.7% -0.6% 40.0% 60.2% 33.1%

100 99 176 92 467

48 73 97 48 266

52 26 79 44 201

108.3% 35.6% 81.4% 91.7% 75.6%

Avondale Chandler McDowell Mesa

S. Central

Phoenix Dental Total Dental FYTD PXC

955 958 2,107 1,065 664 10,530 4,781

1,211 970 1,966 1,074 928 10,808 4,659

-256 -12 141 -9 -264 -278 122

-21.1% -1.2% 7.2% -0.8% -28.4% -2.6% 2.6%

211 177 332 199 154 1,850 777

238 152 355 190 171 1,928 822

-27 25 -23 9 -17 -78 -45

-11.3% 16.4% -6.5% 4.7% -9.9% -4.0% -5.5%

100% 101.1% 110.5% 103.2% 102.7% 101.8% 108.9%

Actual Visits MTD

Valleywise Health Productivity

Budget Visits MTD

Variance by % MTD

Actual Visits FYTD

% Variance MTD

Variance MTD

Budget Visits MTD

Actual Visits MTD

Variance MTD

Dental - Ambulatory

Finance

Variance by % MTD

Total Number of Patients seen by providerOverall Expected Productivity

(Pt visits by provider per session)

Average Pt visits by provider per session MTD

Sessions Worked MTD

Sessions Variance MTD

Sessions Variance FYTD

FTE Variance MTD

Average Pt visits by provider per session YTD

FTE Variance YTD

Valleywise Health Productivity %

Sessions Budgeted YTD

Sessions Budgeted MTD

Sessions Worked YTD

FINANCE - Ambulatory

Actual Visits (includes Nurse Only Visits) MTD

Budgeted Visits MTD

Actual Visits (includes Nurse Only Visits) FYTD

Variance MTD

Budgeted Visits FYTD

Variance FYTD

Variance by % FYTD

Other FQHC Clinics

Ambulatory Pillars Dashboard November 2019

Community Health Centers

Behavioral Health- Ambulatory

Actual Visits FYTD

Budget Visits FYTD

Budget Visits FYTD

Finance

Variance FYTD

% Variance FYTD

Variance by % FYTD

Variance FYTD

Last Revised Date: 12/16/19 Page 1

Avondale Chandler El Mirage Glendale Guadalupe Maryvale McDowell Mesa 7th Ave

S. Central

Phoenix Sunnyslope VCHCs Overall Prior 12 monthsWomen's

Clinic

Antepartum

TestingDiabetes Ed

Internal

Medicine PPeds Primary

Other FQHC

Total

11 81 80 10 3 1 11 47 7 5 9 265 3,974 5 0 0 2 0 7

3.0% 21.3% 21.9% 3.8% 2.2% 0.8% 7.4% 12.1% 3.5% 1.5% 2.4% 8.6% 11.7% 1.0% 0.0% 0.0% 0.4% 0.0% 0.6%

67 48 64 33 24 56 345 40 44 35 38 794 4,303 87 2 0 24 49 162

1.4% 1.9% 2.6% 0.9% 2.4% 3.6% 4.1% 1.2% 1.4% 1.7% 1.4% 2.2% 1.1% 3.9% 2.2% 0.0% 1.4% 6.4% 3.4%

2,733 1,954 2,150 2,132 832 599 3,536 1,256 2,278 1,441 1,585 20,496 261,950 284 13 0 1,379 343 2,019

64.5% 59.8% 87.2% 51.3% 82.5% 80.4% 97.7% 46.2% 63.2% 52.9% 58.7% 65.6% 66.7% 43.2% 17.3% 0.0% 46.4% 52.7% 46.4%

482 526 461 378 122 107 164 293 200 0 227 2,960 42,034 12 0 0 96 65 173

61.4% 72.5% 79.6% 43.4% 50.6% 49.8% 37.0% 45.9% 30.6% 0.0% 47.2% 48.6% 50.9% 6.9% 0.0% 0.0% 16.8% 34.9% 18.5%

3,293 2,609 2,755 2,553 981 763 4,056 1,636 2,529 1,481 1,859 24,515 312,261 388 15 0 1,501 457 2,361

32.2% 37.8% 46.9% 28.8% 41.4% 28.7% 31.9% 23.2% 33.1% 26.9% 29.3% 32.2% 34.1% 10.9% 6.9% 0.0% 25.8% 28.3% 21.1%

LEGEND:

Out of Variance/Not in Target ** Includes all Community Health Centers, PXC Internal Medicine, PXC Women's, PXC Antepartum Testing, PXC Peds5% less than the target * Productivity: Departments above 115% are consider over productiveTarget *** Grand Total FQHC and FYTD FQHC includes Community Health Centers, Other FQHC, Dental, and OP Behavioral Health Clinics

