Quantifying and Communicating the Value of Athletic Trainers in the School and Club Setting Benjamin D. Gecewich, MBA, MS, ATC Great Lakes Athletic Trainers Association March 12, 2016
COI Disclosure The views expressed in these slides and today s discussion are mine My views may not be the same as the views of my company, clients or my colleagues Participants must use discretion when using the information contained in this presentation
Goals for Today Why does value matter? How do you quantify value? How do you communicate value?
The focus of this session is to share methodologies for quantifying the value of athletic training services in different outreach settings to multiple audiences. Without a pragmatic approach, key services can often be overlooked or minimized when sharing the value they provide. There are often multiple ways to communicate objective value findings, with different parties requesting different pieces of information. By going through a structured inventory and analysis, an accurate picture can be formed and replicated month by month, quarter by quarter, and year by year. Once the value is quantified, utilizing ideal methods of communication are key to gather support for growth, maintenance, and other wanted changes. By standardizing the approach to calculating and communicating value, the athletic trainer will be more likely setup for success and support.
Learning Objectives 1) Ability to construct tools to quantify direct value of services provided. 2) Ability to evaluate indirect value and quantify benefits of indirect clinical care provided. 3) Ability to communicate value and ROI for both the payer and recipients of services.
Where is Greenville?
Who is GHS? 6 Hospital Campuses 1,358 Licensed Beds 181 Physician Practice Sites 15,000 Employees 1,200 Employed Providers 5 MD360 Locations USCSOM-Greenville
Who We Are and What We Stand For Our Vision Transform health care for the benefit of the people and communities we serve. Our Mission Heal compassionately. Teach innovatively. Improve constantly. Our Values Together we serve with integrity, respect, trust and openness.
GHS Network History Pre 1997 - Schools that wanted ATC coverage had individual contracts with physical therapy groups to provide ATC coverage as an outreach service, but not dedicated coverage 1997 - After the unfortunate death of high school basketball athlete, more uniform coverage is expedited within the county 1998 - GHS begins the Network with 3 ATCs covering 4 Greenville County High Schools as dedicated ATCs at schools not split roles 1999 - Network expands to 10 ATCs covering 11 Greenville County High Schools 2002 - Network ATC saves high school basketball athlete at Mauldin High School which confirmed purpose and role at schools Network expands to all 14 Greenville County High Schools and AED Movement started 2005 - GHS begins to build Sports Medicine Division with formation of Steadman Hawkins Clinic of the Carolinas Adds 3 Private High Schools in Greenville County AEDs provided in all covered locations Network expands to Spartanburg County including SC School for the Deaf and Blind 2007 - GCSD awards exclusive contract to GHS ATC Network for district wide coverage Network expands to include 19 Greenville County Middle Schools Adds North Greenville University Adds Simpsonville Parks and Recreation 2009 - Network expands to include Greenville County Parks and Recreation 2012 - GCSD contract renews with GHS ATC Network as exclusive provider 2013 - Network expands to include USA Karate
Transforming Healthcare Original intent and purpose was to provide a community service to the athletic population of the county. No competitive differentiator and minimal collaboration as private physicians and groups served as team physicians Integration into the schools critical for access to and by the community at large Improved partnership with school personnel, clinical ATC staff, GHS physicians Full time school coverage, no clinic and no teaching responsibilities, resulting in 100% dedication to taking care of student athletes Directly improve the health and well being of upstate South Carolina impossible to do individually
GHS Athletic Training Complement 2005 2015 13 Network ATCs 41 Network ATCs 17 Clinical ATCs 5 Certified ATCs 1 Advocating ATC
Who is the Network? 39 Athletic Trainers serving 51 local Schools and Venues, with 2 ATC managers 3 ATC per College 1 ATC per HS 1 ATC per 2-3 MS 1 ATC per Community Venue Greenville County North Greenville University 14 Public High Schools 3 Private High Schools 19 Public Middle Schools Greenville County Parks and Recreation Simpsonville Parks and Recreation Spartanburg County 5 Public High Schools 2 Private High Schools 7 Middle Schools Nationwide USA Karate (In partnership with ASI and ATI/Proaxis Therapy)
Structure Official Chain of Command Clinical Chain of Command UMG Medical Director UMG CAO Department Director ATC Manager Network ATC Department Chairman Department Vice Chairman Division Chief Sports Med Network Medical Director ATC Manager Network ATC
Value Proposition By locating the ATC full time at the school, able to provide immediate, no-charge treatments to the athlete, which previously had to be performed in a PT office at a charge to the patient/insurance. Including athletic training rooms in the school athletic facilities, as well as providing basic injury treatment equipment allows these treatments to be performed on site. Able to also benefit from a reduction in missed school time, travel time for parents, as well as increasing visibility of the GHS ATC to the coaches, athletic directors, school faculty and staff Increases the knowledge of all that the ATC offers to the school. When school asks where the coverage is you know you are making a difference
Purpose Injury Prevention and Reduction Monitor and Evaluate Initial Injury Injury Treatment through Onsite Rehabilitation Physician Referral/Communication/Collaboration Monitored Return to Competition
2015 Service Stats Covered Athlete Lives = 18,000+ Total number of treatments = 64,578 Value of onsite treatments = $1,857,976
Service Value Crosstab Service Quantity Market Value Total Service Value Evaluation TherAct - 15 min ImPact Testing TherEx - 15 min TherEx - 30 min TherAct - 30 min Electric Stim Other Services Total
Value Differentiators Anyone can provide onsite healthcare services What have you done for me lately?
