UTAH PARTNERS FOR HEALTH

2024 WAS A PIVOTAL YEAR OF TRANSITION AND STRATEGIC REALIGNMENT FOR UPFH. FOLLOWING THE RETIREMENT OF LONG-SERVING CEO, DEBBIE TURNER, NEW LEADERSHIP WAS ESTABLISHED UNDER CEO VERONICA HOBBY, WHO JOINED UPFH IN JUNE 2024. THE BOARD OF DIRECTORS USED THIS OPPORTUNITY TO REEXAMINE AND UPDATE THE ORGANIZATION'S MISSION, ESTABLISH A 10-YEAR VISION, AND INITIATE A COMPREHENSIVE FINANCIAL AND OPERATIONAL TURNAROUND PLAN. SIGNIFICANT PROGRESS HAS BEEN MADE IN STRENGTHENING INTERNAL LEADERSHIP, PROMOTING ACCOUNTABILITY, AND ADDRESSING LONG-STANDING INEFFICIENCIES. A NEW SENIOR LEADERSHIP STRUCTURE, CULTURAL TRANSFORMATION, AND A RENEWED FOCUS ON SUSTAINABILITY HAVE LAID THE GROUNDWORK FOR LASTING IMPACT. IN 2024, UPFH IMPLEMENTED A SIGNIFICANT STRUCTURAL REORGANIZATION TO STRENGTHEN OPERATIONAL EFFICIENCY, ENHANCE PROGRAM EFFECTIVENESS, AND IMPROVE INTERNAL ACCOUNTABILITY. THIS REORGANIZATION WAS INITIATED FOLLOWING THE RETIREMENT OF LONG-SERVING CEO AND CFO, DEBBIE TURNER, WHICH PROVIDED AN OPPORTUNITY TO EVALUATE AND RESTRUCTURE THE EXECUTIVE LEADERSHIP MODEL TO BETTER SUPPORT UPFH'S SCOPE OF SERVICES AND COMPLIANCE RESPONSIBILITIES. VERONICA HOBBY WAS HIRED AS THE NEW CHIEF EXECUTIVE OFFICER IN MAY AND BEGAN HER ROLE IN JUNE 2024. IN ADDITION, TWO NEW SENIOR LEADERSHIP POSITIONS WERE CREATED TO ADDRESS LONGSTANDING OPERATIONAL AND PROGRAMMATIC CHALLENGES: CHIEF OPERATING OFFICER AND PROGRAM DEVELOPMENT DIRECTOR. THE CHIEF OPERATING OFFICER ROLE, FILLED BY LADD LARSEN AT THE END OF JULY 2024, WAS CREATED TO FOCUS ON INTERNAL OPERATIONS, IMPROVE WORKFLOW EFFICIENCIES, AND PROVIDE GREATER OVERSIGHT OF CLINIC-LEVEL PERFORMANCE. THE PROGRAM DEVELOPMENT DIRECTOR POSITION, ASSUMED BY RACHEL MORTENSON IN LATE AUGUST 2024, WAS ESTABLISHED TO OVERSEE THE DESIGN, IMPLEMENTATION, AND EVALUATION OF NEW AND EXISTING PROGRAMS, WITH THE GOAL OF INCREASING IMPACT AND ALIGNMENT WITH STRATEGIC GOALS. THESE ROLES WERE ADDED TO ADDRESS STRUCTURAL CONCERNS THAT HAD NEGATIVELY AFFECTED STAFF PRODUCTIVITY, SERVICE DELIVERY, AND THE ORGANIZATION'S ABILITY TO SCALE COMMUNITY HEALTH INITIATIVES. IN PARALLEL WITH LEADERSHIP RESTRUCTURING, UPFH LAUNCHED SEVERAL STAFF- DRIVEN INITIATIVES TO SUPPORT CULTURAL AND PERFORMANCE IMPROVEMENTS. THESE INCLUDED THE CREATION OF NON-MANAGERIAL TASK FORCES FOCUSED ON ACCOUNTABILITY AND EMPLOYEE RECOGNITION, A 12-MONTH HR LEADERSHIP DEVELOPMENT PLAN, AND THE EXPANSION OF KEY COMPLIANCE ROLES SUCH AS THE HEALTH & SAFETY COMPLIANCE OFFICER AND FINANCIAL ANALYST. THESE STRUCTURAL AND OPERATIONAL UPDATES WERE DESIGNED TO POSITION UPFH FOR SUSTAINED GROWTH, REGULATORY COMPLIANCE, AND MEASURABLE IMPROVEMENTS IN PROGRAM OUTCOMES - PARTICULARLY IN PRIORITY AREAS SUCH AS BEHAVIORAL HEALTH INTEGRATION