Ambulatory Pillars Dashboard November 2019

Keepage Opportunity

GROWTH - Ambulatory

Percent of Total Outgoing Referrals

Outgoing Referrals-Radiology/Imaging

Outgoing Referrals-Pharmacy

Outgoing Pharmacy % of Total

Outgoing Referrals-Specialty/OP

Outgoing Specialty/OP % of Total

Total Outgoing Referrals

Outgoing Referrals-Laboratory

Outgoing Laboratory % of Total

Outgoing Radiology/imaging % of Total

Last Revised Date: 12/16/19 Page 2

Data Source Owner Frequency System

All visits per Clinic (visit count methodology) same for Other FQHCs,

BH clinic, and Dental Amanda Jacobs Monthly Axiom

All budgeted visits per Clinic (visit count methodology) same for

Other FQHCs, BH clinic, and Dental Amanda Jacobs Monthly Axiom

Actual Visits FYTD (includes nurse only visits) - Budgeted Visits FYTDAmanda Jacobs Monthly Formula

Variance FYTD / Budgeted Visits FYTD (%) Amanda Jacobs Monthly Formula

Actual Visits (all visits per Valleywise Health month end visit count

methodology) Amanda Jacobs Monthly Axiom

Budgeted Visits (all visits per Valleywise Health month end visit

count methodology) Amanda Jacobs Monthly Axiom

Actual Visits MTD (includes nurse only visits) - Budgeted Visits MTDAmanda Jacobs Monthly Formula

Variance MTD / Budgeted Visits MTD (%) Amanda Jacobs Monthly Formula

Includes Month Totals from Community Health Centers, Dental,

Other FQHC, and OP Behavioral Health clinics Maria Aguirre Monthly Formula

Includes YTD Totals from Community Health Centers, Dental, Other

FQHC, and OP Behavioral Health clinics Maria Aguirre Monthly Formula

Closed Appointments by Provider Maria Aguirre Monthly Epic - Clarity Query

FY2020 budget – Total Number of Patients seen by provider /

Sessions Worked (by Clinic, by Specialty, per FTE)Maria Aguirre Monthly McKesson/ Excel

Total Number of Patients seen by provider / Sessions Worked Maria Aguirre Monthly Formula

Budgeted FTEs * Session Days for the month (Working days less

Holidays, Less GME Accrual, Less PTO Accrual) Maria Aguirre Monthly Formula

Amion System Calendar that is Signed by Manager and Medical

Director and report sent to Finance for Reconciliation

Ambulatory Site / Andra

Anderson Monthly Amion/ Manual

Sessions Worked – Sessions Budgeted

For the current month Maria Aguirre Monthly Formula


For the current month Maria Aguirre Monthly Formula

Budgeted FTEs * Session Days for YTD (Working days less Holidays,

Less GME Accrual, Less PTO Accrual) Maria Aguirre Monthly Formula

Amion System Calendar that is Signed by Manager and Medical

Director and report sent to Finance for Reconciliation

Ambulatory Site / Andra

Anderson Monthly Amion/ Manual


For the Fiscal Year to Date Maria Aguirre Monthly Formula

Sessions Worked YTD – Sessions Budgeted YTD Maria Aguirre Monthly Formula

Kronos Report (Data is for a monthly period) Amanda Jacobs Monthly Kronos

Ambulatory Pillars Dashboard Data Dictionary

Federally Qualified Health Centers

FINANCE - Ambulatory

Actual Visits (includes nurse only visits) FYTD


Variance FYTD

Variance by % FYTD

Actual Visits (includes nurse only visits) MTD

Budgeted Visits MTD

Variance MTD

Variance by % MTD

Grand Total FQHC

FYTD FQHC

Total Number of Patients seen by provider

Overall Expected Productivity (Pt visits by provider per session)

Average Pt visits by provider per session

Sessions Budgeted MTD

Sessions Worked MYD

Session Variance MTD

FTE Variance MTD

Sessions Budgeted YTD

Sessions Worked YTD

Session Variance YTD

FTE Variance YTD


Page 3




FINANCE - AmbulatoryAll visits per Clinic (visit count methodology) same for Other FQHCs,








Actual Visits (includes nurse only visits) - Budgeted Visits Amanda Jacobs Monthly Formula

All visits per Clinic (visit count methodology) same for Other FQHCs,




Actual Visits FYTD (includes nurse only visits) - FYTD Budgeted Visits Amanda Jacobs Monthly Formula

Variance FYTD/ Budgeted Visits FYTD (%) Amanda Jacobs Monthly Formula





Actual Visits MTD (includes nurse only visits) - Budgeted Visits MTD Amanda Jacobs Monthly Formula