Additional Benefits Coordinate pre-participation physicals to select schools. Continuity of care by same ATC season after season and year after year Parent education Expedited access to orthopaedics - Team Physician roles Coordination with Emergency Departments, MD360 locations MRI hotline for athlete slots, including after hours and weekends Injury/Illness referrals to network of GHS and other specialists Evening SHIFT
Additional Benefits Safe Sports School Awards Currently 44 Schools recognized as 1 st Team recipients IMPACT concussion testing for all FB athletes, first in state to do IMPACT baseline testing, developed RTP model with UNC and NATA 2011 = 847 2012 = 991 2013 = 1,505 2014 = 1,103 2015 = 1,019 Bump and Bruise Clinic on Saturday mornings during FB season (Greenville and Spartanburg) 2012 = 116 2013 = 104 2014 = 97 2015 = 108
Service Differentiators Feedback and Education related to Athletic Training and Injury Prevention services EMS coordination and training, annual spine board in-service and training Coaches Clinics of in the news topic or per coach request (Sports Psychology, Injury Prevention Program, Nutrition, Female Athlete Triad, Strength Training, Plyometrics, Concussion RTP, Throwing Shoulder, Speed Training, Emergency Action Plan, Coaching to Win) First Responder In-services Monthly meeting with county AD, included in communication pathways Annual SHSM Symposium since 2005 Surveys to schools, coaches, and athletic directors
Athletic Directors Survey Indicate your level of satisfaction with the return to play and treatment results following an injury. How professional is our Steadman Hawkins Sports Medicine (SHSM) Team? How responsive is our SHSM Team to your needs or concerns? How easy is it to schedule urgent appointments with a SHSM physician following an injury? How likely are you to recommend SHSM to others? Do you feel the Coaches Clinic presented by SHSM are beneficial to you and your staff? Indicate SHSM level of commitment to the well being of your athletes How well do you feel SHSM communicates with parents, athletes and staff?
Partnership Differentiators Relationships with ATI/Proaxis Therapy, ASI and other Partners Strength Coach Certifications through ASI Quarterly ATC Bioskills series with SHCC MDs and Hawkins Foundation Integrated Throwing Academy ACL Injury Prevention Program Dynamic Warm Up Program
Communication to Recipients - Annual report out to school district - Inventory of healthcare services provided - Inventory of quantified savings to athletes and families - Additional benefits and outcomes - Feedback from surveys
Importance of Communication - Competition in market - Not just about dollars saved or perceived value contributed - Must share entirety of program - Lessons learned
ROI for system - Main goal is to take care of the athlete - Athlete and parent choose where they go - Better collaboration with GHS, but will assist in other referrals requested and medically necessary
2015 Investment ATC Talent Benefits and Retention Travel Mileage Clothing and Uniforms Communications Computers AED Updates and Supplies Total
Purpose Injury Prevention and Reduction Monitor and Evaluate Initial Injury Physician Referral/Communication/Collaboration Injury Treatment through Onsite Rehabilitation Monitored Return to Competition Market and Promote GHS/SHCC/SHSM -Direct and Indirect
In-Kind Consideration Will it be good for the community where the event is located that we are there providing this service? Does the event promote our values and beliefs? Have we had good working relationships or prior affiliations with the host? Do we anticipate a future relationship with the host? Are we already in the area or are we striving to move that direction? Are we going to benefit from having our name in the market? How do we quantify the value of services provided? Will sponsoring the event promote economic development? How many proposed views will GHS get at/during the event or from items related to the event afterwards?
Additional Healthcare Provided Numerous GHS Sponsored Events and Competitions Upstate Safe Kids event coverage and promotion Greenville County YMCA Soccer All South Lacrosse Men s League US Pro Cycling Championships South Carolina Triathlon Series South Carolina Open Karate Championships Upstate Home School Association Nike Lacrosse Camp at Clemson University Greenville Scottish Games at Furman University The Blade Jr. Golf Championship Web.com Tour BMW Pro Am golf tournament SHCC Southern Slam Wrestling Tournament NCAA Triathlon National Championships SCHSL State Wrestling Tournament
ROI Value Crosstab Service Quantity Charge Net Revenue Eval with X-Ray 1 A 1 x A x Collection Rate Eval without X-Ray 2 B 2 x B x Collection Rate Return Visit 3 C 3 x C x Collection Rate Return Visit with X-Ray 4 D 4 x D x Collection Rate PT Referral 5 E 5 x E x Collection Rate MRI 6 F 6 x F x Collection Rate Surgery 7 G 7 x G x Collection Rate ER Visit 8 H 8 x H x Collection Rate Other Services 9 I 9 x I x Collection Rate Total Sum of Above
Game Changer Transformation in Healthcare Value Measure outcomes on current treatment plan Analysis of data and perform Comparative Effectiveness Research (CER) Establish Protocols based on CER
PHS Baseline Player Registration Database PHS Roster Database student ID year/term registration baseline data Athletic Event Exposure Database school sport date event held (e.g. practice, game) PHS Eligibility Database student ID sport date eligibility status change student ID school year/term sport ATS Athletic Status Change Database student ID date sport status change AT Treatment Center Research Database Sufficient information to calculate for quality : event rates by school/sport effects of baseline characteristics on events effects of baseline characteristics on treatment choices. effects of treatment choices on outcomes Insurer Claims student ID Provider Tx
Future ATC Impact Potential Business Health PCMH Models Mobile Healthcare Clinic Industrial Settings Population Health Value Based Care Models
Great leaders and great organizations are good at seeing what most of us can t see. They are good at giving us things we would never think of asking for. -Simon Sinek, Start With Why
Thank You!! GLATA Committee on Practice Advancement Brent Millikin, M.Ed., ATC Gil Gilliland, MBA, ATC John Thorpe, M.Ed., ATC, CSCS
Ben Gecewich bgecewich@ghs.org