Analysis of LAUSD s Wellness Centers Key Findings and Recommendations UCLA Anderson School of Management Class of 2015 Full-Time MBA Students Jeremiah David Joanne Kang 1
Executive Summary Planned Scope: This project was originally planned as an effort to assess LAUSD Wellness Center (WC) financial models in order to identify key practices that would promote WC financial sustainability. Actual Scope: Due to the limited quantity of WC data, as well as obstacles such as security restrictions and hard-to-retrieve data in paper form, the scope changed to analyze WC operations, build an ideal WC model, and recommend best practices. Key Recommendations: Target awareness initiatives by appealing to audience-specific needs. Enhance patients clinic experience. Promote compliance with revenuemaximizing procedures. 2
About the Board Fellows Program PROGRAM MISSION The Board Fellows Program places select MBA students in nonvoting board-level positions with L.A. area nonprofit organizations to: Provide area nonprofits with services of enthusiastic, talented leaders, and Strengthen UCLA Anderson s ties with the community. The Program is a component of UCLA Anderson s Net Impact club, whose mission is to build a network of leaders committed to using the power of business to make a positive net social, environmental and economic impact. 3
Project Scope OBJECTIVES ACTION STEPS DELIVERABLES Understand best practices that can be replicated across Wellness Centers Determine costs and revenue drivers behind LAUSD Wellness Centers Visit 4-6 Wellness Centers to hold conversations with CEOs and clinic managers Collect cost and revenuerelated documents from Wellness Center staff and administrators Identify commonalities and outliers across Wellness Center financials Share exportable insights collected from Wellness Center visits Suggest metrics for Wellness Centers / LA Trust to pursue to measure Centers success 4
Site Visits and Interviews Jan. 14: Consultation Deloitte Apr. 21: Site Visit 4 Apr. 10: Site Visit 2 February 15: Informational Interview LAUSD, School Mental Health JANUARY FEBRUARY MARCH APRIL Jan. 24: Site Visit 1 Apr. 18: Site Visit 3 Apr. 9: Informational Interview LAUSD, School Mental Health 5
Key Challenges of Wellness Center Network BUILT-IN DIFFICULTIES Wellness Centers mission poses inherent conflict with revenue generation. o Inadequate support & inconsistent funding (both in sources and in amounts provided) Difficult to compare wellness centers (variance in services offered, physical layout, support among principals and nurses, student/community patient distribution, insurance o Difficult to know how, when, and where to support wellness centers (resources, funding, collaborating with third-party providers) OPERATIONAL INEFFICIENCIES Absence of metrics means there is no way to prove value of wellness centers and effectiveness of key initiatives. Longevity of wellness center staff leads to difficulty in gaining compliance with revenuemaximizing procedures 6
Key Challenges of Wellness Center Network [cont.] LACK OF STANDARDIZATION Different levels of support from wellness center stakeholders (school administrators, school staff, parents, students, third-party provider) Changing healthcare regulations, reimbursements, eligibility comprise a A New Normal which wellness centers have never navigated before Some challenges with certain sites regarding facilities and operations o Interaction difficulties among LAUSD services MISSED OPPORTUNITIES Learning Collaborative as an opportunity to share segmented peer-to-peer best practices Raising awareness of wellness centers location/availability/services to the students and community at large 7
Enhancing the Wellness Center Value Chain CREATING VALUE IDENTIFIED CHALLENGE 1. How do we capture enough of the right kind of patients? PROPOSED SOLUTION Target awareness initiatives by appealing to audiencespecific needs. DELIVERING VALUE CAPTURING VALUE SUSTAINED REVENUES 2. How can we encourage patients clinic adoption? 3. How can we ensure that our clinic maximizes its revenue potential? Enhance patients clinic experience. Train and incent office staff to comply with revenuemaximizing procedures. 8
Ideal Wellness Center Model 9
Ideal Wellness Center Model Explained Provide direction, oversight, training and funding for the ideal wellness center model using the key success drivers below: Establish strong relationships with top school administrators, including LAUSD superintendent and school principals. Set clear objectives and expectations of support from the highest levels of school administration. Specifically target community members through demographic analysis and trackable marketing campaigns. Set two new referral incentives: 1) for students to refer their parents to the WC and 2) for parents to refer other family members to the WC. Create formalized hospital referral program for local hospitals so that they are aware and incented to send out-of plan patient referrals to the WC. 10
Proposed Solution #1 Target awareness initiatives by appealing to audience-specific needs. Actions Steps for Wellness Centers 1. Analyze demographic composition of potential student and community patients 2. Create targeted awareness initiatives to attract students and community members Ex: Position WCs as desirable alternatives to family physicians Ex: Experiment with communication media, such as texts and social media 3. Track results of awareness initiatives to replicate successes. Actions Steps for LA Trust 1. Segment Learning Collaborative meetings by role to maximize peer-topeer sharing and learning. 2. Prioritize principals buy-in as a critical linchpin of success. 3. Provide resources, e.g., staffing and funding, for wellness center / clinichosted health fairs. 11
Proposed Solution #2 Enhance patients clinic experience. Actions Steps for Wellness Centers 1. Establish and standardize tested procedures to minimize no-show appointments. 2. Track operational metrics, e.g., patient throughput time, cycle time in important patient experience stages like reception and physician/pa/np utilization rates. 3. Provide convenient, patient-friendly procedure to facilitate switching PCP assignment. Actions Steps for LA Trust 1. Proactively seek and promote importance of receiving patient visit data from each Wellness Center. Ex.: Provide metrics template for WCs to fill out. 2. Facilitate conversation among wellness center leadership to determine achievable, measurable patient visit goals across network. 3. Share compiled metrics dashboard across network to ensure ongoing monitoring and encourage continuous improvement. 12
Proposed Solution #3 Train office staff to comply with revenue-maximizing procedures. Actions Steps for Wellness Centers 1. Train and provide incentives for frontoffice staff to enhance compliance with established billing procedures. 2. Create relationships with local hospitals and establish procedures for streaming out-of-plan patients to wellness centers. Actions Steps for LA Trust 1. Promote and advise on the Ideal Wellness Center model: LAUSD Support Top-Down School Support Community Awareness Program Family Referral Program Hospital Referral Program 3. Establish cross-referral system between wellness centers and mental health centers. 13
Suggested Metrics Target awareness initiatives by appealing to audience-specific needs. Enhance patients clinic experience. Promote compliance with revenuemaximizing procedures. Email open rates Email click-through rates Clarity of teachers / nurses / counselors understanding of how and when to refer students Sources of patient referrals How patients learned of the clinic Patient cycle time Staff utilization rates Patients level of satisfaction (before and after clinic visit) Patients propensity to make repeat visits Patients likelihood of recommending clinic to family and friends Patient no-shows Clarity of staff s understanding of clinic s billing procedures Missed revenue opportunities Number of hospital-referred patients Number of cross-referred patients between wellness center and mental health center 14