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11/4/2019
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Making Metrics Matter:“Strategies For Utilizing Metrics To Maximize Productivity And Reimbursement”
Florida Occupational Therapy AssociationAnnual Conference 2019Embracing Occupation:
Supporting All People, Populations, And Communities
• Brandon Seigel has had financial support from Wellness Works Management Partners for previous educational programs.
• Brandon Seigel is employed by the Wellness Works Management Partners.
• Brandon Seigel has an affiliation with Every Child Achieves, Inc. & Wellness Works, Inc.
• Brandon Seigel is the author of The Private Practice Survival Guide and receives royalty payments
This presentation is protected by U.S. and International copyright laws. Reproduction and distribution of the presentation without
written permission of the sponsor is prohibited.© 2019 Brandon Seigel
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Brandon’s Journey To BecomingAn “Entrepreneur’s Plumber”
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Cleaning Up Your private practice operations and streamlining the flow
Brandon’s Results: About Me:
• Published Author: The Private Practice Survival Guide: A Journey To Unlock Your Freedom To Success (Rebel Press, February 2019)
• Podcast Host: The Private Practice Survival Guide With Brandon Seigel (Produced by Xceptional Ed)
• Internationally Recognized Business Consultant & Private Practice Expert (Supported Thousands Of Entrepreneurs, Practitioners, Etc. Featured By Real Leaders, CBS, CNBC Money Watch, CEO World, Etc.
• CEO, Entrepreneur, & Private Practice Consultant: President With Wellness Works Management Partners, Executive Director With Every Child Achieves, Inc.
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Today’s Agenda
• Why Metrics Matter
• Identify Which Metrics Matter In Private Practice
• Current State Of Data Analytics In Healthcare
• The Synergy Of Metrics & Productivity / Reimbursement
• Using Metrics To Empower Efficiency & Effectiveness
• Question & Answer
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DON’T FORGET: We Are In The People Business!
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Why Metrics Matter:
What Would Happen More Frequently If You Did Not
Have A Fuel Meter?
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What Were Road Trips Like Before An Electronic GPS? (Google Maps, Waze, etc.)
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What Often Happens When You “Bake” Without A Recipe Or Proper
Measurements?
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Benefits Of Utilizing Metrics:
• Metrics Are A Roadmap – Track Journey & Illustrate A Storyline
• Create A Grounding Force Of Accountability
• When Implemented Effectively – Can Be A Tool For Empowerment & Measuring Goal Progress
• Metrics Contribute To Efficiency – They Allow You To Measure Effectiveness In A Streamlined Way.
• They Provide You A Guiding Light To Identify “Right Actions” & “Wrong Actions” For Strategic Planning, Etc.
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How Analytics Can Impact Your Private Practice:
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Sample Key Metrics For Financial Analysis:
• Here Are Some Key Financial Planning Metrics That Should Be Measured:
‐ Profit & Loss Report With Following Variables:
‐ “Accrual-Basis” (If Possible) For The Business Model
‐ “ Cash-Basis” For The Business Model
‐ Employee Individual “P&L” –Measured Through Both Cash Basis & Accrual Basis
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MR. B’s QUICK TIP: “Minimum Of 60% Of Revenue Should Be Collected Within 30 Days From Date Of Service!”
Sample Key Metrics For Financial Analysis:• Here Are Some Key Financial Planning
Metrics That Should Be Measured:
‐ Billed Charges Vs. Contracted Charges Vs. Collected Charges
‐ Aging Report
‐ Patient Acquisition Cost
‐ Marketing Expense Analytics
‐ Avg Financial Value Of Patient
‐ Functional ROI On Administration
‐ Payor Mix Analytics
‐ Opportunity Analytics (Cancellations, Etc.)
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MR. B’s QUICK TIP: “Run A “Clinician Cost Differential” & Goal Is 50% ‐ Clinician Cannot Exceed 60% Expense!”
Additional Key Metrics To Monitor:
• Patient Satisfaction
‐ Measure Satisfaction Scores In Following Variables:
• First Impressions
• After Evaluation
• After 6 Week Increments
• Discharge
‐ Patient Retention & Discharge Qualifiers
‐ Continuity Of Care
‐ Patient Outcome Measure
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MR. B’s QUICK TIP: “A Net Promoter Score Measures Customer Experience & predicts Business Growth.”
