Key Performance Indicators For Pediatric Practices Paul D. Vanchiere, MBA.

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Presentation transcript:

Key Performance Indicators For Pediatric Practices Paul D. Vanchiere, MBA

Important Business Lesson from Melville… Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

How Many Do I Have To Sell To Recover The One Missing Bottle of Coke? Revenue$1.00 Cost$0.98 Margin$0.02 Margin % 2.04% Calculation: $0.98 / $0.02 = 49 Units Does not include labor, floor space, utilities and credit card fees. Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Administrative Costs Clinical Costs Front Office Staff Information System Ancillary Lines Office Manager Admin Assistants Square Feet Allocation Equipment Leases Clinical Staff Clinical Supplies Vaccines Medications Receptionists Clerks Networking Billing System EMR Staff Supplies Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

What reports do you see on a monthly basis? Within 3 days of the month’s close Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Minimum Reports Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA Revenue Generated –By Provider Practice Costs –By Location Labor Cost –Regular Wages –Overtime –Benefits Supply Costs –Vaccines –Medial Supplies

Key Performance Indicator Options

Gross Collection Ratio Total Collections / Total Gross Charges $ 690,000 / $ 975, % Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Net Collection Ratio Total Collections / (Total Charges – Total Adjustments) $ 600,000 / ($ 650,000 – $25,000) 96% Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Charges per Encounter Total Charges / Office Encounters $ 975,000 / 4,000 $ Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Net Collections per Encounter Net Collections / Office Encounters $725,000 / 4,000 $ Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Cost per Encounter Total Operating Cost / Office Encounters $300,000 / 4,000 $75.00 Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Profit per Encounter Revenue per Encounter – Cost per Encounter $ – = $50.00 Will need to examine sick and well child since vaccines skew data. Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Monthly KPI Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Monthly KPI

Labor Cost Labor Cost ItemDirectEmployer Wages - StaffX Wages - PhysiciansX Wages - OvertimeX Bonuses - StaffX Bonuses - PhysiciansX Severance PayX Employer FICA X Employer Medicare X Workers’ Compensation Insurance X Federal Unemployment X State Unemployment X Vacation Pay X Holiday Pay X Sick Pay X Parking X Employer Provided Health Insurance X Employer Provided Life Insurance X Employer Provided 401 K Contributions X Employer Provided IRA Contributions X Employer Provided Pensions & Retirement X

Labor Cost Allocation 1. Clinical Staff 2. Clerical Staff 3. Billing Staff 4. Administration 5. Physician Salary & Bonus 6. Ancillary Services Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Labor Cost Tracking Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

-Calculators/KPIs- Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

-Calculators/KPIs- Key Performance Indicators for Pediatric Practices. Presented by: Paul D. Vanchiere, MBA

Information about Specific Calculation Online Calculator Net Collection Ratio Description: Shows total collections as it relates to expected contracted reimbursement rates from payors. Why Is This Important? While a practice may charge $300 for a series of CPT codes, the managed care company may have a contract to pay you $210 when you add up the combined allowable for the billed CPT codes. As such, many practices use the Net Collection Ratio to examine the amount of payments compared to the negotiated rates. PMI Recommended Frequency to Run this KPI: Monthly Formula: Total Payments / (Total Charges - Contractual Adjustments) Show the Math: $600,000 / ($900,000 - $75,000) = 72.73% How Should I track This? This can be tracked using an Excel spreadsheet by Practice and/or Department. Online Calculator: (Replace The Numbers Below With Your Numbers)