How many times have you heard sentiments from colleagues, administrators, employees – and perhaps yourself – describing your practice? When it comes to the business of a medical practice, we often rely on anecdotal evidence to manage:
If appointment lead times are rising or patients are being turned away, our response is: “Well, we’re just too busy…”
If patient or employee experience is suffering, our response is: “She [referring to a patient or employee] is just crazy…”
If collections are dropping, our response is: “It’s just Medicaid; they are the worst…”
If the fill rate of our schedule is declining, our response is: “If only patients would show up…”
In a world where you use evidence to make decisions about caring for patients, it’s surprising to consider the lack of rigor related to managing the business of medicine. Anecdotes often serve as the basis for decision-making. The deficiency of evidence may result in determinations that hinder the practice.
In management, data are evidence – and they can prevent the drama that adversely affects many medical practices.
While this list is not exhaustive, it provides a foundation to build your practice’s management metrics to avoid problems that ensue from a failure to understand an opportunity.
Demand:
Supply:
Receivables:
Experience: It’s challenging to gather data about the experience of stakeholders, but that doesn't mean that we shouldn’t try.
Given the complexity of a medical practice, analytics may vary based on how data are run. Therefore, establish a dashboard, agree on definitions (inclusion and exclusion criteria, as well as timing), and allow self-service viewing for your team. Sit down with every employee in a management role, share the dashboard, and provide examples of how data can be useful. During meetings, ask your team to share evidence – and use it yourself for management decision-making.
Data can – and should - prevent drama!
What is a Patient Panel?
A patient panel is the cohort of patients under a primary care physician’s care, including direct in-person or virtual encounters and the associated indirect, non-visit work. The latter includes everything from preventive and chronic care management to messages and refills. The calculation of a patient panel focuses on attribution. Sum the number of unique patients seen within the past three years.[1] Next, adjust for acuity and complexity. For this step, consider guidance from industry experts like researchers from the University of Wisconsin’s Department of Family Medicine or Dr. Mark Murray, who co-authored several articles about the topic, including “The Right-Sized Patient Panel: A Practical Way to Make Adjustments for Acuity and Complexity.”[2] Increasingly, patient panels are managed via a care team approach – a physician joined by a nurse practitioner, for example. In this case, the calculations are made for the pair. The notion of a “perfect” panel size is elusive, although many believe that number is between 1,500 and 2,500 patients per provider. Most importantly, the panel should be a size in which the physician, provider, and/or care team can effectively and efficiently deliver quality primary care.
[1] The calculation may be 12, 18, or 24 months; there is no industry standard.
[2] Weber, R. MS, & Murray, M. MD, MPA (2019, November/December). The Right-Sized Patient Panel: A Practical Way to Make Adjustments for Acuity and Complexity. Family Practice Management, 26(6), 23-29.
The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.