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Additional Key Metrics To Monitor:
• Provider Performance:
‐ Billable Hours Productivity
‐ Patient Retention & Discharge Data
‐ Provider Net Promoter Score
‐ # Of Reschedules
‐ Provider’s Patient Engagement
‐ # Of Referrals For Specific Provider
‐ Cost Analysis Of Provider (P&L)
‐ Provider’s Clinical Outcome Metrics –Avg. # Of Visits, Etc.
‐ Labor Utilization
16MR. B’s QUICK TIP:
“Employee Empowerment Requires A Shared Vision, Shared Goals, Intrinsic Motivation, & Transparent Metrics ”
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Additional Key Metrics To Monitor:• Population Health & Care
Management
‐ Patient Demographic Analytics
• Diagnosis
• Age
• Sex
• # Of Visits Until Discharge
• Re-admittance Rate
• Patient Net Promoter Score
• Patient Acuity
• Additional Therapeutic Services
• Transitional Care
• Distance To Private Practice18
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Additional Key Metrics To Monitor:
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A therapist’s MIPS performance score will factor in performance in 4 weighted performance categories.
The scale is based on a 0-100-point scale.
7 Statistics For Survival, Success, & Scalability:
1. Cash Flow Analysis
2. The Meat On The Bone Margin
3. “Aging” Outstanding Due Balance
4. Marketing / Referral Effectiveness
5. Payor Mix / Payment Methods
6. Productivity & Creative Compensation Metrics
7. Cancellation Report
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Synergy Between Predictive Data Analytics & Value-Based Care:
Here Are Some Samples Of HOW Predictive Analytics Are Being Utilized To Synergize With Value-Based Care:
• Risk Scoring For Chronic Diseases, Population Health
• 30-Day Hospital Readmissions
• Tracking Attendance Patterns, No-Shows, HEP Engagement, Etc.
• Clinician Productivity, Discharge Analytics, & Patient Satisfaction Rating
• Data Security – Artificial Intelligence Can Rank Security Risk, Etc.
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Current State Of Data Analytics In Today’s Healthcare Environment:
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Current State Of Data Analytics In Today’s Healthcare Environment:
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Current State Of Data Analytics In Today’s Healthcare Environment:
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Synergy Between Metrics, Productivity, & Reimbursement!
• All Of The Metrics Mentioned In Earlier Slides Can Be Utilized To Empower Productivity & Negotiate Reimbursements.
‐ Examples:
• Utilize “Provider P&L” To Create Bonus Structure, Transparent Empowerment, & Create Opportunistic Buy-In.
• Utilize Your “Population Health Management Metrics” To Negotiate Reimbursement Rates With Insurance.
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3101.5
2905.25
3181.5
3528.25
3730.5
3486
3841.75
3728.25
2800
3000
3200
3400
3600
3800
4000
Jan‐19 Feb‐19 Mar‐19 Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19
Total Monthly Hours
140.98
145.26
151.50
160.38
169.57
174.30174.63
169.47
140
145
150
155
160
165
170
175
180
January February March April May June July August
Daily Average Hours
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1575.25
1506.00
1779.00
1880.25
2050.00
1931.00
2214.75
2163.50
1500.00
1600.00
1700.00
1800.00
1900.00
2000.00
2100.00
2200.00
2300.00
January February March April May June July August
OT Hours
50.79%
51.84%
55.92%
53.29%
54.95%
55.39%
57.65%
58.03%
50.00%
51.00%
52.00%
53.00%
54.00%
55.00%
56.00%
57.00%
58.00%
59.00%
January February March April May June July August
OT Percentage
3631.7
3311.75
3563.5
3795.25
3314.5
3491.75
3069.25
3407.5
3100
2813.5
2905.25
3181.5
3528.25
3486
3841.75
3728.25
2700
2900
3100
3300
3500
3700
3900
Jan‐18 Feb‐18 Mar‐18 Apr‐18 May‐18 Jun‐18 Jul‐18 Aug‐18 Sep‐18 Oct‐18 Nov‐18 Dec‐18 Jan‐19 Feb‐19 Mar‐19 Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19
Total Monthly Hours (20 Month Trend)
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1769
1603.5
1687
1836.25
1645.75
1847
1629
1861.25
1680.75
1503.251506
1779
1880.25
2050
1931
2214.75
2163.5
1400
1500
