University Patient Care

1
University Patient Care Revenue Management

• Jim Grizzell, MBA, MA, CHES, HFI, FACHA

2
Overview

• Effective Student Health Care
• Evidence-based Cost-effective
• Context
• Assumptions
• Standards (AAAHC, CAS, ACHA)
• University Strategic Plan
• Two Patients and Their Care (slides 4-6)
• Patient Care Revenue Management (slides 7-8)
• Expense Management (slides 9-10)
• Notes (slides 12-18)
• Appendices (student health data, HAPM, social
  marketing and ecological approaches slides 20-34)

See additional information in Notes Sections of
slides.
3
Assumptions

• Illness injury expected
• Patient community care expected
• University wants or needs to have health service
• No free health care
• Three ways to pay
• Prepaid fees
• Fee-for-service
• Insurance

• Costs will increase but can be managed and
  minimized
• Patients need support and health promoting
  environment
• Health and productivity are related
• Health problems may not present at the health
  center (see slides 21-22)

4
Two Patients Need Care

• Enhance academic success
• Think health agenda
• Not health care agenda
• Health continuum
• Patients and care
• Individuals
• Campus community
• Cost-effective evidence-based approaches
• High reach
• Low cost

5
Health Continuum
Adapted from ODonnell, M., Definition of Health
Promotion," AJHP. Summer 1986. 11.4.
6
Study Well Health Continuum
7
Patient Care Revenue Management

• Health fee management
• Monitor expenses and adjust
• Health center and program management
• Utilization
• Quality
• Facilities and equipment
• Supplemental sources
• Grants
• Fee-for-service
• New products and services
• Non-student faculty staff
• Minimize uninsured students
• A successful health program characteristic

8
Patient Care Revenue Management

• Student health promotion
• Long-term Return on Investment (ROI)
• Fewer health impediments and risks better
  academic performance
• Higher GPA greater alumni giving
• Faculty staff health promotion
• Affected by Healthy Campus Initiative
• May influence student health
• Short-term Return on Investment (ROI)
• Fewer health impediments better work
  performance (productivity)

9
Expense ManagementEmphasize High Reach / Low
Cost

• Expenses for two patients
• Individuals
• Students needing clinical care
• Health problems related to academic performance
  (see slides 23-25)
• Not necessarily presenting to the center
• Individual/patient care education
• Site virtual (slide 26)
• Campus-Community
• Community health needs
• Healthy Campus Initiative

10
Expense ManagementEmphasize High Reach / Low
Cost

• Health Academic Performance Management (HAPM)
  (see slide 26)
• Inoculate in 1st year experience
• Booster shots throughout academic career
• Healthy Campus Initiative
• Community collaboration
• High reach / low cost approaches
• Social Marketing (see slides 27-30)
• Ecological/Environmental (see slides 31-34)

11
Summary

• Effective Student Healthcare
• Evidence-based Cost-effective
• Context
• Assumptions
• Standards (AAAHC, CAS, ACHA)
• University Strategic Plan
• Two Patients and Their Care
• Patient Care Revenue Management
• Revenue Management
• Expense Management

12
Notes

• Turner, H. and J. Hurley (eds). History and
  practice of college health. University of
  Kentucky Press, Lexington. 2002.
• Agency for Healthcare Research and Quality. Guide
  to clinical preventive services. Available at
  www.ahrq.gov/clinic/cps3dix.htm. Accessed on Feb
  26, 2007.
• Accreditation Association for Ambulatory Health
  Care. Improving Health Care Quality Through
  Accreditation. Available at www.aaahc.org.
  Accesses on Feb 28, 2007.
• American College Personnel Association and the
  National Association for Student Personnel
  Administrators. Learning reconsidered a
  campus-wide focus on the student experience.
  2004.
• American College Health Association. Guidelines
  for college health programs. Baltimore, MD. 1999.

13
Notes (cont)

• American College Health Association. Healthy
  campus 2010 making it happen. Baltimore, MD.
  2001.
• American College Health Association. National
  College Health Assessment. Available at
  www.acha-ncha.org. Accessed on Feb 26, 2007.
• American College Health Association. Standards of
  practice for health promotion in higher
  education. Available at www.acha.org/info_resource
  s/SPHPHE.cfm. Accessed on Feb 26. 2007.
• American College Health Association. Vision into
  action. Baltimore, MD. 2005.
• Centers for Disease Control. Guide to community
  preventive services. Available at
  www.thecommunityguide.org/. Accessed on Feb 26,
  2007

14
Notes (cont)

• Council for the Advancement of Standards in
  Higher Education (CAS). CAS professional
  standards for higher education (6th ed.), College
  Health Programs and Health Promotion Services.
  Washington, DC 2006. National Association for
  Student Personnel Administrators. Health
  education leadership program. Available at
  www.naspa.org/help/index.html. Accessed on Feb
  26, 2007.
• National Association for Student Personnel
  Administrators. Health education leadership
  program. Available at www.naspa.org/help/index.htm
  l. Accessed on Feb 26, 2007.
• McGinnis, J., Williams-Russo, P. and Knickman, J.
  The case for more active policy attention to
  health promotion. Health Affairs. 212.78-93.

