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Increase Productivity-Increase Satisfaction
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A Dental Incentive System that Works
Juris M. Svarcbergs,DMD,MPHDental DirectorCAMcare Health Corporation
Increase Productivity-Increase Satisfaction
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Background
The early years ‘Do gooders’ Focus on ‘ideal service’ Dedication to cause or
philosophy
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Background
Traditional professional ‘formula’ Work in itself a reward (a non-monetary incentive)
Salary adequate compensation(your paycheck is the reward)
Administration outlook(we’re not the private sector)
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Background
The Changing Times Burdened with debt Graduates Business oriented Dentists MBA Administrators
The realization:“To do Good, we must do Well!”
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Driving Forces in today’s environment
Decreased grant funding opportunitiesMainstreamed care delivery
Competition for patients Competition for revenue
Increased opportunity for Revenue generation
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The New Environment
020,00040,00060,00080,000
100,000120,000140,000160,000180,000200,000
Profitability
GoalActual
Cost Center Analysis
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DENTAL PRODUCTIVITY
Target is 2,400/DDS
Annualized Rate: 2,639 enc/DDS
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Improvements in MIS, CIS
Enable accurate dental data collection
RVU capabilty for correlation of amount of care with visit info
Provider profiles
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Why not become …… competitive in today’s environment withMOTIVATED and EFFICIENT PROVIDERS!?!
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Let’s Try an Incentive System!
Money always works!
Should we Increase salary?
Should we consider commissions?
How do we tie work produced to paycheck?
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The Dilemma(s)
Increased Revenue can only be generated withAdministrators don’t want to lose
over expendituresProviders don’t administrators to share income or ‘commission's’ fairly
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Available Incentive Systems
% of Provider generated charges % of collections of Provider’s production “x” % of Medicaid income“y” % of Self Pay income$’s per R.V.U. generatedThe ‘mathematician's dream’ formula
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Satisfaction
Can you really be happy if you Can’t figure out your take
home pay or bonus Can’t ‘trust’ the figures of
billing or admin people You have to treat some
patients in ways to benefit your income
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Real Life
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How to Build an Effective Incentive Program: The “5 Commandments”
Simple and easy to understandAllay administration fearsEmpower providersMake the reward memorableRelate the incentive directly to the organization’s income level
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The CAMcare Incentive Plan
Guaranteed base salary: Reasonable and contractual
Good fringe benefits
Health coverage, malpractice,CME time & coverage, pension
SecurityBudgeting
Goodwill and competitive edgeOnly one concern-PRODUCTIVITY
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The CAMcare Incentive Plan
Quarterly Goals
Quarterly Payout
600 visits/ FTE (not 599!!)
(individual provider not group average)
10% of base salary in contract-exactly
(prorated for quarter i.e 2.5% of annual base salary)
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‘Bonus Payout’ Example
Dr. XYZ had 645 patient visits this quarterAt $80K contract/yr, Dr.XYZ rec’d $20,000 in base salaryReaching/Goal gets $2,000 Bonus
CHC submitted bill for approx. $64,500 to all payorsCHC expects to get min. 2.5 times what pays out docsCHC gets $42,500
(Doc gets $22,000)
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Special Request for Payout!
Goal Achievers:
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Bonus is Recognition of Achievement
Bonus checks are separate and usually presented by CEO
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And it’s part of total Package
Professional Compensation Package:1. Base Salary $ 80,0002. Health Coverage 5,6043. Soc.Security Taxes 4,1424. CME Allowance 1,5005. Vacation,CME,Personal,
Holidays,Sick, time 8,9416. Malpractice Coverage 3,800
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Add up Total Package
Total Value………………$ 103,987If Loan Repayment-add 25,000TOTAL Package without Bonus: $128,987 !!!
Is another $ 8,000 worth the effort???
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Results: Avg.Encounters/DDS
1,0001,2001,4001,6001,8002,0002,2002,4002,6002,8003,000
Visits/ DDS
1998199920002001
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Results: RVU’s per DDS/yr.
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Results: DDS’s reaching goal
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
1998 1999 2000 2001
1998
1999
2000
2001
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DENTAL VISITS by Year
10000
10500
11000
11500
12000
12500
13000
13500
14000
14500
1998 1999 2000 2001
1998199920002001
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The Bottom Line: Dental Cost Center $ EPI (profitability)
0
10,000
20,000
30,000
40,000
50,000
60,000
1998 1999 2000 2001
EPI/ DDS
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CAMcareRevenue & Expenses
1997 1998 1999 2000 2001
Year
8
9
10
11
Millions
$
Revenue
Expenses
CAMcare Health CorporationAnnual Revenue vs Expense
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Increase Productivity-Increase Satisfaction
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S = R/E Choose a ‘goal’ that directly influences the organization’s income level Offer a definite bonus amount that is ‘BIG’ yet ‘small’ Support providers in achieving goal
at every level
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S = R/E Make the reward memorable
(timing, amount, presentation)
Report to Board as a “Dental Department defining” event!
(Dental exceeds expectations)
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Who are the ‘Satisfied Customers’?
Providers (and support staff)
CEO
CFO
Board
Patients
Community
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Simply Satisfying!