ENHANCING PHYSICIANPRODUCTIVITY

AAOS Practice Management Symposium San Francisco February 7, 2012

ADSoyerDO

DISCLOSURES

AAOS Practice Management Committee

Goals

Definition of Productivity Uses of Measuring Productivity Areas to Improve Productivity in the Office -Patient Access to Practice

-Office Operations/ Clinical Workflow

- Management

- Technology & Data

Ancillary Revenue Investments

WHAT IS PRODUCTIVITY?

Measure of physician work

USES OF MEASURING PRODUCTIVITY

Determine Compensation reliable, consistent & objective

To Be Effective:

- must reflect the compensation environment or payer mix

- must allow for improvement

Compare physicians Determine staffing requirements / office

resources More Productive Physicians spend more time in direct patient

contact,

generate more RVUs, consume more practice resources

Therefore, Productivity generates more practice expense

Resource Allocation can thus be adjusted by Physician Productivity

PRODUCTIVITY

How do we Measure Physician Productivity?

# of office visits/ patient encounters -traditional measure of productivity limited by patient demographics

-should include time as unit of measure

Collections -more accurate than charges in fee-for-service environment

RVUs -better measure in fee-for-service environment where multiple CPTs

are

generated

Ancillary output

ENHANCING PRODUCTIVITY

New Era of Patient Centered, Proactive

Healthcare New Models for Physician

Productivity incorporate: evidence-based medicine, cost-effective practice and continued improvement of

outcomes.

AREAS TO IMPROVE PRODUCTIVITY

Office Operations Ancillary Sources

PATIENT ACCESS TO PRACTICE

Increase Online Presence - Web 2.0 compliant website - Social Media Campaign Facebook, Twitter, Blog, YouTube - Marketing Google Ads (Adwords)

AAOS Primer Social Media in Healthcare

OFFICE OPERATIONS

Front Office Patient Direct Access-alleviates burden

on front desk at time of appointment -patient portal via website

-online appt scheduling

-demographic/ insurance forms email &

downloadable

Technology to enable efficient data entry - electronic signature capture

- scanning documents

OFFICE OPERATIONS

Clinical Work Flow

TIME IS MONEY! Efficient Time Management makes money Use technology -EMR (templates)/Scribe / Voice Recognition

(macros) Efficient Time management saves money Reduces staff hours (less overtime)

OFFICE WORK FLOW

RVU value to your work Low or ‘no value’ services should be

delivered by non-physician extender - postop S/R, global fx f/u , etc… High value services should be

delivered by MD -US guided injections - In-office procedures

OFFICE COMMUNICATIONS

Internet phone -cost-effective upgrade with numerous options

Skype Business/ Teleconferencing -efficient time management for regular business meetings

Livestream -Orthopedic channel to live broadcast (e.g. lecture,

community outreach)

Mobile - text -google chat

OFFICE OPERATIONS

Billing & Coding

Code for everything you do Maximize every potential RVU EMR charge entry and PM software

should be integrated Prepare for ICD 10 changes NOW!

OFFICE OPERATIONS

Management Understand Overhead in terms of Cost

per month, day, hour Convert to RVU per month, day and hour Set realistic RVU goals for each physician Use Benchmarks for comparison

Management

Six Step Approach Migliore 2002

Develop a Budget compare actual results to expectations monthly

Monitor Practice Overhead compare to previous year and use benchmarks for FTEs

Monitor Cash Flow have reserve on hand

Monitor A/Rs should be monitored monthly, < 20% @ 90 days

Monitor Collection Rates should have high net collections

RVU Analysis of Practice provides data on higher reimbursing services to increase marketing,

identifies unprofitable services, analyze contracts and negotiate higher reimbursement

http://www.physiciansnews.com/business/502migliore.html

TECHNOLOGY & DATA

Use your Technology to your advantage Website tools enable you to track & plot demographic data Google adwords / Bing campaigns

improve your web presence Maximize your marketing potential to ePatients Engage in social media

ANCILLARY REVENUE

Examine all ancillary revenue streams Consider eliminating options that

require continual investment with low ROI Invest in services that compliment

practice Expand practice portfolio to include

nonclinical revenue streams

OFFICE SPACE

Your Space Consider offering per diem lease when the

space is not

occupied

Complementary services that will generate potential

referrals such as Rheumatology/ Pain Management

Setup ancillary services to have daily production in your absence

EMG/NCS, DME, Xray/ MRI, Urgent Care

http://www3.aaos.org/member/prac_manag/enhancing_revenue_primer.pdf

CLINICAL INVESTMENTShttp://www.beckersorthopedicandspine.com/news-analysis/item/9027-private-equity-investing-in-healthcare-%E2%80%94-13-hot-and-4-cold-areas

13 ‘Hot’ Areas in Healthcare Becker Aug 2011

Hospitals & Health Systems Hospital-based Specialists ASC chains HIT & mobile Health (mHealth) Chronic Disease Cancer & Hospice Wound Care Physical Therapy Revenue Cycle Companies Overseas Markets/ Addiction/ Rehabilitation/ Dental

Practice Management

NON-CLINICAL INVESTMENT

Latest Trends are in Social Media Companies& Internet Marketing

Real Estate –buyers market

SUMMARY

Evaluate Individual & Practice Productivity Benchmark with RVUs Use Productivity to re-evaluate practice costs &

resource allocation Evaluate Clinical Workflow for Efficiency Use Technology to improve Efficiency Evaluate Ancillary Revenue Streams – eliminate low

profit ancillaries and consider new investments (both clinical & nonclinical)

Determine Need for Practice Executive if anticipating growth/ expansion

Thank You

Resources:www.beckersorthopedicandspine.comEmail: ADSBONES@gmail.comTwitter@ADSoyerDOAdamDSoyerDO @ Facebook