Variance MTD / Budgeted Visits MTD (%) Amanda Jacobs Monthly Formula

Kronos Report (Data is for a monthly period)Amanda Jacobs Monthly Kronos

FINANCE - BEHAVIORAL HEALTH

Actual Visits FYTD


Actual Visits MTD

Budgeted Visits MTD

Variance

FINANCE-DENTAL

Actual Visits FYTD


Variance FYTD

Variance by % FYTD

Actual Visits MTD

Budgeted Visits MTD

Variance MTD

Variance by % MTD


Page 4




FINANCE - AmbulatoryGROWTH - Ambulatory

Clarity Data

Radiology:

Data is extracted from Epic Clarity data tables “REFERRAL” and

“ORDER_PROC” where:

The Referral Status field is not equal to “Cancelled”

The Order Type field is equal to “Imaging”

Internal Referral: The Order Class field is equal to “Internal’

Outgoing Referral: The Order Class field is equal to “Outgoing” Sandra Delaney Monthly EPIC Clarity

Clarity Data Sandra Delaney Monthly EPIC Clarity

Clarity Data

LAB ORDERS:

Data is extracted from Epic Clarity data table “ORDER_PROC” where:


The Order Type field is equal to “Lab” or “Pathology”

Internal Referral: The RESULTING_LAB field is equal to “MIHS LAB”

or “LAB_CHG_TRG_YN” field is equal to “Y”.

Outgoing Referral: The RESULTING_LAB field is not equal to a MIHS

LAB “Outgoing” and “LAB_CHG_TRG_YN” field is not equal to “Y”. Sandra Delaney Monthly EPIC Clarity


Clarity Data

RX Scripts:

Data is extracted from Epic Clarity data table “ORDER_MED” where:

The Order Status is not equal to “Cancelled” or “Suspend”

Internal Scripts: The Pharmacy Name field is equal to an MIHS

pharmacy

Outgoing Scripts: The Pharmacy Name field is not equal to an MIHS

pharmacy. Sandra Delaney Monthly EPIC Clarity


Clarity Data

OP Referrals:

Data is extracted from Epic Clarity data tables “REFERRAL” and

“ORDER_PROC” where:


The Order Type field is equal to “Outpatient Referral”

Internal Referral: The Order Class field is equal to “Internal’

Outgoing Referral: The Order Class field is equal to “Outgoing” Sandra Delaney Monthly EPIC Clarity

Clarity Data Sandra Delaney Monthly EPIC ClaritySum of all outgoing referrals (Radiology/Imaging, Laboratory,

Pharmacy, Specialty/OP) for the month Sandra Delaney Monthly EPIC Clarity

Total Outgoing Referrals for month/Total Internal Referrals for the

month (%) Sandra Delaney Monthly EPIC Clarity

Kee

pag

e O

pp

ort

un

ity

Outgoing Referrals-Radiology/Imaging

Radiology/imaging % of Total

Outgoing Referrals-Laboratory

Laboratory % of Total

Outgoing Referrals-Pharmacy

Pharmacy % of Total

Outgoing Referrals-Specialty/OP

Specialty/OP % of Total

Total Outgoing Referrals

Percent of Total Outgoing Referrals

Page 5

Productive Days

Prior Year Prior Month Prior YTD

NOV FY 2019 OCT FY 2020 NOV FY 2020 Variance NOV FY 2019 NOV FY 2020 Variance

Actual Actual Actual Budget (Unfavorable) % Actual Actual Budget (Unfavorable) %

VCHC Clinics

FQHC CLINIC - SOUTH CENTRAL PHOENIX 1,334 1,576 1,215 1,581 (366) (23%) 7,282 7,070 8,443 (1,373) (16%)

FQHC CLINIC - 7TH AVENUE 1,247 2,057 1,774 1,976 (202) (10%) 6,820 9,813 10,743 (930) (9%)

FQHC CLINIC - AVONDALE 2,055 2,143 1,904 1,944 (40) (2%) 10,886 10,572 10,181 391 4%

FQHC CLINIC - MARYVALE 1,650 1,882 1,585 1,617 (32) (2%) 8,497 8,533 8,829 (296) (3%)

FQHC CLINIC - GLENDALE 1,369 1,846 1,394 1,397 (3) (0%) 7,821 7,883 7,809 74 1%

FQHC CLINIC - EL MIRAGE 1,114 1,269 1,045 834 211 25% 5,789 5,460 4,795 665 14%

FQHC CLINIC - MESA 1,334 1,654 1,358 1,284 74 6% 6,416 7,196 6,672 524 8%

FQHC CLINIC - CHANDLER 1,529 1,690 1,390 1,440 (50) (3%) 8,365 7,794 7,953 (159) (2%)

FQHC CLINIC - GUADALUPE 692 756 606 543 63 12% 3,641 3,700 3,238 462 14%

FQHC CLINIC - SUNNYSLOPE 1,353 1,407 1,300 1,260 40 3% 7,277 6,625 7,034 (409) (6%)

FQHC CLINIC - MCDOWELL 1,108 1,632 1,304 1,393 (89) (6%) 5,870 7,064 7,740 (676) (9%)

