Department of Pathology Benchmarking

1. Department of Pathology Benchmarking Marty Lawlor Friday, November 8, 2013

2. Financial Metrics • Questions vs. Answers • Reviewing financial data rarely gives us the answers we are looking for. • It will direct us to the questions we need to ask about changes in our operations.

3. HOSPITAL METRICS

4. Hospital Consolidated FY13 June YTD Financials

5. Hospital Financial Performance FY13 December YTD by Entity

8. Hospital Pathology Consolidated Statement

9. Hospital Pathology Consolidated Statement Individual Lab

10. Managing a Practice

11. Sources of Departmental Revenue • Clinical Revenue Margin – Currently 36% • Extramural Funding – Direct & Indirect Costs • Educational Transfers • Part A Transfers • Clinical Ph.D. Transfer • Professional Component Billing • Additional Contractual Agreements

12. Faculty Provide BothPart A and Part B Services • Part A • Role as a lab director • Services provided to the facility or for the benefit of patients in general (autopsies) • Part B • Services provided to individual patients • Surgical pathology • Transfusion medicine • Interpretive services

13. Tax Equity and Fiscal ResponsibilityAct of 1982 (TEFRA) • Clarified Part A and Part B services and payments • Eliminated professional component billing on routine laboratory tests for Medicare inpatients (other payors have adopted this policy) • Defined reasonable compensation equivalent (RCE) • Part A Transfer is Payment for Professional Services

14. Part A Services • Autopsies • Medical Administration • Supervisory and Consulting Activities • Medical Education

15. Clinical Laboratory Improvements of 1988Codified the Role of Lab Director • Assure accuracy of test results • Interact with medical staff • Establish parameters for performance of tests • Recommend additional diagnostic/therapeutic tests • Advise lab personnel regarding aberrant results

16. Clinical Laboratory Improvements of 1988Codified the Role of Lab Director • Select, evaluate and validate test methodologies • Direct performance and evaluation of quality control and quality assurance procedures • Evaluate clinical data; establish process for review of tests prior to issuance of patient reports • Assure compliance with accrediting agencies

17. RVU Report

18. Collections

20. PART A REPORTING

21. Clinical Incentive Payment Calculations The Pathology Incentive program is divided into four major categories: Extramural Consults, Outreach Part B Billings, Outreach Part A Payment and Department margin. Incentives are provided twice a year (July – December; January – June). Limits to total compensation are imposed by the Medical School. The current salary limit is 25% or $60,000 per year, which ever is higher, of base, academic, clinical supplement A and administrative differential (basically total compensation received less the incentive payments). • Extramural Consults • Outreach Part B Billings • Outreach Part A Payment • Department Margin

23. RESEARCH

24. FINANCIAL SUMMARY FOR FACULTY X

25. FINANCIAL SUMMARY FOR FACULTY Y

26. Research Incentive

27. NATIONAL BENCHMARKING ISSUES • Phlebotomy – Is it housed in Pathology or Nursing? • Pathology Informatics – Departmental or centralized? • Send-outs – Are these shown as supplies? • Complexity of Test Menu

28. Case Studies • Why are the total supplies and supply metrics for Molecular Diagnostics up? • Why are FTE’s up across the board in FY14? • Why are FTE’s up in Molecular Diagnostics? • Why is there an increase in FTE’s in the HLA Lab?

29. Questions