1600
1700
1800
1900
2000
2100
2200
2300
Jan‐18 Feb‐18 Mar‐18 Apr‐18 May‐18 Jun‐18 Jul‐18 Aug‐18 Sep‐18 Oct‐18 Nov‐18 Dec‐18 Jan‐19 Feb‐19 Mar‐19 Apr‐19 May‐19 Jun‐19 Jul‐19 Aug‐19
OT Monthly Hours (20 Month Trend)
Prizes:• Platinum: Work From Home Reward For Week Plus
Gold & Silver Prizes• Gold: 2 Hours Of Paid Time Off Plus Silver Prize• Silver: $15 Gift Card
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Examples Of Using Metrics To Empower Productivity:
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Example Of Hours Productivity Percentage Action / Result
4 Hours Of Billable Productivity In 8 Hour Day 50% Productivity
Not Sustainable Major Out Of ExchangeAccountability Required
5 Hours Of Billable ProductivityIn 8 Hour Day 62% Productivity
Not Sustainable Not Optimal ExchangeResearch & Empower
6 Hours Of Billable Productivity In 8 Hour Day 75% Productivity
Sustainable Base Exchange
Optimize & Empower
6 1/2 Hours Of Billable Productivity In 8 Hour Day 81% Productivity
Sustainable Optimal Exchange
Acknowledge & Empower
7 Hours Of Billable Productivity In 8 Hour Day 87% Productivity
Caution / Burnout AlertHigh Producer
Ongoing Check‐ins / Self Care Bonuses
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Examples Of Using Metrics To Increase Reimbursement:
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Understanding Efficiency & Effectiveness:
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Synergy Between Metrics & Efficiency & Effectiveness:
• Metrics allow us to measure efficiency and effectiveness.
• Metrics allow us to analyze and strategize efficiently and effectively
• Metrics allow us to identify goals, measure progress, and empower accountability.
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The Elephant In The Room“The Barriers”:
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The Facts:• 11 Billion Dollars Are Lost Annually Due To Employee
Turnover. (Bureau of National Affairs)
• Supply & Demand Metrics Favor Employees In The OT/PT/SLP Industries. (Ex. The PT Industry is on track to have a shortage of 26,560 Physical Therapists by 2025)
• Higher Productivity Standards / Higher Employee Burnout (Upwards To 95% Productivity Expectations In Some Settings)
• Fixed Expenses On Rise / Net Income On Decline (Therapist’s Compensation Expectations On The Rise While Reimbursement Stagnant If Not On The Decline)
The Elephant In The Room“The Barriers”:
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The Facts:• More Than 50% OT/PT/SLP Students Will Graduate With Over
$70,00 in debt. 34% will graduate with over $100,000 in debt.
• 52% Of OT/PT/SLPs Reported Desire To Make Professional Change Within 5 Years With 20% Expressing Interest In Non-Clinical Role.
• 70% of professionals who are thinking about transitioning to a non-clinical role are doing so in order to improve work-life balance or increase fulfillment.
• Two-Thirds Of American Employees Are Not Fully Engaged At Work. (Dale Carnegie)
• Disengaged Employees Cost Organizations Between $450 And $550 Billion Annually.
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How Do We Use Metrics For Employee Empowerment:
Shared Reality, Transparency, & Collaborative Relationship Is a
Necessity
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Brandon’s Journey To “Creative Compensation”:
• Before I go into “creative compensation”, I want to indicate that intrinsic motivation is ultimately the most essential attribute linked to top producers.
• With that being said, “creative compensation” has been an extremely successful strategy for me.
• Before “creative compensation” was part of our employee culture:
‐ Employees were paid a flat salary
‐ No differentiation factors for wages
‐ Productivity was sub-par & retention waivered because there was no clear growth trajectory.
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Brandon’s Journey To “Creative Compensation”:
• First Off, I believe that creating a road map of compensation for employees is one of the most essential strategies to employee empowerment and identifying goals that impact both employee growth and private practice growth!