AND EXPANDED CLINIC AND PHARMACY HOURS. THE REORGANIZATION HAS LAID A FOUNDATION FOR IMPROVED INTERNAL CONTROLS AND INCREASED CAPACITY TO MEET FUTURE PROGRAMMATIC AND FISCAL DEMANDS. FEDERALLY QUALIFIED HEALTH CENTER IN-SCOPE PROGRAM ACCOMPLISHMENTS: ENCOUNTERS UPFH SERVED A TOTAL OF 8,169 PATIENTS IN 2024. THIS WAS A SLIGHT INCREASE OVER 2023 WITH 8,160 PATIENTS SERVED. TOTAL OVERALL ENCOUNTERS DECREASED 3% FROM 20,142 ENCOUNTERS IN 2023 TO 19,609 ENCOUNTERS IN 2024 (BOTH UDS AND NON UDS VISITS ARE INCLUDED IN TOTAL). - MEDICAL: 12,016 (MOBILE UNIT: 597; IN-CLINIC: 11,419) - DENTAL: 3,524 - BEHAVIORAL HEALTH: 1,862 - VISION: 2,207 (MOBILE UNIT: 1,478; IN-CLINIC: 729) THE DECREASE IN ENCOUNTERS FROM 2023 IS ATTRIBUTED TO TWO MEDICAL PROVIDERS BEING OUT ON MATERNITY LEAVE FOR A TOTAL OF 6 MONTHS COLLECTIVELY, ONE BEHAVIORAL HEALTH PROVIDER OUT ON MATERNITY FOR THE LAST 4 MONTHS OF 2024, AND ONE DENTAL PROVIDER OUT ON MEDICAL LEAVE DURING JUNE 2024 AND A REORGANIZATION OF THE DENTAL PROGRAM BEGINNING IN DECEMBER 2024. THE INCREASE IN VISION ENCOUNTERS IS DUE TO EXPANDING SERVICES TO INCLUDE IN- CLINIC SERVICES AND CONTINUING OUTREACH TO AT-RISK SCHOOL AGED CHILDREN THROUGH A PARTNERSHIP WITH THE PROMISE NEIGHBORHOOD INITIATIVE WITH UNITED WAY. PHARMACY: THE UPFH PHARMACY CONTINUED TO PROVIDE PATIENTS WITH AFFORDABLE MEDICATIONS THROUGH THE 340B PRESCRIPTION PROGRAM. IN 2024, THE PHARMACY FILLED 16,823 PRESCRIPTIONS-AN INCREASE OF 10.5% FROM 15,225 IN 2023. THIS GROWTH IN PRESCRIPTION VOLUME LED TO A 16.5% INCREASE IN PHARMACY REVENUE, WITH ONLY A 10% INCREASE IN ASSOCIATED COSTS. TO MEET THE RISING DEMAND, UPFH HIRED AN ADDITIONAL FULL-TIME PHARMACIST IN 2024. UNFORTUNATELY, THE PHARMACY EXPERIENCED TWO BREAK-INS IN JUNE, RESULTING IN A TOTAL LOSS OF 12,761.50. PAYOR MIX: UPFH'S PAYOR MIX CONTINUES TO SHIFT AS WE IMPLEMENT STRATEGIES TO INCREASE PATIENTS' ACCESS TO INSURANCE THROUGH MEDICAID AND/OR PRIVATE INSURANCE OPTIONS. IN AUGUST 2024, UTAH LOST ITS NAVIGATOR FUNDING THROUGH CMS DECREASING FUNDING FOR UPFH BY 120,000 THAT PAID FOR TWO PATIENT NAVIGATORS. WITH FUNDING DECREASED, UPFH WAS NO LONGER ABLE TO PAY FOR NAVIGATORS TO FOCUS SOLELY ON HELPING PATIENTS NAVIGATE THE INSURANCE MARKET AND MEDICAID APPLICATION PROCESSES. HOWEVER, PRIOR TO THE DECREASE IN FUNDING, NAVIGATORS WERE ABLE TO HELP ELIGIBLE PATIENTS SIGN UP FOR INSURANCE COVERAGE THROUGH THE MARKETPLACE, WHICH SIGNIFICANTLY SHIFTED OUR PAYOR SOURCE. OUR UNINSURED PATIENT RATIO DECREASED 7% FROM 2023 AND PRIVATE INSURANCE RATIOS INCREASED 20% OVER 2023. A DETAILED COMPARISON OF THE SHIFTS IN INSURANCE COVERAGE BETWEEN 2023 AND 2024 IS BELOW. SELF-PAY: 2024 - 66%; 2023 - 71% MEDICAID: 2024 - 8%; 2023 - 7% MEDICARE: 2024 - 2%; 2023 - 2% PRIVATE INSURANCE: 