Total 14,785 17,912 14,875 15,269 (394) (3%) 78,664 81,710 83,437 (1,727) (2%)

OP BH Clinics

BH FQHC - 7TH AVENUE 21 82 92 48 44 92% 21 386 241 145 60%

BH FQHC - AVONDALE 8 105 100 48 52 108% 8 344 241 103 43%

BH FQHC - MARYVALE 7 98 99 73 26 36% 37 359 361 (2) (1%)

BH FQHC - MESA 10 137 176 97 79 81% 10 675 482 193 40%

Total 46 422 467 266 201 76% 76 1,764 1,325 439 33%

WHH Clinics

FQHC WHH CLINIC - POCN COMUNIDAD - - - - - - 242 - - - -

Total - - - - - - 242 - - - -

VCHC - Phoenix Clinics

FQHC MARICOPA WOMENS CARE - PHOENIX 1,723 2,046 1,666 1,904 (238) (13%) 9,394 9,288 11,037 (1,749) (16%)

FQHC ANTEPARTUM TESTING - PHOENIX 676 579 510 629 (119) (19%) 3,675 3,170 3,604 (434) (12%)

FQHC DIABETES OUTREACH CLINIC - PHOENIX 221 44 57 - 57 - 1,315 345 - 345 -

FQHC PEDIATRIC CLINIC - PHOENIX 1,606 1,692 1,506 1,515 (9) (1%) 7,933 7,944 8,031 (87) (1%)

FQHC MEDICINE CLINIC - PHOENIX 1,250 1,151 1,018 1,148 (130) (11%) 5,871 5,592 5,670 (78) (1%)

Total 5,476 5,512 4,757 5,196 (439) (8%) 28,188 26,339 28,342 (2,003) (7%)

7th Avenue Walk-In Clinic

FQHC WALK IN CLINIC - 7TH AVENUE 1,503 - - - - - 6,913 - - - -

Total 1,503 - - - - - 6,913 - - - -

Dental Clinics

FQHC DENTAL - PHOENIX 865 969 777 822 (45) (5%) 4,696 4,781 4,659 122 3%

FQHC DENTAL - CHANDLER 160 231 177 152 25 16% 976 958 970 (12) (1%)

FQHC DENTAL - SOUTH CENTRAL PHOENIX 76 108 154 171 (17) (10%) 944 664 928 (264) (28%)

FQHC DENTAL - AVONDALE 261 235 211 238 (27) (11%) 1,158 955 1,211 (256) (21%)

FQHC DENTAL - MESA 218 198 199 190 9 5% 1,117 1,065 1,074 (9) (1%)

FQHC DENTAL - MCDOWELL 375 456 332 355 (23) (6%) 2,066 2,107 1,966 141 7%

Total 1,955 2,197 1,850 1,928 (78) (4%) 10,957 10,530 10,808 (278) (3%)

Grand Totals 23,765 26,043 21,949 22,659 (710) (3%) 125,040 120,343 123,912 (3,569) (3%)

FEDERALLY QUALIFIED HEALTH CENTERS

Year To Date FY 2020

MTD Analysis

Month To Date FY 2020

NOV FY 2020

VISITS SUMMARY

YTD Analysis

Prepared By: ESandoval Page 1 of 1


Finance Committee

Meeting

January 2, 2020

Item 3.a.

FQHC Clinics MTD and YTD Financials and

Payer Mix

Valleywise Health

FQHC

With Ancillary Services

NOV FY 2020

Variance Variance

FY20 FY20 Favorable FY20 FY20 Favorable

Actual Budget (Unfavorable) % Actual Budget (Unfavorable) %

(a) Visits 15,342 15,535 (193) (1%) 4,757 5,196 (439) (8%)

Operating Revenues

(b) Net patient service revenue 3,256,431$ 3,503,437$ (247,006)$ (7%) 847,680$ 912,869$ (65,189)$ (7%)

(c) Other Operating Revenue 156,687 65,411 91,276 140% - 83 (83) (100%)

(d) PCMH Revenue 8,002 8,000 2 0% - - -

(e) Total operating revenues 3,421,120$ 3,576,848$ (155,728)$ (4%) 847,680$ 912,952$ (65,272)$ (7%)

Operating Expenses

(f) Salaries and wages 925,279 879,619 (45,660) (5%) 334,402 328,616 (5,785) (2%)

(g) Contract labor 86 1,988 1,901 96% 34 785 751 96%

(h) Employee benefits 393,519 298,447 (95,073) (32%) 113,199 102,608 (10,591) (10%)

(i) Medical service fees 1,253,644 1,279,945 26,301 2% 424,780 370,808 (53,972) (15%)

(j) Supplies 134,066 101,054 (33,013) (33%) 37,209 29,249 (7,960) (27%)

