A Dental Incentive System that Works

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A Dental Incentive System that Works

• Juris M. Svarcbergs,DMD,MPH
• Dental Director
• CAMcare Health Corporation

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Background

• The early years
• Do gooders
• Focus on ideal service
• Dedication to cause or philosophy

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Background

• Traditional professional formula
• Work in itself a reward
• (a non-monetary incentive)
• Salary adequate compensation
• (your paycheck is the reward)
• Administration outlook
• (were not the private sector)

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Background

• The Changing Times
• Burdened with debt Graduates
• Business oriented Dentists
• MBA Administrators
• The realizationTo do Good,
• we must do Well!

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Driving Forces in todays environment

• Decreased grant funding opportunities
• Mainstreamed care delivery
• Competition for patients
• Competition for revenue
• Increased opportunity for Revenue
  
  generation

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The New Environment
Cost Center Analysis
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DENTAL PRODUCTIVITY

• Target is 2,400/DDS

• Annualized Rate 2,639 enc/DDS

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Improvements in MIS, CIS

• Enable accurate dental data collection
• RVU capabilty for correlation of amount of care
  with visit info
• Provider profiles

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Why not become competitive
in todays environment withMOTIVATED and
EFFICIENT PROVIDERS!?!
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Lets Try an Incentive System!

• Money always works!
• Should we Increase salary?
• Should we consider commissions?
• How do we tie work produced to paycheck?

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The Dilemma(s)

• Increased Revenue can only be generated with
• Administrators dont want to lose
• over expenditures
• Providers dont administrators to
  share income or commission's fairly

Increased Productivity
control
trust
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Available Incentive Systems

• of Provider generated charges
• of collections of Providers production
• x of Medicaid income
• y of Self Pay income
• s per R.V.U. generated
• The mathematician's dream formula

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Satisfaction

• Can you really be happy if you
• ? Cant figure out your take home pay or
  bonus
• ? Cant trust the figures of billing or
  admin people
• ? You have to treat some patients in ways to
  benefit your income

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Real Life

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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
  organizations income level

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The CAMcare Incentive Plan

• 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

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The CAMcare Incentive Plan

• 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)

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Bonus Payout Example

• Dr. XYZ had 645 patient visits this quarter
• At 80K contract/yr, Dr.XYZ recd 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)

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Special Request for Payout!

• Goal Achievers

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Bonus is Recognition of Achievement

• Bonus checks are separate and usually presented
  by CEO

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And its 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

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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???

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Results Avg.Encounters/DDS
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Results RVUs per DDS/yr.
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Results DDSs reaching goal
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DENTAL VISITS by Year
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The Bottom Line Dental Cost Center EPI
(profitability)
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CAMcareRevenue Expenses
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S R/E
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S R/E

• Choose a goal that directly influences the
  organizations income level
• Offer a definite bonus amount that is BIG
  yet small
• Support providers in achieving goal
• at every level

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S R/E

• Make the reward memorable
• (timing, amount, presentation)
• Report to Board as a Dental Department
  defining event!
• (Dental exceeds expectations)

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Who are the Satisfied Customers?

• Providers
• (and support staff)
• CEO
• CFO

• Board
• Patients
• Community

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Simply Satisfying!