Hispanics

When patients receive a diagnosis of Type 2 diabetes, they have to navigate a complex and often intimidating healthcare system. They may require treatment by multiple specialists. Managing Type 2 diabetes can be confusing and overwhelming for any patient. In many cases, Hispanics with a diagnosis of Type 2 diabetes face even more challenges than other patients. For many of my patients, there is a language barrier. But the barriers to my Hispanic patients getting proper care for diabetes go beyond a language issue. The issue is a complex combination of culture, accessibility, healthcare literacy, and finances.

6

CDC Implementation Timeline:

These time is for the duration of 15 months begin January to April, which will be the month for launching and operationalization of the CDC center.

7

CDC Program Milestones:

Reduction/mitigation diabetes progression and optimizing risk factors reduction related to micro-& macro-vascular diabetes complications

Reduction in average HbA1xc levels from the current 10.5 to 8.5 within 2 years

35 percent reduction in cardiovascular complications

Reduction in mortality, heart, & stroke rates related with diabetes complications

Increased diabetes prevention & management awareness & number of targeted population involved in these activities

Increased number of diabetic diagnosed and pre-diabetic targeted population in medication management for diabetes

Over 4,882 benefitting from the program

These milestones will be used to measure success of the Center for Diabetes Care, including Increased diabetes prevention and management awareness & number of targeted population involved in physical activities, basic nutrition & goal setting, besides engaging in health and lifestyles that support them to live better and managing diabetes.

8

CDC Financial Analysis:

Approximated number of patient visitations per year

Year Patients Visitations
1 4,882
2 4,8821.05 = 5,126 3 5,1261.05 = 5,382
Capital Requirements:

Description Year 1 Year 2 Year 3
Server $ 15,000
Remodel of Office Space $ 98,550
Security System $ 2,654
Furniture $ 12,281 $ 1,000 $ 1,000
Practice Management System $ 5,000 $ 2,500 $ 2,500
Computers & Cabling $ 41,696
Total $ 175,181 $ 3,500 $ 3,500
The probable patient visits is approximated to increase annually by 5 percent. Therefore, the projection for the subsequent years are as illustrated in the first Table. The second table illustrates the capital requirements needed to operationalize the program

9

CDC Financial Analysis:

Non-Staffing Costs

Year 1 Year 2 Year 3
Fringe Benefits $ 59,609 $ 60,802 $ 62,018
Travel $ 5,000 $ 5,000 $ 10,000
Training $ 35,000 $ 10,000 $ 15,000
Equipment $ 5,000 $ 2,000 $ 2,000
Supplies $ 15,000 $ 15,300 $ 15,606
Contractual $ 8,000 $ 8,160 $ 8,323
Allocated Rent $ 23,418 $ 23,769 $ 24,126
Depreciation $ 26,277 $ 35,036 $ 35,036
Insurance $ 4,004 $ 4,204 $ 4,414
Overhead Allocation $ 9,167 $ 9,442 $ 9,725
Uncollectible Income $ 21,281 $ 39,865 $ 55,177
Marketing $ 45,000 $ 15,000 $ 15,000
Indirect Charges $ 54,764 $ 56,955 $ 59,233
Total $ 311,520 $ 285,533 $ 315,659
This table illustrates the non-staffing costs needed to operationalize the program

10

CDC Financial Analysis:

Staffing Costs

Designation FTE Year 1 Year 2 Year 3
Endocrinologist 0.93 $146,940 $154,287 $162,001.35
Contract Specialists 0.30 $22,500 $23,625 $24,806.25
Nurse Practitioner 0.95 $79,889.3 $82,285.979 $84,754.5584
Community Health Workers 4.00 $976,000 $1,00,5280 $1,035,438.4
Reception/Office Management 1.00 $35,000 $35,700 $36,414
Total $1,260,329.3 $1,301,177.98 $1,343,414.56
Every patient visitation will be charged a base value of US$450. However, certain incentives will be allowed to certain patients basing on their economic stratification. The insurance will be 30 percent of every patient visit gross revenue. The staff salaries will increase by 5 percent per year and the total salary will be based on FTE as illustrated in Table

11

CDC Financial Analysis: Proforma Statement:

Particulars Year 1 Year 2 Year 3
Patients Visits Revenue
Patient Visits 4882 5126 5382
Revenue Per Visit $450 $450 $450
Gross Patient Visits Revenue $2,196,900 $2,306,745 $2,422,084.50
Deduction from Patient Revenue $65,907.00 $69,202.35 $72,662.54
Net Patient Visits Revenue $2,130,993.00 $2,237,542.65 $2,349,421.97
Operating Expenses
Staffing Salaries $1,260,329.30 $1,301,177.98 $1,343,414.56
Fringe Benefits $ 59,609 $ 60,802 $ 62,018
Travel $ 5,000 $ 5,000 $ 10,000
Training $ 35,000 $ 10,000 $ 15,000
Equipment $ 5,000 $ 2,000 $ 2,000
Supplies $ 15,000 $ 15,300 $ 15,606
Contractual $ 8,000 $ 8,160 $ 8,323
Allocated Rent $ 23,418 $ 23,769 $ 24,126
Depreciation $ 26,277 $ 35,036 $ 35,036
Insurance $ 4,004 $ 4,204 $ 4,414
Overhead Allocation $ 9,167 $ 9,442 $ 9,725
Uncollectible Income $ 21,281 $ 39,865 $ 55,177
Marketing $ 45,000 $ 15,000 $ 15,000
Indirect Charges $ 54,764 $ 56,955 $ 59,233
Capital Costs $175,181 $3,500 $3,500
Net Operating Expenses $1,747,030.30 $1,590,210.98 $1,662,572.56
Excess of Revenue Over Expenses $383,962.70 $647,331.67 $686,849.40
Cumulative Income $383,962.70 $1,031,294.37 $1,718,143.77
Net Cash From Excess Revenue $410,239.70 $1,066,330.37 $1,753,179.77
Cumulative Income/Net Cash $410,239.70 $1,476,570.07 $3,229,749.84
Basing on the financial analysis, the program stands to yield remarkable profits in a win-win gain situation. Therefore, it has the ability to sustain itself even after the donor withdrawal, whereas providing pre-diabetic and diabetic patients with the much-needed access to education along with ongoing treatment in the language of their choice, besides in a manner that is culturally appropriate, patient-centered, timely, cost-effective, and high quality, with ultimate aim of community health enhancement.

12

Reference

American Diabetes Association [ADA]. (2018). Standards of Medical Care in Diabetes 2018. http://care.diabetesjournals.org/content/diacare/suppl/2017/12/08/41.Supplement_1.DC1/DC_41_S1_Combined.pdf

Dr. Novak, S. (2014). Excerpts from Dr. Novak’s presentation to Center for Diabetes Care Steering Committee.

Healthy People.gov. (2010). Healthy People 2020: Diabetes. https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes

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Designing of Detailed Strategic

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Healthcare Consultant

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Committee Presentation,

Relevant Peer-Reviewed

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30 Days

Submission of the Detailed

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Dr. Novak

Detailed Strategic Plan &

Business Plan

3 Weeks

Business case Presentation to the

Western Hospital Board of

Directors and Chief executive

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Dr. NovakBusiness case Presentation1 day

Upon Approval by the BOD & CEO,

design the Center for Diabetes

Care Proposal

Dr. Novak &

Healthcare Consultant

Detailed Strategic Plan &

Business Plan &

2 Weeks

Submission/Application of the

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to PPACA

Dr. NovakTthe Center for Diabetes Care

Proposal

1 Day

Designing of the Center for

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Policies & Procedures

Dr. Novak & Western

Hospital HRM

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Recruitment Policies &

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30 days

Renovation of the Westen Hospital

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Dr. Novak &

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Dr. Novak & Western

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Recruitment Policies &

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30 days

Procurement & Transportation of

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Specialists & Supplier

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30 days

Procurement & Transportation of

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Dr. Novak, Contract

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Instillation Manuals60 Days

Intensive Training of the Recruited

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Dr. Novak, Western

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Training Manual on Center of

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30 Days

Marketing of the Center of

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Marketing Startegy of the

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30 Days

Insuring the Center for Diabetes

Care

Dr. Novak, Contract

Specialists & Insurance

Company

Insurance Policy2 weeks

Designing of the Center for

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Dr. Novak, Contract

Specialists & Nurse

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Diabetes Management Best

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60 days

Intensive Training of the

Community Health Workers

Dr. Novak, Contract

Specialists & Nurse

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Community Education

Programs Manuals

60 days

Monitoring & Follow-up of

Activities

Center for Diabetes

Care TeamMonitoring Reports

Continious

Launching & Operationalizing of

the Center for Diabetes Care

Dr. Novak, Western

Hospital CEO, PPACA

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Luncheon Session2 Days

Activity(s)Responsible Person (s)Resources

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Duration

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