Archives for August 2017

Key Messages from UPG Board of Directors Meeting June 15, 2017

Financial Performance and Operations

UPG Interim CFO Beth Allen provided information on UPG financial performance and operations. The consolidated balance sheet at the end of April showed a 0.8% decline in net assets over the 10-month period in FY2017, while cash on hand remained strong at $33.5M. The consolidated accrual-based UPG income statement for FY2017 showed an operating deficit of $12.3M through April, reflecting the first year of a new Health System Funds Flow model and transition to mission-based financial reporting for the clinical departments. Total revenue was marginally favorable to budget (1%), and indigent care revenue was over budget with mid-year projections indicating that this revenue would exceed budget for the year by roughly $7.8M. Total pension expense for the fiscal year is expected to be $25.8M; the unbudgeted cost of which is expected to be $15.3M. While this is not a direct cash outlay, it reflects annual expense and therefore can create an operating loss. Workload trends reflect strong productivity in March with lower productivity in April, and higher productivity is expected in May and June based on trend data from FY2015 and FY2016. Clinical departments as a whole are exceeding the 65th percentile in productivity. Investment results for the 9-month period ending March 31, 2017, showed positive returns with strong market conditions. Cash collections from patient care services exceed cumulative year-to-date targets but April results reflect low collections due to a Medicare processing issue. Ms. Allen submitted resolutions for approval of the FY2018 Consolidated Budget, and Approval of the Group Practice Fund Budget for 2018. Both were unanimously approved with no abstentions.

Fiduciary Training

Mr. David Pettit, outside counsel for UPG from firm Lenhart Pettit, provided training information with regard to the fiduciary duty of the UPG Board of Directors as the governing body of the Foundation. The function of the UPG Board of Directors is to make decisions about the operations of UPG, and to exercise oversight and planning to enable UPG to fulfill its best interest and mission in support of UVA Health System. Directors are legally bound to discharge their duties in accordance with their good faith business judgment of the best interests of UPG. Mr. Pettit emphasized the point that in order for a decision to be made in good faith, UPG directors must be fully informed of all the facts and circumstances associated with the decision before they take action.

Ufirst

UVA EVP COO Patrick Hogan addressed the Board with regard to the letter he had received from UPG Board Chair Dr. Kate Acuff on May 30, 2017, about the Ufirst initiative, which stated that UPG Board members felt that that they needed more information and proof of concept to outsource UPG’s Human Resources and Payroll functions to the University as a vendor. Mr. Hogan stated that he would be happy to provide further information on the initiative before asking them to vote on the issue of UPG participating in Ufirst. Mr. Hogan stated that a 15% savings could be promised by participation in Ufirst. A number of options were discussed regarding UPG employees, including employees remaining at UPG and UPG using the Workday IT platform. Mr. Hogan stated that he plans to present more data to the UPG Board at its meeting in September.

Audit Plan

UPG Board of Directors charter requires partnership with an independent audit firm. Members of the Audit Committee voted to engage BDO for the third consecutive year. A resolution to engage BDO for the FY2017 independent audit was passed unanimously with no abstentions.

Consent Agenda

A resolution approving Scopes of Practice for UPG Outreach Practitioners was approved, as were resolutions honoring retiring Department Chairs Thomas Leinbach, D.D.S. and M. Norman Oliver, M.D., M.A.

Key Messages from Clinical Chairs Committee Meetings June 13, 2017 and July 11, 2017

Key Messages from Clinical Chairs Committee Meeting June 13, 2017

Robin Parkin, Epic Phase 2 Administrator, provided an Epic update focusing on the Command Center plan for Epic Go-Live, the Super User Support Plan and what to expect at Go-Live.

UPG Interim CFO Beth Allen provided an overview of UPG financial performance and operations. The consolidated balance sheet at the end of April showed a 0.8% decline in net assets over the 10-month period in FY2017, while cash on hand remained strong at $33.5M. The consolidated accrual-based UPG income statement for FY2017 showed an operating deficit of $12.3M through April, reflecting the first year of a new Health System Funds Flow model and transition to mission-based financial reporting for the clinical departments. Total revenue was marginally favorable to budget (1%), and indigent care revenue was over budget with mid-year projections indicating that this revenue would exceed budget for the year by roughly $7.8M. Total pension expense for the fiscal year is expected to be $25.8M; the unbudgeted cost of which is expected to be $15.3M. While this is not a direct cash outlay, it reflects annual expense and therefore can create an operating loss. Workload trends reflect strong productivity in March with lower productivity in April, and higher productivity is expected in May and June based on trend data from FY2015 and FY2016. Clinical departments as a whole are exceeding the 65th percentile in productivity. Investment results for the 9-month period ending March 31, 2017, showed positive returns with strong market conditions. Cash collections from patient care services exceed cumulative year-to-date targets but April results reflect low collections due to a Medicare processing issue. Below are the slides Ms. Allen presented at the meeting.

