FOR HRSA USE ONLY DEPARTMENT OF HEALTH AND HUMAN SERVICES Application Tracking Health Resources and Services Administration Grant Number Number NATIVE HAWAIIAN HEALTH CARE SYSTEM REQUIRED AND OPTIONAL FINANCIAL PERFORMANCE MEASURES 3. Optional Focus Area Medical Costs – Performance Measure Medical cost per medical visit Is this Performance Measure Applicable to your Organization? [_] Yes [_] No Target Goal Description Total accrued medical staff and medical other costs Numerator Description after allocation of overhead (excludes lab and x-ray costs) Non-nursing medical visits (excludes nursing [RN] Denominator Description and psychiatrist visits) Baseline Year: Measure Type: Baseline Data Numerator: Denominator: Calculated Baseline: Projected Data (by End of Project Period) Data Source & Methodology Key Factor Type: [_] Contributing [_] Restricting Key Factor and Major Planned Action #1 Key Factor Description: Major Planned Action Description: Key Factor Type: [_] Contributing [_] Restricting Key Factor and Major Planned Action #2 Key Factor Description: Major Planned Action Description: Key Factor Type: [_] Contributing [_] Restricting Key Factor and Major Planned Action #3 Key Factor Description: Major Planned Action Description: Comments
DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration NATIVE HAWAIIAN HEALTH CARE SYSTEM REQUIRED AND OPTIONAL FINANCIAL PERFORMANCE MEASURES FOR HRSA USE ONLY Grant Number Application Tracking Number 3. Optional Focus Area – Medical Costs Performance Measure Medical cost per medical visit Is this Performance Measure Applicable to your Organization? [_] Yes [_] No Target Goal Description Numerator Description Total accrued medical staff and medical other costs after allocation of overhead (excludes lab and x-ray costs) Denominator Description Non-nursing medical visits (excludes nursing [RN] and psychiatrist visits) Baseline Data Baseline Year: Measure Type: Numerator: Denominator: Calculated Baseline: Projected Data (by End of Project Period) Data Source & Methodology Key Factor and Major Planned Action #1 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #2 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Key Factor and Major Planned Action #3 Key Factor Type: [_] Contributing [_] Restricting Key Factor Description: Major Planned Action Description: Comments
fy2015reqclinperformmeasures.docx