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TFC Survey 2012 The Pulse of the Nation

TFC Survey 2012 The Pulse of the Nation. Debbie Mast Stanford Hospital and Clinics, Database Administrator and Financial Manager Amy Hackney, MBA Manager, Transplant Reimbursement Tulane Transplant Institute TFCA Workshop September 18-20 th , 2013. TFC Survey 2012. 1 st Survey – 1997

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TFC Survey 2012 The Pulse of the Nation

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  1. TFC Survey 2012The Pulse of the Nation Debbie Mast Stanford Hospital and Clinics, Database Administrator and Financial Manager Amy Hackney, MBA Manager, Transplant Reimbursement Tulane Transplant Institute TFCA Workshop September 18-20th, 2013

  2. TFC Survey 2012 • 1st Survey – 1997 • 2nd – 2002 • 3rd – 2007 • Who participated in the survey? • Transplant Administrators • Transplant Financial Coordinators – Solid Organ and BMT

  3. 2012 Survey Focus • Program volumes • FTE’s • Educational requirements • Reporting Structure • Salaries • Job duties and responsibilities • Certification

  4. How was the survey conducted? • E-mail via TFCA and Administrators List serves with link to survey • SurveyMonkey.com • Secure and confidential • Professional online survey • Results collected and compiled Reminder notices were sent out encouraging everyone to complete along with passing along to other team members who might not be on the list serves.

  5. Response Rate by Survey Year • 133 of 274 (49%) of transplant centers responded to 1998 survey • 130 of 257 (51%) of transplant centers responded to 2002 survey • 147 of 261 (56%) of transplant centers responded to 2007 survey • 158 of 250 (63%) of transplant centers responded to 2012 survey 67 Administrators and 175 TFC’s responded to the survey

  6. UNOS Regional Map

  7. Administrator Responses by Region

  8. Types of Transplants Performed

  9. Number of Referrals per Calendar Year

  10. How Many Transplants per Year?

  11. Let’s Take Another Look…

  12. Are the Transplant Financial Coordinators Dedicated to the Transplant Program? Of the 4 centers responding NO; 3 Region 10 and 1 Region 3

  13. Who handles the responsibilities of the TFC if there is no primary TFC dedicated? Social Worker 3% Billing/Collections Representative 1.5% Other (shared position) 1.5%

  14. How Many Transplant Financial Coordinators (FTE’s) are Assigned by Program One Liver Program and One Kidney program had > 5 FTE’s per Organ

  15. Program Examples of FTE per Referrals/Transplants

  16. Who is the TFC Employed by? Hospital/Medical Center – 63, 94% Physicians Group – 1, 1.5% Patient Financial group (Billing/PFS) – 2, 3% Outside Contracted Agency - 1, 1.5%

  17. Who does the TFC Report to? • Supervisor - Financial Coordinators 7.6% • Manager - Financial Coordinators 19.7% • Admissions Manager/Director 4.5% • Transplant Administrator 50% • Contracting Manager/Director 3% • Patient Accounts Manager/Director 9.1% • Other (includes: Medical Director; Program Manager; Operations Manager; Business Manager; Supervisor of Operations) 19.7%

  18. Minimum Education Requirements Other: BA Business; SW for combined role; BA preferred; don’t know Out of 64 respondents: 37 HS/GED; 5 AS/AA; 15 BS/BA; 1 Masters; 6 Other

  19. Experience Required In comparison to 2007 survey: 0-2 years 31% increased by 16% 2-5 years 57% decreased by 10% 5-8 years 12% decreased by 7% 8 or more years 0% increased by 1%

  20. Area of Experience Required

  21. Salary Range Salary In comparison to 2007 survey: Salaries above 35k in 2007 encompassed 59.5% of TFC’s In 2012, 64.5% of TFC’s salaries are above 35k

  22. Salary Range by Region

  23. On what Position is salary Based? Similar positions within the hospital 80.3% Specifically on TFC position 19.7% Additional Compensation includes: Overtime 60.9% Compensatory Time 14.1% Education and Travel expenses 71.9% Call Pay 9.4% Annual Bonus 17.2%

  24. On-call Days % # Days on-call

  25. Would your Center be willing to Pay for TFC Certification? 66.2% - YES 7.7% - NO 16.9% - Maybe 9.2% - Not Sure

  26. How do our Administrators feel? The TFC role is a requirement of the OPTN for transplant center membership. Education and certification will only help to emphasize the need for development of these positions within the transplant program. We can't really have enough resources or expertise in this area. I believe the certification of TFC's is very important to the organization and its credibility. A certification program would allow us (administrators) to lobby for higher pay and stand along titles as we could establish the field better than we currently can