(k) Purchased services 471 5,060 4,589 91% - 972 972 100%

(l) Other expenses 34,765 89,172 54,408 61% (20,209) 859 21,068 2,452%

(m) Interest expense - 40 40 100% - - -

(n) Allocated ancillary expense 637,696 605,828 (31,868) (5%) 96,894 85,635 (11,259) (13%)

(o) Total operating expenses 3,379,526$ 3,261,153$ (118,373) (4%) 986,310$ 919,534$ (66,776) (7%)

(p) Margin (before overhead allocation) 41,594$ 315,695$ (274,101)$ (138,630)$ (6,582)$ (132,048)$

(q) Percent Margin 1% 9% (16%) (1%)

(u) Overhead Allocation 858,402 828,123 (30,278) 275,662 264,009 (11,653)

(v) Margin (after overhead allocation) (816,808)$ (512,428)$ (304,379)$ (414,292)$ (270,591)$ (143,701)$

(w) Percent Margin (24%) (14%) (49%) (30%)

Per Visit Analysis ($/Visit)

(x) Net patient service revenue 212.26$ 225.52$ (13.26)$ 178.20$ 175.69$ 2.51$

(y) Other Operating Revenue 10.21 4.21 6.00 - 0.02 (0.02)

(z) PCMH Revenue 0.52 0.51 0.01 - - -

(aa) Total operating revenues 222.99$ 230.24$ (7.25)$ (3%) 178.20$ 175.70$ 2.49$ 1%

(ab) Total operating expenses 220.28 209.92 (10.36) (5%) 207.34 176.97 (30.37) (15%)

(ac) Margin (before overhead allocation) 2.71$ 20.32$ (17.61)$ (650%) (29.14)$ (1.27)$ (27.88)$ (96%)

(ae) 2.71$ 20.32$ (17.61)$ (650%) (29.14)$ (1.27)$ (27.88)$ (96%)

(af) Overhead Allocation 55.95 53.31 (2.64) (5%) 57.95 50.81 (7.14) (12%)

(ag) Margin (after overhead allocation) (53.24)$ (32.99)$ (20.25)$ (38%) (87.09)$ (52.08)$ (35.01)$ (40%)

NOV Month to Date NOV Month to Date

MTD Actual vs Budget

Margin (after Non-Operating Revenue

(Expense))

VCHC and Behavioral Health VCHC - Phoenix


Valleywise Health

FQHC


NOV FY 2020

(a) Visits

Operating Revenues

(b) Net patient service revenue

(c) Other Operating Revenue

(d) PCMH Revenue

(e) Total operating revenues

Operating Expenses

(f) Salaries and wages

(g) Contract labor

(h) Employee benefits

(i) Medical service fees

(j) Supplies

(k) Purchased services

(l) Other expenses

(m) Interest expense

(n) Allocated ancillary expense

(o) Total operating expenses

(p) Margin (before overhead allocation)

(q) Percent Margin

(u) Overhead Allocation

(v) Margin (after overhead allocation)

(w) Percent Margin


(x) Net patient service revenue

(y) Other Operating Revenue

(z) PCMH Revenue

(aa) Total operating revenues

(ab) Total operating expenses

(ac) Margin (before overhead allocation)

(ae)

(af) Overhead Allocation

(ag) Margin (after overhead allocation)


(Expense))

Variance Variance



1,850 1,928 (78) (4%) 21,949 22,659 (710) (3%)

315,111$ 351,375$ (36,264)$ (10%) 4,419,222$ 4,767,681$ (348,459)$ (7%)

32,381 24,354 8,027 33% 189,068 89,848 99,220 110%

- - - 8,002 8,000 2 0%

347,492$ 375,728$ (28,236)$ (8%) 4,616,292$ 4,865,529$ (249,237)$ (5%)

302,886 296,935 (5,951) (2%) 1,562,566 1,505,170 (57,396) (4%)

7 156 149 96% 127 2,929 2,802 96%

100,307 80,926 (19,381) (24%) 607,026 481,981 (125,045) (26%)

- - - 1,678,424 1,650,753 (27,671) (2%)

22,018 21,721 (297) (1%) 193,293 152,024 (41,270) (27%)

8,893 9,890 997 10% 9,364 15,923 6,559 41%

(7,748) 907 8,655 954% 6,808 90,939 84,131 93%

- - - - 40 40 100%

- - - 734,590 691,464 (43,126) (6%)

426,362$ 410,534$ (15,828) (4%) 4,792,198$ 4,591,222$ (200,977) (4%)

(78,870)$ (34,806)$ (44,065)$ (175,907)$ 274,307$ (450,214)$ (164%)

(23%) (9%) (4%) 6%

114,986 110,601 (4,385) 1,249,050 1,202,733 (46,317)

(193,857)$ (145,407)$ (48,450)$ (1,424,957)$ (928,426)$ (496,531)$

(56%) (39%) (31%) (19%)

