AAAAI Practice Management

Financial Survey ResultsDecember 2009

Purpose • Allows us to monitor practicing allergist’s

average performances over time

• Allows us to establish benchmarks that we can use for internal comparisons

• Educates all so that we can eliminate the uncertainty and confusion when negotiating with a new associate

2009 Financial Data Survey:

• Survey data was collected over the internet on the Academy web site at www.aaaai.org from April to September, 2009.

• Followed same format done in 2006-2008.

• Responses for 2009 were significantly less than in previous years making analysis difficult.

2009 Financial Data Survey:

• Members logged into members only area, then clicked on link to survey. ID number is only used as an automated mechanism to prevent duplication of data entry. Strict anonymity of respondents in data review is insured.

• Only 17 practices representing 62 physicians responded to the survey, and only 10 practices representing 39 physicians gave collection & expenses data for analysis.

2008 Financial Data Survey:

• 26 questions on practice demographics and manpower utilization asked along with information on charges, collections, and expenses

• 76 practices representing 237 physicians responded. Several did not adequately fill out charge, collection, and expense data, although all responded to manpower questions.

2008 Physician Hours

• Of the 237 physicians reporting:

34 (14.35%) See patients < 24 hrs / week

49 (20.68%) See pts 24 hrs – 32 hrs/ week

99 ( 41.77%) See pts 32 hrs – 38 hrs/ week

61 (25.74%) See patients > 38 hrs / week

Work Hours • 23.7% ( 18 of 76) practices report working Saturday

hours.

• 27.6% (21 / 76) report starting hours <8 AM an average of 2.48 + 1.84 days/week

• 32.9% (25/ 76) report working past 6 PM an average of 1.90 + 1.26 days/wk

Manpower UtilizationJob Description % practices 2007 response

Practice Administrator 39.5% 36.5 %

Office Manager 61.8% 61.5 %

(Employ both) 19.7% 18.7 %

Clinical Supervisor 51.3% 47.1 %

Asthma Educator 34.2% 20.2 %

Billing Supervisor 55.3% 57.7 %

Bookkeeper 47.4% 41.0 %

Manpower Needs:

• Dramatically varies

• Mean result 6.0434 FTE/physician with S.D. of 4.0704 (Median: 4.9458 FTE/phys). For FTE physician correction Mean = 6.9843 FTE/phys.

• 2006 Data results= Mean result 5.2671 FTE/physician with S.D. of 2.1528 ( Median: 4.850 FTE/phys)

Employ Physician Extenders• 43.4% of practices (33/76) report employing

physician extenders (PA or APRN), (compared to 38.9% response in 2007).

• 20/33 practices employ more than 1 extender (total of 74 extenders reported employed). In 2007, 15/43 practices employed multiple extenders (66 total)

• 41.4% (12/29) of solo practices employ extenders. (versus 32.5% of solo practices in 2007.)

Who’s Giving Immunotherapy

% of practices reporting uses this staffer

Physicians 26.3 % (20/76 practices)

RNs 69.7% (53/76 practices)

LPNs 60.5% (46/76 practices)

Medical Assistants 53.9% (41/76 practices)

Physician Extenders 1.3% ( 1/76 practices)

Who’s Giving Immunotherapy 2007 results

% of practices reporting uses this staffer

Physicians 26.2 % (28/111 practices)

RNs 67.3% (72/111 practices)

LPNs 54.2% (58/111 practices)

Medical Assistants 41.1% (44/111 practices)

Physician Extenders 3.7% ( 4/111 practices)

Performance Evaluations

• 64/76 practices report completing regular staff performance evaluations. 52 report giving written evaluations, and 43 give verbal reports.

• 52 of the evaluations were done annually, while 10 are twice yearly. 2 reported quarterly.

Benefits given% responses

Health Insurance 88.2% (67/76)

Retirement plan contribution 88.2% (67/76)

Continuing Educational 76.3% (58/76)

Paid personal time 85.5% (65/76)

Other: Life Insurance or Dental 5.3% (4/76)

Personal time range from 1 to 30 days per year. Mean was 9.709 + 7.32 days per year. Median Value was 6 days.

Salary increases

% responses

Performance Based 76.3% (58/76)

Cost of Living 67.1% (51/76)

Attendance 46.1% (35/76)

Seniority 32.9% (25/76)

Other: regional wage level

incentive/practice profit

5/76 2/76

Bonuses:

• Productivity Bonuses given to: Employed physicians: 33/76 (43.4%) Physician extenders: 14/33 (42.4%) Supervisory staff: 12/70 (17.1%) Nurses: 9/75 (11.8%) Receptionists: 11/76 (14.5%) Billers: 8/76 (10.5%)• 8 Practices report giving employees bonuses for

employment referrals.

