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In 2005, Mayor Newsom and the Board of Supervisors requested the Controller's Office to evaluate the Department of Public Health under the Controller's mandate to measure, audit, and report on government performance. Critical analysis is increasingly needed as the City implements Healthy San Francisco and rebuilds Laguna Honda Hospital and San Francisco General Hospital and Trauma Center. This website provides information on the Controller's Office analyses on the performance and efficiency of the Department of Public Health from 2005-2008.
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Performance and Efficiency Report, 2008
(Click on the link above to view the report)
This report analyzes the San Francisco Department of Public Health's provision of services, efficiency of operations, and patients and payer mix. It draws on multiple analyses planned and coordinated by the San Francisco Controller's Office from 2005-2008. The strong performance of San Francisco General Hospital and Trauma Center and the Department of Public Health's role as the City's healthcare safety net provider is featured, along with recommendations from the Controller's Office.
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I. Consultant Reports, 2005-2008
The Controller's Office contracts with internationally-recognized healthcare consulting firms to bring best practices and expert analysis to San Francisco public health.
- Market Assessment and Benchmarking
Lewin Group
The market analysis summarizes the current healthcare environment in the City, makes projections of demand for healthcare services, and examines the Department of Public Health's role in providing direct healthcare to San Franciscans. The benchmarking analysis compares San Francisco General Hospital and Trauma Center with comparable Bay Area, California and national public healthcare delivery systems using industry measures of efficiency and effectiveness.
- Revenue Management
Phase 2 Consulting
This revenue maximization analysis reviews the Department of Public Health's revenue cycle at San Francisco General Hospital and Trauma Center, Laguna Honda Hospital, Community Health Centers, and Behavioral Health Services. The report concludes that revenue cycle processes and procedures are among the most complete and effective as compared with other large public health systems in the nation. By implementing Phase 2's recommendations, the Department will save $10 million in annual revenues and $11 million in one-time gains.
- Healthy San Francisco Implementation Support
Lewin Group
The Lewin Group provided expert analysis, modeling and recommendations to assist with the Department of Public Health's planning and launch of Healthy San Francisco. This presentation projects demand for health services, analyzes the Department's capacity to take new patients and meet the service demands, models the impact of changes in fees for the safety-net population, and analyzes a 'one-stop' web-based eligibility and enrollment system.
- Continuum of Acute and Long Term Healthcare
Health Management Associates
This report focuses on the effectiveness of the Department of Public Health in providing a continuum of acute and long term healthcare services. It finds that the City needs to substantially improve the integration of its hospitals and community-based services. San Francisco can better meet the needs of its citizens and gain significant financial benefits by providing a mix of long term, skilled nursing, in-home and community-based services.
- Community Clinic Revenue Maximization
Moss Adams
This report reviews revenue cycle efficiency in Department of Public Health clinics and identifies two million dollars of revenue opportunity. Following the release of the report, the Department enhanced patient finance services and registration processes and is now exceeding the national standard in the accounts receivable area. In addition, clinic patients are now allowed to see a physician on a walk-in basis, reducing unfilled patient slots and increasing physician productivity.
- Upcoming Analyses
The Controller's Office is currently working with the Department of Public Health and expert consultants to assist with the transition to the rebuilt Laguna Honda Hospital, as well as planning evaluation and technical assistance for the Department's substance abuse treatment services. This website will be updated as these projects are completed.
II. Nonprofit Financial Monitoring and Audits, 2005-2008
The Controller's Office regularly conducts financial review and audits of Department of Public Health nonprofit contractors to ensure adequate internal controls and efficiencies. In the last three years, the Controller's Office has conducted about 150 financial reviews of nonprofits that provide services for the Department of Public Health, with contracts totaling tens of millions of dollars.
Recent Financial Reviews and Audits
Nonprofit Contracting
The Controller's Office provides on-going support to the Department of Public Health through its administration of the Citywide Nonprofit Monitoring and Capacity Building Program. This program streamlines, coordinates, and improves the City's efforts to effectively monitor and ensure adequate capacity of nonprofit organizations providing health and human services to San Francisco residents.
The Controller's Office also participates in the City's Nonprofit Review Appellate Panel which is overseeing improvements to the way the City does business with the nonprofit sector in response to the 2003 Nonprofit Task Force Report.
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