2024 - 24%; 2023 - 20% PATIENT DEMOGRAPHICS UPFH CONTINUES TO SERVE PATIENTS WHO ARE AT RISK OF NOT RECEIVING ESSENTIAL HEALTHCARE TREATMENT DUE TO SOCIAL ECONOMIC FACTORS. IN 2024, 89% OF PATIENTS WERE BELOW 200% OF FPG, AN INCREASE OF 2% FROM 87% IN 2023. SIXTY PERCENT OF PATIENTS FELL BELOW 100% OF FPG, AN INCREASE OF 6% FROM 2023. TWENTY-THREE PERCENT OF PATIENTS WERE UNDER THE AGE OF 18 WITH 40% OF PATIENTS IDENTIFYING AS MALE AND 60% AS FEMALE. SIXTY-EIGHT PERCENT OF PATIENTS WERE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH, A 1% DECREASE FROM 69% IN 2023. EIGHT PERCENT OF PATIENTS WERE OVER THE AGE OF 65 COMPARED TO 7% IN 2023. STAFFING UPFH CONCLUDED 2024 WITH A TOTAL OF 69 EMPLOYEES, A SLIGHT DECREASE FROM 72 EMPLOYEES AT THE BEGINNING OF THE YEAR. KEY STAFFING CHANGES DURING THE YEAR INCLUDED THE CREATION OF TWO NEW LEADERSHIP POSITIONS - CHIEF OPERATING OFFICER AND PROGRAM DEVELOPMENT DIRECTOR - AS PART OF A BROADER STRUCTURAL REORGANIZATION. ADDITIONALLY, A LICENSED PSYCHOLOGIST WAS ADDED TO THE BEHAVIORAL HEALTH TEAM TO ENHANCE CLINICAL CAPACITY AND EXPAND ACCESS TO MENTAL HEALTH SERVICES. ONE MEDICAL PROVIDER DEPARTED DURING THE YEAR AND WAS SUBSEQUENTLY REPLACED IN EARLY 2025. AS OF THE END OF 2024, UPFH MAINTAINED A CLINICAL PROVIDER TEAM CONSISTING OF SIX MEDICAL PROVIDERS, THREE BEHAVIORAL HEALTH PROVIDERS, TWO DENTISTS, AND ONE VISION PROVIDER. REVENUE SHIFTS, BUDGET LOSSES, AND COSTS: UPFH PROJECTED A LOSS OF 631,076 FOR 2024 BUT ENDED THE YEAR WITH AN ACTUAL LOSS OF 477,137, REPRESENTING A 32% VARIANCE FROM THE PROJECTED BUDGET. THIS LOSS WAS PRIMARILY DUE TO THE EXPIRATION OF ONE-TIME COVID-19 FUNDING FROM THE AMERICAN RESCUE PLAN ACT. GROSS PATIENT REVENUE INCREASED TO 6,733,525 IN 2024, A 7% INCREASE FROM 6,317,256 IN 2023. REVENUE FROM UNINSURED PATIENTS ACCOUNTED FOR 65% OF TOTAL PATIENT REVENUE IN 2024 (4,350,694) SYNONYMOUS WITH 65% IN 2023 (4,090,026). SLIDING FEE DISCOUNTS ROSE 9%, TOTALING 3,472,215 IN 2024, UP FROM 3,185,529 IN 2023. GRANT REVENUE DECLINED BY 28%, TOTALING 2,874,806 IN 2024 COMPARED TO 4,018,066 IN 2023. THE LARGEST PORTION OF THIS DECREASE CAME FROM FEDERAL FUNDING, WHICH DROPPED 37% YEAR OVER YEAR. IN CONTRAST, NON-FEDERAL GRANT REVENUE INCREASED SLIGHTLY BY 6%, AND RENTAL INCOME ROSE BY 5.3%. INTEREST INCOME, HOWEVER, DECLINED SHARPLY BY 36.7%, ENDING AT 111,571. TOTAL COSTS INCREASED BY 9%, RISING FROM 6,670,364 IN 2023 TO 7,291,788 IN 2024. THE MAJORITY OF EXPENSES-64%-WERE RELATED TO EMPLOYEE COMPENSATION. ADDITIONAL COST INCREASES WERE DUE TO HIGHER PHYSICAL THERAPY SERVICES FOR UNINSURED PATIENTS, FACILITY REPAIR COSTS (WHICH MORE THAN DOUBLED), COLLECTION FEES FOR PAST-DUE ACCOUNTS, AND INCREASED SPENDING ON EQUIPMENT, LABORATORY, AND PHARMACY SERVICES.