2009 AAAAI Practice Management Financial Survey Data

10 practices of 39 physicians

Median Mean Ranges

Charges 675,000 599,440 + 567,127

225,000 to

2,000,000

Collections 650,000 597,992 + 241,366

150,000 to 1,000,000

Expenses 455,006 419,215 + 98,180

247,658 to

550,000

Profit 260,761 274,900 + 76,631

200,000 to

450,000

Result Comparison 2006, 2007, & 2008 (median values)

2006 (n= 53 pract/139

phys)

2007 (n=89 pract/210

phys)

2008 (n= 57 pract/180 phys)

Collections 695,101 736,930 714,896

Expenses 387,500 420,000 400,000

Profit 270,000 319,717 291,198

Collection Ratio Results

• Collection ratio (collections/charges):

Median: 0.68501

Mean: 0.68527

Range: 0.4444 - 1.0020

2007 results showed Median value of 0.70416

Expense Ratio Results

• Expense ratio (expenses/collections):

Median: 0.590005

Mean + SD: 0.618638 + 0.282343

Range: 0.0800 to 1.9554

2007 Expense Ratio Median value was 0.57692

2008 Group Versus Solo Breakdown (mean)

Solo (n=29)

Group 2 & 3 (23 for 52)

Group > 4 (14 for 103)

Charges 1,366,533 + 1,047,220

1,037,963 + 498,336

1,145,560 + 594,557

Collections 915,272 + 663,103

697,367 + 305,490

709,162 + 292,047

Expenses 588,484 + 461,142

359,282 + 147,234

446,052 + 283,956

Profit 394,332 + 332,168

338,086 + 225,595

326,140 + 255,344

Group Versus Solo Breakdown 2007 results (mean)

Solo (n=50)

Group 2 & 3 (21 for 47)

Group > 4 (18 for 113)

Charges 1,181,307 + 716,304

932,021 + 401,864

1,439,263 + 802,929

Collections 804,985 + 477,495

643,826 + 238,435

1,058,601 + 531,425

Expenses 469,028 + 255,987

355,371 + 176,239

576,726 + 293,626

Profit 354,063 + 232,213

301,390 + 111,952

404,012 + 164,298

Group Versus Solo Breakdown (median)

Solo (n=29) Group 2 & 3 (23 for 52)

Group > 4 (14 for 103)

Charges 1,014,387 983,481 1,062,197

Collections 714,896 680,750 730,497

Expenses 441,860 344,743 454,220

Profit 297,480 331,827 255,771

Group Versus Solo Breakdown 2007 results (median)

Solo (n=50) Group 2 & 3 (21 for 47)

Group > 4 (18 for 113)

Charges 951,319 888,306 1,156,002

Collections 692,551 675,000 874,060

Expenses 400,000 365,544 517,446

Profit 300,000 274,891 403,342

Breakdown by Region (median)

Charges Collect Expense Profit

Northeast (16 for 46)

852,793 664,954 395,145 242,787

South (8 for 16)

1,244,641 868,442 478,975 403,360

Central (12 for 60)

1,160,000 700,000 400,000 214,286

Mideast (13 for 30)

970,801 677,396 302,625 325,000

West (8 for 30)

1,066,189 792,910 419,089 289,604

2007 Regional breakdown (median)

Charges Collect Expense Profit

Northeast (25 for 46)

866,829 604,263 400,000 335,539

South (23 for 58)

1,131,412 780,067 478,562 322,800

Central (16 for 54)

950,937 1,138,793 555,654 319,717

Mideast (16 for 32)

1,183,712 757,192 455,464 340,980

West (9 for 20)

900,000 675,000 257,350 252,800

Physician Extender EffectPractices with (27 of 111 phys)

Practices without (39 of 83 phys)

Charges (median/mean)

1,263,896 1,454,852

970,801

973,937

Collections (median/mean)

814,650

950,117

644,798

649,798

Expenses (median/mean)

459,372 572,709

350,000

384,155

Profit (median/mean)

323,579 428,054

247,809

302,999

Preliminary ResultsImmunotherapy % in Billing

Median 0.32955

Mean 0.31000

St. Dev. + 0.15454

Range 0.01000 to 0.58148

2007 Mean results were 0.3524 + 15938