How to Use Data for Decision Making in RHCs - nosorh.org to Use Data for Decision Making in RHCs ....

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How to Use Data for Decision Making in RHCs

Transcript of How to Use Data for Decision Making in RHCs - nosorh.org to Use Data for Decision Making in RHCs ....

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