170.33$ 182.25$ (11.92)$ 201.34$ 210.41$ (9.07)$

17.50 12.63 4.87 8.61 3.97 4.65

- - - 0.36 0.35 0.01

187.83$ 194.88$ (7.05)$ (4%) 210.32$ 214.73$ (4.41)$ (2%)

230.47 212.93 (17.53) (8%) 218.33 202.62 (15.71) (7%)

(42.63)$ (18.05)$ (24.58)$ (58%) (8.01)$ 12.11$ (20.12)$ (251%)

(42.63)$ (18.05)$ (24.58)$ (58%) (8.01)$ 12.11$ (20.12)$ (251%)

62.15 57.37 (4.79) (8%) 56.91 53.08 (3.83) (7%)

(104.79)$ (75.42)$ (29.37)$ (28%) (64.92)$ (40.97)$ (23.95)$ (37%)

NOV Month to Date NOV Month to Date

MTD Actual vs Budget

All Clinics CombinedDental


Valleywise Health

FQHC


NOV FY 2020

Variance Variance



(a) Visits 83,474 84,762 (1,288) (2%) 26,339 28,342 (2,003) (7%)

Operating Revenues

(b) Net patient service revenue 18,035,264$ 19,155,383$ (1,120,119)$ (6%) 4,721,750$ 4,915,976$ (194,226)$ (4%)

(c) Other Operating Revenue 340,926 327,054 13,872 4% - 417 (417) (100%)

(d) PCMH Revenue 40,902 40,000 902 2% - - -

(e) Total operating revenues 18,417,092$ 19,522,436$ (1,105,344)$ (6%) 4,721,750$ 4,916,393$ (194,643)$ (4%)

Operating Expenses

(f) Salaries and wages 4,670,092 4,744,563 74,472 2% 1,697,602 1,782,910 85,308 5%

(g) Contract labor 45,139 18,286 (26,852) (147%) 17,549 7,226 (10,324) (143%)

(h) Employee benefits 1,731,352 1,620,401 (110,951) (7%) 513,840 562,322 48,482 9%

(i) Medical service fees 6,004,863 6,518,660 513,797 8% 2,074,105 1,854,040 (220,065) (12%)

(j) Supplies 758,789 546,275 (212,515) (39%) 166,449 154,798 (11,652) (8%)

(k) Purchased services 10,436 25,531 15,095 59% 2,216 4,847 2,630 54%

(l) Other expenses 477,371 537,994 60,623 11% (2,769) 24,465 27,233 111%

(m) Interest expense - 198 198 100% - - -

(n) Allocated ancillary expense 3,333,494 3,192,558 (140,936) (4%) 519,676 453,712 (65,965) (15%)

(o) Total operating expenses 17,031,535$ 17,204,466$ 172,930 1% 4,988,669$ 4,844,318$ (144,351) (3%)

(p) Margin (before overhead allocation) 1,385,557$ 2,317,971$ (932,414)$ (266,919)$ 72,074$ (338,993)$

(q) Percent Margin 8% 12% (6%) 1%

(u) Overhead Allocation 4,338,532 4,370,218 31,686 1,406,990 1,395,213 (11,777)

(v) Margin (after overhead allocation) (2,952,976)$ (2,052,247)$ (900,728)$ (1,673,909)$ (1,323,138)$ (350,770)$

(w) Percent Margin (16%) (11%) (35%) (27%)


(x) Net patient service revenue 216.06$ 225.99$ (9.93)$ 179.27$ 173.45$ 5.82$

(y) Other Operating Revenue 4.08 3.86 0.23 - 0.01 (0.01)

(z) PCMH Revenue 0.49 0.47 0.02 - - -

(aa) Total operating revenues 220.63$ 230.32$ (9.69)$ (4%) 179.27$ 173.47$ 5.80$ 3%

(ab) Total operating expenses 204.03 202.97 (1.06) (1%) 189.40 170.92 (18.48) (10%)

(ac) Margin (before overhead allocation) 16.60$ 27.35$ (10.75)$ (65%) (10.13)$ 2.54$ (12.68)$ (125%)

(ae) 16.60$ 27.35$ (10.75)$ (65%) (10.13)$ 2.54$ (12.68)$ (125%)

(af) Overhead Allocation 51.97 51.56 (0.42) (1%) 53.42 49.23 (4.19) (8%)

(ag) Margin (after overhead allocation) (35.38)$ (24.21)$ (11.16)$ (32%) (63.55)$ (46.68)$ (16.87)$ (27%)

VCHC and Behavioral Health

NOV Year to Date NOV Year to Date


(Expense))