  27. How do our administrators feel? TFCs are one of the most under valued team members on the Transplant team. Somewhat due to lack of professional development opportunities. Please let us know how to better help develop this profession. TFC is an excellent organization This is a specialized position and very demanding. We would welcome certification to justify appropriate compensation for the role. It would be awesome if you can provide certification for our team members. It will help internally to further differentiate them from the rest of the hospital employees as specialty trained

  28. Now It’s Our Turn What Did the TFC’s have to say...

  29. TFC Responses by Region

  30. What Programs are the TFC’s Assigned to? Kidney = 122; Liver = 74; Lung = 32; Heart = 51; Pancreas = 73; Intestine = 12; Bone Marrow = 37

  31. Experience

  32. Primary Method of Training

  33. Training (other) • None provided • Prior experience • TFCA Forums • Supervisors • Training manual • “On my own” • “I had no help, I learned as I worked” • “I winged it” • Self trained

  34. How Long at your Current Position?

  35. Educational Level

  36. Professional Certifications or Licensures

  37. Full-Time TFC?

  38. Do You Have More Than One Role? 97 respondents reported they have a dual role in their program • 7 (7.2%) spend 0 - 10% of time as a TFC • 2 (2.1%) spend 10 - 20% of time as a TFC • 2 (2.1%) spend 20 - 30% of time as a TFC • 3 (3.1%) spend 30 - 40% of time as a TFC • 4 (4.1%) spend 40 - 50% of time as a TFC • 3 (3.1%) spend 50 - 60% of time as a TFC • 6 (6.2%) spend 60 - 70% of time as a TFC • 7 (7.2%) spend 70 - 80% of time as a TFC • 8 (8.2%) spend 80 - 90% of time as a TFC • 56 (57.7%) spend 90 - 100% of time as a TFC > 82%

  39. Hours Worked The average responding TFC works 42 hours per week Median hours = 40

  40. Coverage Availability During TFC Absence

  41. Who is Covering? TFC’s noted that coverage is typically only for URGENT issues that arise in their absence

  42. TFC Job Responsibilities Attend patient selection 87.2% Obtain insurance precerts for transplant admissions 87.2% Verify RX benefits 77.3% Maintain database for financial screenings 73.8% Obtain insurance precerts for pre/post transplant services 73.8% Research and explore alternate funding sources 71.5% Obtain referrals for pre/post transplant outpatient services 64.5% Coordinate contractual arrangements 55.8% Monitor federal/commercial industry reimbursement changes 52.3% Follow inpatient admissions (admitting office function) 51.2%

  43. More Responsibilities Assist patients in completing Medicaid applications 43.0% Verify RX benefits and obtain auths 37.8% Assist patients in completing Medicare applications 34.3% Prepare monthly financial reports 32.6% Register patients (outpatient registration function) 29.1% Assist patients in applying for manufacturer grants for RX 29.1% Obtain RX auths 22.7% Make payment arrangements for patient liabilities 22.1% Additional duties noted as: Monitor clinic and inpatient accounts for charge capture and coding; Assist with Medicare D applications; RFI’s; VAD authorizations; Re-pricing claims; Policy and procedure development; clinical trial approvals

  44. Average Time Spent on Tasks

  45. % of TFC’s Responding to Completion of Tasks Inpatient account handling: follow admit, notify case manager, update benefits 93.7% Outpatient registration 90.3% Handling patients' billing questions/billing problem resolution for transplant-related claims 94.9% Billing and collecting on transplant accounts 90.9% Informing patient/family of insurance benefits for transplant; advising of other funding options 98.3% Obtaining transplant approval and other ongoing communications with insurers 97.1% Verifying insurance coverage for transplantation 97.7% Prescription verification/authorizations 93.7%

  46. Patient Educational Classes 71.2% of respondents advised their programs offer/they participate in education classes to their patients

  47. TFC Provides Coverage for:

  48. TFC Provides Services for:

  49. Staff Education On-site seminars Off-site seminars Self-guided manuals TFCA Resource Guide TFCA List serv Medicare Manuals Webinars UNOS Conference Co-Workers Internet None offered

  50. Funding for Off-Site Seminars/Conferences 10.1% of respondents advised they are not allowed to go to conferences or there is no funding available

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