2009 National Primary Oral Health Conference

1. 2009 National Primary Oral Health Conference November 3, 2009 Nashville, TN

2. Efficiency Improvements and Cost-Saving Ideas in Tough Times Panel Format Carolyn Brown, DDS Moderator Dental Director, SF Native American Health Center San Francisco, CA

3. Panel Members Andrea Hight Henry Schein, Inc. “Managing up with your suppliers” Kevin Hursh, DDS NAHC, Inc. “AEGD Residents- Productivity Gains and Salary Savings” Jack Luomanen, DMD Dental Consultant “Patient-Centered Efficiencies”

4. Practice Management Resources • Practice Management Consultants with I.H.S./CHC experience • Safety Net Solutions • Pride Institute • National Network Oral Health Access NNOHA • Small, individual private practice consultants • Other resources • California Health Care Foundation www.chcf.org • “The Good Practice: Treating Underserved Dental Patients While Staying Afloat.” Aug 2008 • Dental Clinic Manual www.dentalclinicmanual.com

5. Layers to Practice Management • Administration • Patient Flow • Staffing Patterns • Billing • Inventory Management • Early Intervention Programs • Collaborations

6. Administration • Budgets (annual, quarterly, monthly) • Data Sources • Chain of command and internal processes • Quality Improvements/Reports • Production • Billing/Collection • Aging reports • Salary Allocations • Policies • Patient payment policy • No Show policy (including enforcement) • Scope of service • Payer mix • Demographics • % of payer types

7. Patient Flow • Examine check-in to check-out process (Time study) • Patient Satisfaction • Scheduling patterns • Waitlist or Patient appointment availability • Recall protocol • No show rate • Managing missed appointments • Managing emergency patients • Optimizing patient volume • Creating positive reception areas/experience

8. Staffing patterns • Front desk and back office staff • Provider staffing, scheduling, admin time • Strategic use of hygienists and licensed assistants • Ex: RDA with sealant certificate • Recruiting and retention • Technology adjunctives • Software for EDR • Software for automatic calling • Software and hardware for inventory control

9. Business of Dentistry • Evaluate your costs- fixed and non-fixed • Fixed: Rent/mortgage, depreciation, indirect rate, etc… • Non-fixed: salaries, supplies, lab fees • Strategies • Low hanging fruit- Fix easy things first • Big game sport- Address largest non-fixed costs first • Billing Process • Eligibility • Collections/Aging • Encounter forms • Treatment plan presentation/ revenue collection

10. Business of Dentistry • Inventory management • Standardize!! • Look at costs over a quarter and one year • Calculate cost per patient • Supply expenses for 3 months/# patients seen for 3 months • National average $4.61-7.50 per patient • Strategies • Managing your relationship with suppliers • Managing your relationship with manufacturers • Just-in-time mngt • Lab fees • Evaluate your environment, your fees, your regularity of svcs • Relationship build with your labs

11. Prevention, Intervention and other Programs • Expansion of services, patient pool • Teambuilding programs (incentive programs) • Collaborating with medical or other internal departments • Partnering with private practices, county or state, or other CBOs • Be careful-Evaluate • Return on investment • Demands on staff • Sustainability • New patient visit generated • PSDA study

12. Ex: NAHC Incentive Program • Increase Access • Decrease the No Show rate • Increase Production • the # of patients served per day • Increase revenues to the clinic • Increase staff productivity • Build Team Mentality • Improve the morale of the Dental Staff • Build cohesiveness of the dental team

13. Panel Members Andrea Haight, DMD Henry Schein “Managing up with your suppliers” Kevin Hursh, DDS Native American Health Center “AEGD Residents- Productivity Gains and Salary Savings” Jack Luoanamen, DDS Consultant “Patient-Centered Efficiencies”

14. Panel Members Andrea Hight Henry Schein, Inc. “Managing up with your suppliers” Kevin Hursh, DDS NAHC, Inc. “AEGD Residents- Productivity Gains and Salary Savings” Jack Luomanen, DMD Dental Consultant “Patient-Centered Efficiencies” Questions: Carolynb@nativehealth.org