VCHC - Phoenix

YTD Actual vs Budget


Valleywise Health

FQHC


NOV FY 2020

(a) Visits

Operating Revenues

(b) Net patient service revenue

(c) Other Operating Revenue

(d) PCMH Revenue

(e) Total operating revenues

Operating Expenses

(f) Salaries and wages

(g) Contract labor

(h) Employee benefits

(i) Medical service fees

(j) Supplies

(k) Purchased services

(l) Other expenses

(m) Interest expense

(n) Allocated ancillary expense

(o) Total operating expenses

(p) Margin (before overhead allocation)

(q) Percent Margin

(u) Overhead Allocation

(v) Margin (after overhead allocation)

(w) Percent Margin


(x) Net patient service revenue

(y) Other Operating Revenue

(z) PCMH Revenue

(aa) Total operating revenues

(ab) Total operating expenses

(ac) Margin (before overhead allocation)

(ae)

(af) Overhead Allocation

(ag) Margin (after overhead allocation)


(Expense))

Variance Variance



10,530 10,808 (278) (3%) 120,343 123,912 (3,569) (3%)

1,798,336$ 1,968,079$ (169,743)$ (9%) 24,555,350$ 26,039,438$ (1,484,088)$ (6%)

119,706 121,768 (2,062) (2%) 460,631 449,238 11,394 3%

- - - 40,902 40,000 902 2%

1,918,041$ 2,089,847$ (171,805)$ (8%) 25,056,883$ 26,528,676$ (1,471,792)$ (6%)

1,570,792 1,592,386 21,594 1% 7,938,486 8,119,859 181,374 2%

3,477 1,434 (2,043) (142%) 66,165 26,946 (39,219) (146%)

475,524 466,891 (8,633) (2%) 2,720,716 2,649,614 (71,102) (3%)

- - - 8,078,968 8,372,700 293,732 4%

103,830 121,100 17,270 14% 1,029,068 822,172 (206,896) (25%)

80,821 54,866 (25,955) (47%) 93,473 85,243 (8,230) (10%)

(636) 10,556 11,192 106% 473,967 573,015 99,048 17%

- - - - 198 198 100%

- - - 3,853,161 3,646,270 (206,891) (6%)

2,233,808$ 2,247,233$ 13,425 1% 24,254,003$ 24,296,017$ 42,013 0%

(315,767)$ (157,386)$ (158,381)$ 802,880$ 2,232,659$ (1,429,779)$

(16%) (8%) 3% 8%

601,822 606,177 4,355 6,347,342 6,371,608 24,266

(917,588)$ (763,563)$ (154,025)$ (5,544,462)$ (4,138,949)$ (1,405,513)$

(48%) (37%) (22%) (16%)

170.78$ 182.09$ (11.31)$ 204.04$ 210.14$ (6.10)$

11.37 11.27 0.10 3.83 3.63 0.20

- - - 0.34 0.32 0.02

182.15$ 193.36$ (11.21)$ (6%) 208.21$ 214.09$ (5.88)$ (3%)

212.14 207.92 (4.21) (2%) 201.54 196.07 (5.47) (3%)

(29.99)$ (14.56)$ (15.43)$ (51%) 6.67$ 18.02$ (11.35)$ (170%)

(29.99)$ (14.56)$ (15.43)$ (51%) 6.67$ 18.02$ (11.35)$ (170%)

57.15 56.09 (1.07) (2%) 52.74 51.42 (1.32) (3%)

(87.14)$ (70.65)$ (16.49)$ (19%) (46.07)$ (33.40)$ (12.67)$ (27%)

Dental All Clinics Combined

NOV Year to Date NOV Year to Date

YTD Actual vs Budget


Valleywise Health

FQHC


NOV FY 2020

(a) Visits The number of times patients were seen at the clinics

Operating Revenues

(b) Net patient service revenue This amount reflects the estimated amount of revenue we expect to collect as cash

from regular operations

(c) Other Operating Revenue All other operating revenue not listed in another category (Ex: rental revenue, financial assessment form program renvenue)

(d) PCMH Revenue Patient Centered Medical Home payments, which represent per member per month capitation agreements with Care 1st.

(e) Total operating revenues Net patient service revenue (b) + Other Operating Revenue + PCMH revenue (d) = (e)

Operating Expenses

(f) Salaries and wages Salaries and wages paid to MIHS employees via payroll

(g) Contract labor Temporary staff and contractors

(h) Employee benefits Benefits paid to MIHS employees (Ex :health insurance)

(i) Medical service fees Fees paid per the contract with District Medical Group (DMG) for providing physician/provider services

(j) Supplies Expenses related to items consumed (Ex: medical and office supplies)

(k) Purchased services Expenses related to consulting, dental lab services, lab courier services, and uniform/laundry cleaning

(l) Other expenses All other expenses not listed in another category (Ex: equipment or facility maintenance agreements, utilities, etc.)