 

 

 

 

 

 

 

Corey Feist provided a contracting update. UPG and UVAMC have contracts with Anthem expiring December 31, 2019. In May 2017, UPG and UVAMC representatives began negotiations for new contracts to be effective upon expiration. UPG has received commitment from UVAMC Associate VP for Business Development and Finance Larry Fitzgerald that the Medical Center contract will not be signed unless UPG terms are met. Melanie Lewis has been chairing the Performance-Based Contracting Committee and discussing strategy with the group. Feedback and questions can be directed to Ms. Lewis: msl4a@hscmail.mcc.virginia.edu

Brad Haws shared feedback from the June 1 UPG Discussion Session with providers and UPG Board of Directors public members. Roughly 100 clinicians attended the two-hour event, which provided clarity on some issues and brought clinician questions and concerns to light. Further dialogue and forums can be expected in the near future. UPG members are encouraged to submit input of any kind to the new email address designated for feedback: upgfeedback@virginia.edu. Link to video footage of the presentation can be found here as well as a copy of the slide presentation and an executive summary of the event.

 

Key Messages from Clinical Chairs Committee Meeting July 11, 2017

Brad Haws provided an update on UPG’s involvement with the Ufirst initiative and solicited input from the group on their recommendation to obtain faculty input regarding the UPG Board’s decision about whether or not to participate in Ufirst. Mr. Haws explained that there are two parts to the initiative: changes in technology using the Workday IT platform, and changes in management and staffing structure. The UPG Board of Directors wants to ensure the feedback from UPG’s constituents is received to help inform the Board’s decision. Pat Hogan, UVA EVP and COO, plans to bring a presentation to the UPG Board of Directors at the September 2017 meeting and, we believe, ask for UPG’s participation in all of Ufirst. The chairs asked to be educated about the details of Ufirst including a list of pros and cons.

Dr. Levine plans to step down as UPG President in September 2017. An election for his replacement will take place during the September 2017 Clinical Chairs Meeting. Nominations can be sent to Brad Haws. Nominees will be asked to provide biographical information upon acceptance.

There are two public members of the UPG Board of Directors who will be rotating off the Board in December: Mr. James Rutrough and Ms. Ella Strubel. The Nominating Committee of the UPG Board of Directors requests that Public Director nominations be sent to Brad Haws or Corey Feist.

UPG Interim CFO Beth Allen provided a summary of the FY2018 budget. The UPG Consolidated budget reflects a loss of $15.8M before transfers and $10.6M after transfers. The 21 clinical departments represent an $8.2M loss before transfers and $3M after transfers. UPG has worked with actuarial firm AON Hewitt to assist with analysis on the future expenses of the retirement plans. Should rates change, the possible fluctuation of the expense is significant, which UPG is monitoring closely. However, both the CSRP and CRP plans are well funded with the expectation that the CRP plan will be fully funded by FY2021. Overall, the impact of the expense is concerning to the overall performance of the group practice plan; however, the expense is an amortization cost and not a direct cash outlay. Below are the slides Ms. Allen presented at the meeting.

UPG Chief of Audit and Billing Quality Melanie Lewis provided an Epic Go-Live update. Indications from implementation team members are that implementation has gone well with some issues to address. Most Go-Live areas are meeting their Key Performance Indicators. Clinical Pathology issues need attention; Medical Center charges are roughly 66% while UPG is 97%. Feedback from departments was that most were doing well but there was some difficulty with charges being posted and concern about long registration times. There were 1300 tickets outstanding and over 6,000 tickets received to date. There is an increase in manual work-arounds, which should be avoided when possible in favor of reporting issues and submitting tickets to optimize the system during implementation. Brad Haws expressed appreciation to the group for their dedication and hard work throughout the transition.