Two Tools for Keeping Physicians Informed and Involved
By Daniel J. Marino
For a medical practice to be successful, physicians, practice administrators, and staff need to be aware of operational problems. However, some physicians are not informed about office-related issues that affect financial performance and, therefore, are not aware of opportunities to develop their practices. Healthcare financial leaders for independent medical groups or in hospitals that employ physician practices can change that situation by providing physicians and others with two dashboard reports that provide key performance data and enable a proactive approach to solving operational problems.
The sample office scorecard (see top of next page) summarizes performance in critical front-end and back-end processes, including scheduling, charge entry, payments, and denials. The office collection report (see bottom of next page) presents key measures of up-front collections. Together, the reports provide a snapshot that can help physicians stay informed about practice operations, follow performance trends, support improvement initiatives, and make changes to their own work patterns.
The office scorecard is useful for focusing attention on how office processes impact revenue:
- Several data points help providers track processes they are in a position to improve. For example, reviewing the “number of patients bumped ” every month can be a catalyst for a variety of changes in physician workflow. Monitoring “missing charges” and “office charge lag days” are important when working with physicians to improve charge capture.
- Other indicators are important for maintaining physician awareness of business office challenges. Physicians can play a significant role in reducing denials for their practice. Reporting key denial metrics and developing processes for managing rejections are important steps in reducing a practice’s denial rate.
- Certain indicators gauge the overall performance and stability of the practice. Trends in “number of patients scheduled” can provide a quick read on the general strength and direction of the organization. An ongoing awareness of the “payer mix” breakdown enables physicians to participate in decision making to ensure the long-term viability of the practice.
The office collection report tracks four aspects of time-of-service (TOS) collections: cashiering, copayment collections, balance collections, and total TOS collections. Because this area is so critical to revenue cycle performance, the data are presented graphically as well as numerically. In addition to monthly results, the report provides historical averages and benchmark targets that give physicians a sense of where the organization has been—and where it should be headed.
Both reports should be distributed monthly to the entire employed medical staff, practice administrators, and office personnel. As physicians become more familiar with these reports, finance leaders may consider developing physician-specific dashboards that also incorporate information on personal productivity. Using dashboards to keep physicians, practice administrators, and staff informed about practice operations will help align them with organizational goals, ultimately leading to better financial performance.
Daniel J. Marino is president, Health Directions, LLC, Chicago
(dmarino@healthdirections.com)
OFFICE SCORECARD - LOCATION: ABC MEDICAL GROUP
| Processes | 08-Jan | 08-Feb | 08-Mar | 08-Apr | 08-May | 08-Jun |
|---|---|---|---|---|---|---|
| Provider Scheduling Activity | ||||||
| Number of patients scheduled | 26,735 | 25,151 | 25,378 | 27,037 | 24,971 | 25,449 |
| Number of patient arrivals | 16,359 | 15,410 | 15,275 | 16,327 | 15,174 | 15,374 |
| Percentage of patient arrivals | 61% | 61% | 60% | 60% | 61% | 60% |
| Percent of patients bumped | 5% | 5% | 6% | 6% | 4% | 4% |
| Percentage of patient no shows | 14% | 14% | 13% | 14% | 14% | 14% |
| Charge & Collection Metrics | ||||||
| Missing charge percentage | 3% | 4% | 4% | 4% | 4% | 4% |
| Office charge lag days | 3 | 4 | 2 | 3 | 4 | 2 |
| Charges | $3,047,267 | $2,767,178 | $2,687,353 | $3,064,089 | $2,701,831 | $3,105,585 |
| Payments | $1,950,251 | $1,826,337 | $1,800,527 | $2,022,299 | $1,918,300 | $2,173,910 |
| TOS payments | $271,360 | $276,718 | $232,230 | $337,050 | $378,256 | $403,726 |
| Percentage of TOS payments to charges | 9% | 10% | 9% | 11% | 14% | 13% |
| Front-End Denials & Edits | ||||||
| Front-end edits | 6.54% | 6.25% | 5.78% | 5.43% | 5.78% | 5.15% |
| Registration edit rate | 4.23% | 3.98% | 4.02% | 3.57% | 3.10% | 3.43% |
| Charge (coding) entry rejection rate | 5.34% | 5.21% | 4.98% | 4.75% | 4.80% | 4.21% |
| Insurance verification rejection rate | 9.14% | 7.56% | 8.76% | 7.72% | 6.88% | 5.92% |
| Payer Mix | ||||||
| Managed care | 51% | 50% | 57% | 55% | 58% | 58% |
| Medicaid | 26% | 23% | 25% | 22% | 24% | 22% |
| Medicare | 15% | 16% | 15% | 14% | 15% | 16% |
| Self-pay | 4% | 4% | 3% | 4% | 3% | 3% |
| Other | 4% | 6% | 0% | 5% | 0% | 3% |
OFFICE COLLECTION ANALYSIS
Collections Percentage
| Indicator Category | 08-Jan | 08-Feb | 08-Mar | 08-Apr | 08-May | 05-Jun | 08-Jul | Avg - 13 Mth | 2007 Avg | Benchmarks |
|---|---|---|---|---|---|---|---|---|---|---|
| Patients Cashiered | 89.95% | 88.61% | 86.67% | 79.42% | 84.80% | 85.56% | 85.59% | 85.89% | 81.20% | 95.00% |
| Copay Collection | 92.25% | 93.23% | 93.78% | 94.23% | 93.15% | 91.27% | 95.10% | 92.87% | 88.67% | 98.00% |
| Outstanding Balance | 64.15% | 68.73% | 72.87% | 71.67% | 78.65% | 79.54% | 81.45% | 74.12% | 58.78% | 85.00% |
| Total TOS Office Ctns. | 82.27% | 84.73% | 85.39% | 86.55% | 86.55% | 84.85% | 88.40% | 84.12% | 74.71% | 92.00% |
For more information, call 1-800-252-HFMA or visit www.hfma.org.
This article was featured in the December 2008 edition of Health Facilities Management.