(m) Interest expense Interest paid that is related to a capital lease

(n) Allocated ancillary expense Expense amounts from the following departments are allocated to the individual FQHC cost centers: radiology, pharmacy, and laboratory because those services were done at the clinics. This is done in order to match revenue with expenses.

(o) Total operating expenses Sum of all Operational Expenses, lines (f) through (n) = (o)

(p) Margin (before overhead allocation) Total Operating Revenue (e) - Total Operating Expense (o) = (p)

(q) Percent Margin Margin (before overhead allocation) (p) / Total operating revenue (e) = (q)

(u) Overhead Allocation Expense amounts from departments that provide indirect services to the FQHC departments (such as: Human Resources, Accounting, Payroll, Security, Information Technology). This is done in order to match revenue with expenses.

(v) Margin (after overhead allocation) Margin (before overhead allocation) (s) - Overhead Allocation (u) = (v)

(w) Percent Margin Margin (after overhead allocation) (v) / Total operating revenue (e) = (w)


(x) Net patient service revenue Net patient service revenue line (b) / Visits line (a) = (x)

(y) Other Operating Revenue Other Operating Revenue line (c) / Visits line (a) = (y)

(z) PMPM Revenue PMPM Revenue line (d) / Visits line (a) = (z)

(aa) Total operating revenues Total operating revenues line (e) / Visits line (a) = (aa)

(ab) Total operating expenses Total operating expenses line (o) / Visits line (a) = (ab)

(ac) Margin (before overhead allocation) Margin (before overhead allocation) line (p) / Visits line (a) = (ac)

(ad) Non-Operating Revenue (Expense) Non-Operating Revenue (Expense) line (r) / Visits line (a) = (ad)

(ae) Margin (after Non-Operating Revenue (Expense)) Margin (after Non-Operating Revenue (Expense)) line (s) / Visits line (a) = (ae)

(af) Overhead Allocation Overhead allocation line (u) / Visits line (a) = (af)

(ag) Margin (after overhead allocation) Margin (after overhead allocation) line (v) / Visits line (a) = (ag)

Note: Reports do not include overhead allocations (i.e. additional expenses related to Financial Services (including: Payroll, Accounts Payable, Billing), Human Resources, Facilities and Maintenance, etc.)


Payer June July August September October November Payer June July August September October November

COMMERCIAL 3,149 3,557 3,652 3,277 3,708 3,133 COMMERCIAL 14.1% 14.8% 14.6% 14.1% 14.2% 14.3%

MEDICAID 11,058 11,878 12,486 11,327 12,647 10,668 MEDICAID 49.6% 49.2% 49.9% 48.8% 48.6% 48.6%

MEDICARE 2,541 2,533 2,671 2,516 2,820 2,305 MEDICARE 11.4% 10.5% 10.7% 10.8% 10.8% 10.5%

OTHER GOVT 79 114 130 114 116 104 OTHER GOVT 0.4% 0.5% 0.5% 0.5% 0.5% 0.5%

SELF PAY & OTHER 5,486 6,040 6,072 5,984 6,752 5,739 SELF PAY & OTHER 24.6% 25.0% 24.3% 25.8% 25.9% 26.2%

Total 22,313 24,122 25,011 23,218 26,043 21,949 Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Valleywise Health - Federally Qualified Health Centers

Comparison ALL FQHC Visits by Payor - 6 Month Trend

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

COMMERCIAL MEDICAID MEDICARE OTHER GOVT SELF PAY & OTHER

June July August September October November


Payer FY 17 FY 18 FY 19 YTD FY 20 Payer FY 17 FY 18 FY 19 YTD FY 20

COMMERCIAL 30,298 36,284 39,715 17,327 COMMERCIAL 10.0% 12.3% 13.4% 14.4%

MEDICAID 158,128 149,566 147,246 59,006 MEDICAID 52.2% 50.6% 49.6% 49.0%

MEDICARE 31,493 32,266 32,111 12,845 MEDICARE 10.4% 10.9% 10.8% 10.7%

OTHER GOVT 5,726 3,204 1,931 578 OTHER GOVT 1.9% 1.1% 0.7% 0.5%

SELF PAY & OTHER 77,596 74,347 75,642 30,587 SELF PAY & OTHER 25.6% 25.2% 25.5% 25.4%

Total 303,241 295,667 296,645 120,343 Total 100.0% 100.0% 100.0% 100.0%

Valleywise Health - Federally Qualified Health Centers

Comparison ALL FQHC Visits by Payor - 4 Year Trend

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

COMMERCIAL MEDICAID MEDICARE OTHER GOVT SELF PAY & OTHER

FY 17 FY 18 FY 19 YTD FY 20



Finance Committee

Meeting

January 2, 2020

Item 4.

Closing Comments (No Handout)


Finance Committee

Meeting

January 2, 2020

Item 5.

Staff Assignments (No Handout)

Valleywise Community Health Centers Governing Council Finance … · Chairman Benelli noted...

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