Calculator

Calculator 1: Outreach and Enrollment Calculator

Last entry saved: May 12, 2024

  • Potential Revenue
  • Level of Effort
  • Costs per FTE per Year

Section 1: This section estimates the total possible revenue per year from patient visits that result from patients becoming insured through outreach and enrollment efforts. It also allows you to indicate what percentage of patients new to the health center will interact with your outreach program as opposed to reaching the health center in a different way.

Section 1: Potential Revenue

How many of your current patients are uninsured (including those that have some categorical funding but are not eligible for full scope insurance coverage)? Click on each leaf to get a more detailed explanation of needed inputs.
Estimate: Of your current uninsured patients in Line 1, what percent are eligible, or will become eligible under health reform, for the following payer sources, but are not yet enrolled?
Medicaid Marketplace Self-pay/Uninsured
Medicaid Marketplace Self-pay/Uninsured
The total cumulative percentage equals to 100%
Medicaid Marketplace Self-pay/Uninsured
Projection – payer mix: How many new patients to the health center, in the following payer categories, do you anticipate serving annually? Medicaid Marketplace Self-pay/Uninsured
What percent of patients new to the health center will be recruited through outreach? Medicaid Marketplace Self-pay/Uninsured
How many visits per patient per year on average? Medicaid Marketplace Self-pay/Uninsured
Average reimbursement per visit? Medicaid Marketplace Self-pay/Uninsured
Collection rate Medicaid Marketplace Self-pay/Uninsured
  • Potential Revenue
  • Level of Effort
  • Costs per FTE per Year

Section 2: This section of the calculator estimates how many patients could be recruited and enrolled in insurance products and/or become new uninsured health center patients on a per 1.0 outreach FTE and 1.0 eligibility and enrollment FTE basis.

Section 2: Level of Effort

Task: Outreach (recruitment of patients new to the health center)
Outreach contacts/FTE/day
Days per year worked per 1.0 outreach FTE
What percent of persons contacted are uninsured and ineligible? (Draws from projected payer mix above)
Average number of times an outreach worker contacts a targeted enrollee.
What percentage of potential enrollees come to the clinic to meet with eligibility staff?
What percentage of uninsured and ineligible patients contacted become new patients?
Task: Eligibility & Enrollment (Assister)
Enrollment contacts/FTE/day
Days per year worked per 1.0 eligibility and enrollment FTE
What percentage of potential enrollees successfully enroll after meeting with an assister?
Total number of new insured patients to the health center per 1.0 outreach FTE
Total number of new uninsured patients to the health center per 1.0 outreach FTE
  • Potential Revenue
  • Level of Effort
  • Costs per FTE per Year

Section 3: This section covers costs associated with outreach and eligibility staff. In addition to an average annual salary, the calculator includes other costs as a percent of salary based on local estimates for overhead and fringe benefits.

Section 3: Costs per FTE per Year

Outreach Eligibility & Enrollment
Personnel (annual salary)
Fringe %
Overhead %
Supplies %
Total cost per FTE per year

CALCULATOR 2: Clinical Efficiency Calculator

Last entry saved: May 12, 2024

How much time could you save a provider per visit by adding an outreach worker to the team? Click on each leaf to get a more detailed explanation of needed inputs.
 		minutes
In order to save the provider the number of minutes per visit estimated, how much time, on average, would the outreach worker need to spend with the patient? minutes
What percent of visits could be made more efficient by having an outreach worker assist the provider?
Number of visits per provider per hour
Direct patient care hours per day for providers
Patient care hours in a work day for an outreach worker
Percent of patients seen by an outreach worker
Number of providers
Number of working days in a year
Average reimbursement rate per Medicaid visit
Percent of patients covered by Medicaid for whom you receive PPS
Outreach Worker Personnel (Annual Salary)
Fringe %
Overhead %
Supplies %

Calculator 3: Alternative Payment Calculator

Last entry saved: May 12, 2024

Section 1: If your health center receives supplemental payment for patient-centered medical home or patient-centered health home services and your outreach program could support these efforts, consider what percentage of these payments could be attributed to outreach .

Section 2: If you are held accountable for quality outcomes/processes that an outreach program could help achieve and you are eligible for pay-for-performance (P4P), consider what percentage of these earnings could be attributed to outreach.

Example: Pap screening, colorectal cancer screening, or immunizations for infants and children.

Section 3: If you are eligible for shared savings from reducing the total cost of care, consider what percentage of these savings could be attributed to your outreach program.

Calculator 4: Avoided Costs Calculator

Last entry saved: May 12, 2024

Section 1: Consider what portion of your current marketing expenditures could be avoided by relying on outreach to inform the community about the health center.

Section 2: In the course of their work, outreach staff may be able to gather some of the data needed for a community needs assessment. If your health center currently budgets for this process, there may be an opportunity to use outreach staff to reduce the costs associated with data collection.

Section 3: Consider how outreach workers as experts in linguistic and cultural competency can be leveraged internally and externally.

Summary and Analysis

The summary below uses the latest results of each calculator completed.

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The estimated net financial benefit of investing in outreach and enrollment activities for your health center is $0. This net financial benefit is based on data you entered and on the following assumptions:
  • An estimated 0 FTE outreach staff successfully refer 0 new patients to assisters per year (per outreach FTE);
  • An estimated 0 FTE eligibility/enrollment workers successfully enroll 0 individuals per year (per eligibility and enrollment FTE); and,
  • The health center invests an estimated $0 in outreach and enrollment FTEs (including salary, fringe and overhead costs).
The estimated outreach-related return on investment from increased provider efficiency for your health center is $0. This estimated return on investment is based on the data you entered and on the following assumptions:
  • An estimated 0 FTE outreach staff successfully assist an average of 0 total patients per day per outreach FTE
  • Adding 0 outreach worker(s) to the team will save providers

    0

    minutes per patient visit;
  • Each outreach worker spends an estimated average of

    0

    minutes per patient per visit; and,
  • The health center invests an estimated $0 in outreach staff.

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The estimated outreach-related financial benefit from alternative payment sources including PCMH/PCHH supplemental payments, pay for performance, and/or shared savings for your health center is $0.
This net financial benefit is based on the data you entered including:
  • Total possible amount of PCMH/PCHH Payment attributable to outreach: $ 0
  • Total possible amount attributable to outreach through pay-for-performance: $ 0
  • Total possible amount attributable to outreach from shared savings: $ 0
It is important to note that the possible revenue generated in this calculator is in part based on risk-based payments. The model only includes potential upside revenue rather than per FTE estimates. The results alone, however, are not considered a basis for making staffing decisions. Rather, health center leadership is encouraged to consider how these results may be used to demonstrate the helpfulness of outreach in supporting their supplemental and risk-based payments.
The estimated value of avoided marketing costs, needs assessment costs, and/or culturally competency training costs attributable to outreach services for your health center is $0 .
This net financial benefit is based on the data you entered including:
  1. Total available for outreach program from avoided marketing costs: $ 0
  2. Total available for outreach program from avoided costs associated with conducting needs assessments: $ 0
  3. Total available for outreach programs from avoided training costs and potential training revenue: $ 0
It is important to note that the model only includes potential upside revenue rather than per FTE estimates. The results alone, however, are not considered a basis for making staffing decisions. Rather, health center leadership is encouraged to consider how these results may be used to demonstrate the helpfulness of outreach in supporting marketing, conducting needs assessments, and providing cultural competency trainings.