15
Notes (cont)

• Grizzell, J. The university learning mission,
  college health and the health agenda. NetResults.
  March 8, 2005. Available at www.naspa.org/members
  hip/mem/nr/article.cfm?id1486. Accessed February
  25, 2007.
• ODonnell, M., Definition of Health Promotion,
  AJHP. Summer 1986. 11 p4.
• Teague, M., R. Cipriano, V. McGhee. Health
  promotion as a rehabilitation service for people
  with disabilities. J Rehab. Jan-March 1990.
  Available at www.findarticles.com/p/articles/mi_
  m0825/is_n1_v56/ai_8844435. Accessed on Feb 26,
  2007.
• Chapman, L. Do we need a virtual program
  infrastructure for worksite and population health
  promotion efforts? Art Health Promo Nov/Dec
  20061-7.

16
Notes (cont)

• Grizzell, J. Helping policy makers discover the
  health and productivity connection (presentation
  at ACHA Annual Meeting on health and academic
  performance management). Available at
  www.csupomona.edu/jvgrizzell/hc2010/acha05nho/ind
  ex.htmhealthandproductivity. Accessed on Feb
  25, 2007.
• Hunter, C., E. Jones, C. Boger. A study of the
  relationship between alumni giving and selected
  characteristics of alumni donors of Livingstone
  College, NC. J Black Studies March, 1999. 294.
• Ott, C., Haertlein, C. Craig, D., A collaborative
  student affairs and faculty health assessment and
  intervention initiative. JACH. 516.257-261.
• American College Health Association. Behavior
  change and the frosh 15 tracking women's
  physical activity and dietary patterns in 1st
  year university. JACH. 2006. Unpublished
  manuscript.

17
Notes (cont)

• Centers for Disease Control. Health Marketing
  CDCynergy Social Marketing. Available at
  www.cdc.gov/healthmarketing/cdcynergy/index.htm.
  Accessed on Feb 25, 2007.
• Academy for Educational Development. Innovations
  in social marketing conference. academic
  roundtable positioning social marketing in the
  academic environment. Available at
  www.ismconference.com/confagenda.htm. Accessed on
  Feb. 25, 2007.
• Grizzell, J. Monitoring a program history of
  the wellness center and The wellness card a
  health promotion and disease prevention program
  to help the university achieve its mission.
  Available at www.csupomona.edu/jvgrizzell/eval/ou
  tcomes.htm. Access on Feb 25, 2007.

18
Notes (cont)

• Lictman, P. CMU and employees save money on
  health care. Mar. 22, 2006. Available at
  http//news.cmich.edu/archived/index.asp?id1253.
  Accessed on Feb 28, 2007
• Smith, S. CMU and employees benefit from
  self-insurance. Available at http//news.cmich.edu
  /news/index.asp?id1795. Access on Feb 28, 2007.

19
Contact Information

• Phone
• [phone]
• Email
• jvgrizzell_at_csupomona.edu
• jvgrizzell_at_earthlink.net
• Address
• 1805 S. Grant St. Arlington, VA 22202
• Web Page
• www.csupomona.edu/jvgrizzell
• https//experts.csupomona.edu/expert.asp?id120

20
Top 10 Physical and Mental Health
ProblemsAggregate NCHA Data Spring 2004
(N47,202)American College Health Association.
National College Health Assessment Web Summary.
Updated June 2004. Available at
http//www.acha.org/projects_programs/ncha_sampled
ata_mbrs.cfm.2004
21
Healthy Campus 2010Top 10 Health Impediments to
Academic Performance
22
Health Behaviors Which Students Would Like to
Improve Results of a Student Health Needs Survey
www.csupomona.edu/jis/1998/brown.pdf
23
GPA Number of Top 10 Health Impediments to
Academic Performance (NCHA q44)
24
GPA Number of Health Risks
25
GPA Number of Top 10 Health Physical and Mental
Health Problems (NCHA q43)
26
Evolution of Campus Health Promotion (follows
Worksite HP)
From Chapman, L. Do we need a virtual program
infrastructure for worksite and population health
promotion efforts? Art Health Promo. Nov/Dec
20062.
27
Social Marketing
28
True or False
29
Social Marketing

• Use of commercial marketings marketing mix of
• product planning
• pricing
• communication
• distribution
• marketing research
• Strategic planning framework comprising
• consumer research
• segmentation and targeting
• objective setting
• manipulation of the marketing mix
• to influence the acceptability of health
  promoting behaviors

30
Social Marketing

• Determinants of behavior
• Fun
• Are the consequences of behavior both real and
  rewarding for me?
• Easy
• Can I do it? Am I capable?
• Popular
• What do the people I care about want me to do?

31
A New Paradigm The Ecological Approach to
Campus Health

• Views the connections among health, learning, and
  the campus structure
• Explores relationships between and among
  individuals and the learning communities that
  comprise the campus environment

http//www.naspa.org/help/index.html
32
Influencing Factors
Individual
Community
Place
Organization
People
33
Environmental Influences
Place
People
Behavior settings Rituals, student
organizations Cultural Influences Customs,
traditions, values Economic Forces Student
financial stability, budget Inhabitants
Diversity, Athletics, Greek, campus communities,
etc.
The location of the campus The weather The
constructed designs Landscapes
Organizational Structure Policies Organizational
Climate
Organization
Community
Political Climate Conservative/liberal Pro
education? Reinforcement and Rewards For healthy
org indiv behaviors
34
Stress Environmental Influences
Warm climate Lack of parking High traffic Campus
sizedistances Crowdinglong lines
Place
People
Financial concerns ISO global
troubles Relationships w/friends Lack of
friends/commuters Irresponsible
drinkers Uninvolved students
Services--lack of info Depts disconnected Too
many steps Weak policy enforcement Inconsistent
messages
State budget crisis Increase in
tuition/fees Rewards for over commitment Culture
of stress
Institution
Community