how to use data for decision making in rhcs - nosorh.org to use data for decision making in rhcs ....
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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]
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.
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?
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…