FTEs per Adjusted Discharge Part II

Major Markets and Relationships with Outcomes & Value

Picking up where we left off…we’re exploring differences in major markets and whether there is a solid relationship between this key staffing metric and outcomes.  

First, looking at the top 5 major markets:

  • There are wide staffing level variations within each market
  • There are wide staffing level variations among these markets
  • High FTE’s/AD-CMI adj. impacts cash flow negatively with market-specific benefit to outcomes within and among the markets

Below find tables of FTE’s/AD-CMI adj. and HVBP Total Performance Scores of the top 5 major markets.  (We are using HVBP-Total Performance Score as an important overarching outcome measure.)

What we see is remarkable:

For Staffing across the Top 5 markets we can see that:

  • Houston has the best staffing ratios of any of these Top 5 Markets with
  • Chicago a close second
  • New York has the worst staffing ratios of the top 5 markets across the board

For HVBP Performance across the Top 5 markets:

  • LA is the best performer overall with
  • Chicago a close second
  • New York has the worst HVBP Performance Score

The real story is found by looking at the two metrics together, where we see:

  • In 4 of these top 5 markets there is a relationship between FTEs/Adjusted Discharge-CMI Adjusted and the HVBP Total Performance Score. As labor goes up, so do outcomes.
  • As FTEs/100 Adjusted Discharges continue trending down, how will hospitals in these major markets sustain improving outcomes?
  • Only in Philadelphia do we see a reverse relationship between FTE labor and HVBP Outcomes.  At high levels of FTE/AD staffing, Outcomes suffer significantly. Yet they are no better than Houston at low staffing ratios. Not a good story.

There are many more layers…do investor-owned outperform not-for-profits? Does it help to be in a system? Are there standout Best Practice facilities? It’s all available uniquely to you via Franklin:BI. We’ll move on from here, but the platform we have should be of interest to anyone in the business of healthcare.

Franklin:BI curates virtually all healthcare provider data for every year published and ties it together contextually and competitively. Connecting financial and operational performance to outcomes; quality and safety with your own market’s data gets you to better, faster, smarter answers.