Identifying Optimal Panel Size for Primary Care Physicians Methods to adjust panel size for patient and practice variables

What is panel size? A patient panel is a group of patients for whom one specific physician or clinical team is primarily responsible. Panel size has effects on: care quality patient and physician satisfaction access

Five steps to optimize panel size for primary care physicians Identify your patient population Choose the method for determining an optimized panel size Adjust panel size based on patient and practice variables Modify clinician panel sizes Monitor and maintain panel sizes

Benefits Associated with Setting Up Appropriately Sized Panels Appropriately sized panels will: Prevent under-utilization of physician skills and unnecessary limited access for patients of over-empaneled practices Decrease stress on physicians and care teams of over- empaneled practices Facilitate equitable compensation within organizations moving away from a production model of payment Develop sustainable models of primary care to reduce physician burnout

Metrics to Begin Defining Optimal Panel Size Define the look-back period (the duration of the patient’s care in the practice) Determine the number of qualifying visits Attribute the patient to a specific physician Establish the frequency of panel size assessment

Methods That Estimate Optimal Panel Size Description Visit-Based Method Based on the office visit capacity (supply) being equal to the panel size (demand) Time-Based Method Estimates the overall physician work effort required to deliver comprehensive care (total hours to provide patient care) Normative Benchmarking Uses existing panel sizes in different healthcare setting as benchmarks

Indicators to Modify Panel Size Proxy indicators of sub-optimal panel size: Burnout scores Less than full-time effort Physicians decreasing their clinic time Total time spent in the EHR After hours documentation including weekends and vacation Chart closure rates

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