Adapting to the New Funds Flow Tony Ngo Tom McElderry September 7, 2016

Goals for this talk Explain the new clinical funds flow Explain Radiology’s hybrid model used to budget for funds flow payments Discuss what has been done to mitigate the impact on the Department Tony

What is “funds flow?” Funds flow is the transfer of money between the Medical Center and the School of Medicine / clinical departments related to professional services UCSF moved to a wRVU-based Funds Flow in July, 2014 But before we go on, let’s talk about who we are.

How did we get paid in the past? Care Faculty provide care to patients Billing Billing group bills insurance companies, other payers Collections Pro fee collections are passed back to departments Deductions for billing costs, dean’s tax, direct expenses

Why did UCSFHealth adopt a new funds flow? Increasing competition threatens UCSF market share No financial incentive for departments to expand primary care Primary care brings in new patients, feeds specialists UCSF must expand to remain a top hospital and research institution

What is the new model Redistribute Collections Departments based on survey of private practice salaries More work = more payments, providing incentive to expand services Reduce Practice Expenses Managed by UCSFHealth, which has incentive to streamline and reduce costs Improve Care Ensuring reasonable return for physician services increases availability of appointments Expanded primary care increases volume for specialties

What are wRVUs? RVUs = Relative Value Units Definition: a standard measure of resources required to provide physician services wRVUs are the RVUs related to the physician’s work Examples Full body PET: 2.0 wRVUs Chest x-ray with fluoroscopy: 0.38 wRVUs Tony

The Hybrid Model – We choose by clinical section: wRVU model OR Staffing Model MGMA $ per wRVU by subspecialty x actual wRVUs MGMA compensation by subspecialty x clinical FTE (cFTE) 11/16/2018

Why is Qgenda important? Qgenda is a calendar system used to track and report physician schedules For staff model budget: Shifts scheduled are converted to clinical FTE Clinical FTE x MGMA median salary = staff model payment We only are paid if shift if recorded in Qgenda

What is the impact on Radiology? Significant reduction in overall payment Coverage for so many sites means most sections are in staff model Additional payment for adding a new faculty member in a staffing model section may not be sufficient to cover costs

What have we done to reduce the impact on Radiology missions? Negotiated hybrid model Negotiated additional joint venture for China Basin MRs Supplemented bonuses to FY14 $/wRVU Negotiated change in staffing model calculation Support from Dean’s Office for CB Rent Increasing efficiency in use of research space Ongoing discussions with Dean’s Office, Transition Oversight Committee to mitigate impact of funds flow

How can you help? Offer ideas for cost savings Help maintain accurate and consistent scheduling records in Qgenda Encourage faculty to ensure accuracy in Qgenda schedule Continue providing excellent service!

Thank you! Questions?