How to Use Data for Decision Making in RHCs
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How to Use Data for Decision Making in RHCs
Context Current environment Strategies to improve
Context
Primary care clinics are the nucleus of the new rural
healthcare delivery system
Hospitals have different objectives and metrics than
primary care practices
CAHs have performance improvement networks –
most RHCs don’t
Too often Primary Care is undervalued and ignored
Current Measurement
Rural primary care needs data
q Public reporting: Quality [NOPE] q Public reporting: Financial [NOPE] q Grant-based Benchmarking [SOME…] q PQRS [EXEMPT] q MACRA/MIPS [EXEMPT]
The Result: There are few means to dispel myths or apply
advocacy
Rural primary care needs data Quality. Heroic efforts have
been made to identify relevant primary care quality metrics.
But they are just not there yet.
Cost Reports. They provide useful, easy-to-get data but not the kind of timely information practice
operators want and need.
Right Data, Wrong Fit. MGMA is the industry leader in tracking physician practice data. The only
problem is that their database includes very few rural practices or providers.
Strategies
Improvement Requires Information
• How does the Clinic currently perform? • What are the relevant measures? • Who manages the data? • How are decisions made? • How are initiatives managed?
Sources of Data
EMR
Financials
Benchmarks
Practice Management
Reporting Infrastructure
Operations Dashboard
Monthly Operations 10 Metrics
Practice Scorecard
Quarterly Strategy
10 Metrics
Physician Scorecard
Quarterly Value Performance
6 Metrics per
Best Practice Operating Ratios • Gross collection rate
• Net collection rate
• Overhead ratio
• Individual category expense ratio
• Days in accounts receivable
• Accounts receivable per FTE physician
• Staff ratio
• Average cost and revenue per patient • Aging of accounts receivable by payor
• Payor mix ratio
Success Criteria • Leadership • Culture of measurement • Physician engagement • Reporting systems • Current, accurate and relevant data • Performance targets (to budget, to benchmark…) • Staff resources • Initiative infrastructure • Executive buy-in
But What Really Matters Strategically?
• Practice profitability • Practice efficiency • Provider productivity • Provider compensation • Clinical quality
Staffing Finances
Compensa1on Produc1vity
ClinicalStaffper…
Non-ClinicalStaffper…
ProviderWorkedHoursper…
ClinicProfitMargin
Expenseper…
NetRevenueper…
TotalCompensa1onper…
BaseSalaryper…
VariableCompensa1onper…
WorkedRVUsper…
Pa1entVisitsper…
Pa1entPanelSizeper…
POND SM
Practice Operations National Database
SORHs Subscribe Clinics use for FREE
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