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Practice Performance Management

In today's era of rapid economic and technological growth, the business of medicine has become an all-too-consuming aspect of most practices that cannot be ignored. You know yourself how much time you devote to sorting out staffing issues, juggling schedules, figuring out billing and coding rules, meeting governmental compliance requirements, etc. Often, you see a full load of patients during the day and spend lunch hours, evenings and/or weekends doing the business "stuff" that's required to keep the practice going. Family and personal time ends up being disrupted.

This problem is especially critical for physicians in solo and small group practices since they are generally unable to afford the services of a full-time professional administrator who is specially trained in business and medical practice management. Practices of this size frequently employ an operations-focused "office manager" who, through no fault of his/her own, is often ill-equipped to think "big picture" with respect to seeking opportunities for increased profitability, developing new income streams, strategic planning, etc. This individual may also lack the necessary skills for financial management, operational assessment, human resources, risk management, etc.

For this reason most small practices are operating at a distinct economic disadvantage, unable to perform on-going operational assessment and unable to insure success in meeting profitability, productivity and quality performance goals. However, the business decision-making skills required to position your practice to insure future profitability, and even survivability, are no less important for small practices than for larger groups.

To address this problem, Marc H. Bailey & Associates designed a specific consulting service - Practice Performance Management (PPM) for smaller practices. Our PPM consulting service allows physician decision makers in small practices to make more informed decisions about how and where to change their operations so that they can be more productive and profitable while delivering quality care. PPM is rooted in the effective use of resources. This effectiveness is measured by quantifying financial and clinical processes and outcomes using key performance indicators that can help decision makers gauge the performance of their practices.

Our PPM projects begin with a "mini" practice assessment. This assessment benchmarks your practice with national and/or regional averages and other "better performing" practices in your specialty. A sampling of the benchmark indicators typically used in our PPM projects is shown below:

Profitability and Operating Costs:

  • E/M coding assessment
  • Total net revenue per FTE physician
  • Total operating cost per FTE physician
  • Revenue after operating cost per FTE physician
  • Total operating cost as a percent of total net medical revenue
  • Total physician cost as a percent of total net medical revenue

Productivity, Capacity and Staffing:

  • Total gross charges per FTE physician
  • Total support staff per FTE physician
  • Procedures per FTE physician
  • Square feet per FTE physician

Accounts Receivable and Collections:

  • Percent of total A/R over 90 days
  • Number of months gross FFS charges in A/R
  • Gross and adjusted collection ratios

Upon completion of this "mini" assessment, Marc H. Bailey & Associates will:

  1. Decide which specific performance indicators to monitor for your practice,
  2. Establish an acceptable range of values for each indicator,
  3. Analyze your practice data,
  4. Recommend actions to correct identified problems,
  5. Work with you and/or your practice staff to insure the recommended actions are implemented, and
  6. Monitor the results to insure the recommended actions achieve the desired outcomes.

Once this process has been established, Marc will visit your practice on a routine basis according to a schedule that has been mutually determined with you. These visits are typically every two weeks during the initial months of the project but are later extended to monthly and quarterly visits after the practice has grown accustomed to the process and progress has been demonstrated in meeting established goals.

Performance management isn't a one-time sprint; it's a continuous process intended to last the life of your practice. Meaningful results generally require behavior change. After the changes have been made and the practice has been allowed to stabilize, the process begins again. New performance indicators and/or higher standards for existing indicators are introduced to improve workflow processes until the desired level of financial or clinical performance is achieved. The pace of the initiative is naturally tailored to suit your practice's budget, timeline and ability to change.

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Marc H. Bailey and Associates • 5013 Butterfield Court • Culver City, CA 90230 • Tel. 310.838.9170 • marcbailey@ca.rr.com