“Doing Well to Do Well” – Financial Health Vital Signs MGMA Data Experience 2013

Objectives List vital metrics in determining practice financial health. Identify importance of meaningful analytics to delivering quality health care Identify action steps to convert metrics into practice improvement.

Traditional Practice Questions How well is my practice performing financially? Are we being under paid? How can we better manage A/R? How can I score payer performance? How well are we coding our procedures? Are we doing better/worse than others?

Why Business Intelligence?  Data driven decision making is the future of healthcare  Decisions are driven by the following criteria: - Financial Performance - Clinical Quality Measures - Productivity and Performance Benchmarking - Marketing and Referral Analysis - Population Management - Health Risk and Wellness Assessments  Independent clinics in a variety of specialties are financially struggling and having difficulty keeping up with market influences and demand  Clinics need deeper insight to make the best possible decisions  Clinics need technology and information to help drive success

Data Experience Terminology Key Performance Indicators (KPIs) ◦The “indication” and evaluation success Performance Metric ◦The “measure” of activities and performance Benchmarking ◦“Compare” performance and metrics to other strong performing entities Thresholds ◦A “level” or rate by which performance is negatively or positively reached and requires attention

Terminology Cont’d Target ◦Proceeding or improving to a “specific” goal Normalize ◦Using calculations to take data from fragmented elements to data that generates the “norm” or desired value ◦Reduce redundancy and “clean” Aggregate ◦A “whole” produced by several individual elements

Establishing KPIs Developing KPIs usually follows a process of: 1.Determine critical processes 2.Identify specific, quantifiable outputs of data 3.Establish targets against which results can be measured and scored 4.Establish a maintenance plan

Rubik’s Cube Theory

Steps to your Data Experience KPIs Determine Critical Processes Determine Metrics Data Sources Target Determine Benchmarks Establish Targets Determine Thresholds Analysis Drill Down Isolate Problem Areas Determine Corrective Action Action Evaluate Implications (Rubik’s Cube) Determine Timeframes and Resources Take Action Maintain Measure Actions Determine if Iterations are Needed Establish Maintenance Plan and Occurrence

Example Critical Processes

Example Critical Processes Cont’d

Determine Metrics - Example Payer MixContractingDenials Patient Satisfaction Lag time Patient Volume Days in A/R Collection Rates

Determine Benchmarks - Example

MGMA Benchmark Data MGMA is armed with accurate, up-to-date data on the industry and comparable data on your practice: Physician Compensation Productivity Number of Patients Staffing Revenue Operating Expenses Accounts Receivable

Determine Thresholds - Example Example Threshold Chart

Do you have the right tools?

Possible Analysis Tools Practice Management Reporting EHR Reporting Clearinghouse Reporting Data Feeds into Excel Third Party Reporting Business Intelligence Platform

“Doing Well to Do Well” – Financial Health Vital Signs MGMA Data Experience 2013