A Dental Incentive System that Works

1. A Dental Incentive System that Works Juris M. Svarcbergs,DMD,MPH Dental Director CAMcare Health Corporation Increase Productivity-Increase Satisfaction

2. Background • The early years ‘Do gooders’ Focus on ‘ideal service’ Dedication to cause or philosophy Increase Productivity-Increase Satisfaction

3. 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) Increase Productivity-Increase Satisfaction

4. Background • The Changing Times Burdened with debt Graduates Business oriented Dentists MBA Administrators The realization:“To do Good, we must do Well!” Increase Productivity-Increase Satisfaction

5. Driving Forces in today’s environment • Decreased grant funding opportunities • Mainstreamed care delivery Competition for patients Competition for revenue • Increased opportunity for Revenue generation Increase Productivity-Increase Satisfaction

6. The New Environment Cost Center Analysis Increase Productivity-Increase Satisfaction

7. DENTAL PRODUCTIVITY • Target is 2,400/DDS Annualized Rate: 2,639 enc/DDS Increase Productivity-Increase Satisfaction

8. Improvements in MIS, CIS • Enable accurate dental data collection • RVU capabilty for correlation of amount of care with visit info • Provider profiles Increase Productivity-Increase Satisfaction

9. Why not become …… competitive in today’s environment withMOTIVATED and EFFICIENT PROVIDERS!?! Increase Productivity-Increase Satisfaction

10. 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? Increase Productivity-Increase Satisfaction

11. The Dilemma(s) • Increased Revenue can only be generated with • Administrators don’t want to lose over expenditures • Providers don’t administrators to share income or ‘commission's’ fairly Increased Productivity control trust Increase Productivity-Increase Satisfaction

12. 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. generated • The ‘mathematician's dream’ formula Increase Productivity-Increase Satisfaction

13. 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 Increase Productivity-Increase Satisfaction

14. Real Life Increase Productivity-Increase Satisfaction

15. How to Build an Effective Incentive Program:The “5 Commandments” • Simple and easy to understand • Allay administration fears • Empower providers • Make the reward memorable • Relate the incentive directly to the organization’s income level Increase Productivity-Increase Satisfaction

16. Guaranteed base salary: Reasonable and contractual Good fringe benefits Health coverage, malpractice,CME time & coverage, pension Security Budgeting Goodwill and competitive edge Only one concern-PRODUCTIVITY The CAMcare Incentive Plan Increase Productivity-Increase Satisfaction

17. 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) The CAMcare Incentive Plan Increase Productivity-Increase Satisfaction

18. Dr. XYZ had 645 patient visits this quarter At $80K contract/yr, Dr.XYZ rec’d $20,000 in base salary Reaching/Goal gets $2,000 Bonus CHC submitted bill for approx. $64,500 to all payors CHC expects to get min. 2.5 times what pays out docs CHC gets $42,500 (Doc gets $22,000) ‘Bonus Payout’ Example Increase Productivity-Increase Satisfaction

19. Special Request for Payout! Goal Achievers: Increase Productivity-Increase Satisfaction

20. Bonus is Recognition of Achievement • Bonus checks are separate and usually presented by CEO Increase Productivity-Increase Satisfaction

21. And it’s part of total Package Professional Compensation Package: • Base Salary $ 80,000 • Health Coverage 5,604 • Soc.Security Taxes 4,142 • CME Allowance 1,500 • Vacation,CME,Personal, Holidays,Sick, time 8,941 6. Malpractice Coverage 3,800 Increase Productivity-Increase Satisfaction

22. Add up Total Package Total Value………………$ 103,987 If Loan Repayment-add 25,000 TOTAL Package without Bonus: $128,987 !!! Is another $ 8,000 worth the effort??? Increase Productivity-Increase Satisfaction

23. Results: Avg.Encounters/DDS Increase Productivity-Increase Satisfaction

24. Results: RVU’s per DDS/yr. Increase Productivity-Increase Satisfaction

25. Results: DDS’s reaching goal Increase Productivity-Increase Satisfaction

26. DENTAL VISITS by Year Increase Productivity-Increase Satisfaction

27. The Bottom Line: Dental Cost Center $ EPI (profitability) Increase Productivity-Increase Satisfaction

28. CAMcareRevenue & Expenses Increase Productivity-Increase Satisfaction

29. S = R/E Increase Productivity-Increase Satisfaction

30. S = R/E • Choose a ‘goal’ that directlyinfluences the organization’s income level • Offer a definite bonus amount that is ‘BIG’ yet ‘small’ • Support providers in achieving goal at every level Increase Productivity-Increase Satisfaction

31. S = R/E • Make the reward memorable (timing, amount, presentation) • Report to Board as a “Dental Department defining” event! (Dental exceeds expectations) Increase Productivity-Increase Satisfaction

32. Providers (and support staff) CEO CFO Board Patients Community Who are the ‘Satisfied Customers’? Increase Productivity-Increase Satisfaction

33. Simply Satisfying! Increase Productivity-Increase Satisfaction