Samantha Sizemore, Director of Operations, Holston Medical Group
As a 150 provider, independent multi-specialty practice, Tennessee’s Holston Medical Group (HMG) strives to improve performance measures across its 26 locations. We all need to make the most of our resources and HMG looked to analytics as a means to do just that. Being part of a successful, physician-owned Accountable Care Organization (ACO) has also increased our need for insightful data. Our organization has been working with OnePartner and PrecisionBI to ensure we have access to the information we need in real-time to make the best decisions for our organization.
One related initiative for HMG has been to bring awareness of the organization’s financial side to physicians, who are mainly concerned with the clinical aspects of the practice, as they should be. We have been using analytics in operations to educate them on key performance metrics, including accounts receivable, charges and payments. Dashboards allow us to take a high-level view of the organization and then drill down to the practice and individual provider. These dashboards show month over month and year over year. Each physician can see how they are performing over time in relation to the entire organization.
To understand how metrics compared to overarching goals, HMG set benchmarks based on research from MGMA and learned best practices, which we shared with all providers. The results speak for themselves. Over the past year and a half, our claims denial rate has declined to almost half of what it was—formerly 11.5 percent and now 6 percent. Our charge lag was between 12 and 14 days and is now down to 6 days. Adding a co-pay collections tab doubled collections at the point of care. This is especially important with the growing number of high-deductible plans held by our patients. Educating practices and arming them with information that, until then, had been outside of their main focus has made our organization stronger.
Without a proper game plan, implementing analytics for improving medical practice performance can appear to be a daunting challenge, but it should not be. For practices looking to incorporate analytics, here are some factors to keep in mind:
- Keep analytics with those that need information. Many times, analytics projects start with IT but should not end up there. People who need this information should have access to it and IT resources can be better allocated elsewhere.
- Conduct an honest assessment. You have to know where each part of your organization is in regard to analytics. As an example, the clinical side may not be as advanced in this area as finance. Understanding where each department stands will help you know how to tackle analytics. HMG began with practice management, starting with the systems we look at daily and then expanded.
- Select tools with business intelligence (BI). Niche tools may do the job short-term, but you need a solution that can adjust to future industry requirements. BI gives that flexibility and enables users to build what they need without always going through the IT department.
- Choose one tool for all data. Information residing in different systems for separate functions becomes cumbersome to access. Only by having a complete view across the organization can you truly gain a complete image.
- Act on real-time data. Who wants to react to information that is, in some cases, months old? Current metrics enable the organization to correct a course before there is a problem and ensure a positive trajectory significantly earlier than historical data permits. Real-time information will allow you to see the positive changes in outcomes as they are occurring, without waiting months for the data to catch up to the actions.
Medical analytics aid organizations, including HMG, in identifying and setting priorities, and making the most of finite resources. Once you have the proper information, the real work begins. Then it is time to go in and make the improvements that the data brought to light. Keep an eye on metrics as you implement projects to ensure they are moving in a desired direction and enjoy the results.