• I typically create compensation structure that is 70% fixed expense & 30% variable expense. The variable expenses are based on key performance indicators for the employee. The key performance indicators may include productivity, clinical outcomes, direct referrals, successful marketing actions, etc.
• The end all goal is to create financial stability while creating financial opportunities that align with employee’s intrinsic motivation. 48
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Brandon’s Journey To “Creative Compensation”:
• Example Of Base Compensation:
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ScenarioPeriod Of
EmploymentStatus Billable Rate
Completed Billable Hours Per Month
Projections Based on Period Of Time (Billable Treatment Compensation)
Monthly Paid Clinic Time (1
hour per 6 treatment hours)
Annual Projections Based on
Period of time (Documentation
Time)
Admin Meetings @ $15 per hour Based
on Period Of Employment
($200) Monthly Bonus
Calculated Into Period Of Emp.
Projection
PTO (SICK TIME) Projection Based On
period Of Time
Gross Income Before Taxes
Based On Period Of Time
Annual Gross Income
Retirement (Simple IRA) (annual)
Continued Education
Reimbursement
Employee Expenses (Taxes,
Insurances, etc.)
Mentorship (Expenses To Employer To
Train Employee)
Total Employee
Package Value (Employer Spends)
Employee Expense Broken Down By Billable Hour Equivelency
Scenario 1
First Six Months Part‐Time (Under 26 billable hours per week) $43.00 100 $25,800.00 $716.67 $4,300.00 $270.00 $1,200.00 $516.00 $32,802.67$67,062.67
$2,011.88 $1,050.00 $10,059.40 $12,120.00 $92,303.95 $76.92Month 7‐12 Part‐Time (Under 26 billable hours per week) $45.00 100 $27,000.00 $750.00 $4,500.00 $270.00 $1,200.00 $540.00 $34,260.00
Month 13‐18 Part‐Time (Under 26 billable hours per week) $50.00 100 $30,000.00 $833.33 $5,000.00 $270.00 $1,200.00 $600.00 $37,903.33$78,721.33
$2,361.64 $1,500.00 $11,808.20 $6,500.00 $100,891.17 $84.08Month 19‐24 Part‐Time (Under 26 billable hours per week) $54.00 100 $32,400.00 $900.00 $5,400.00 $270.00 $1,200.00 $648.00 $40,818.00
Scenario 2
First Six Months Full‐Time (Over 27.7 billable hours per week) $43.00 110 $28,380.00 $788.33 $4,730.00 $270.00 $1,200.00 $516.00 $35,884.33$73,369.33
$2,201.08 $1,050.00 $11,005.40 $12,120.00 $99,745.81 $75.57Month 7‐12 Full‐Time (Over 27.7 billable hours per week) $45.00 110 $29,700.00 $825.00 $4,950.00 $270.00 $1,200.00 $540.00 $37,485.00
Month 13‐18 Full‐Time (Over 27.7 billable hours per week) $50.00 110 $33,000.00 $916.67 $5,500.00 $270.00 $1,200.00 $600.00 $41,486.67$86,174.67
$2,585.24 $1,500.00 $12,926.20 $6,500.00 $109,686.11 $83.10Month 19‐24 Full‐Time (Over 27.7 billable hours per week) $54.00 110 $35,640.00 $990.00 $5,940.00 $270.00 $1,200.00 $648.00 $44,688.00
Scenario 3
First Six Months High Producer (30 billable hours per week) $43.00 120 $30,960.00 $860.00 $5,160.00 $270.00 $1,200.00 $516.00 $38,966.00$79,676.00
$2,390.28 $1,050.00 $11,951.40 $12,120.00 $107,187.68 $74.44Month 7‐12 High Producer (30 billable hours per week) $45.00 120 $32,400.00 $900.00 $5,400.00 $270.00 $1,200.00 $540.00 $40,710.00
Month 13‐18 High Producer (30 billable hours per week) $50.00 120 $36,000.00 $1,000.00 $6,000.00 $270.00 $1,200.00 $600.00 $45,070.00$93,628.00
$2,808.84 $1,500.00 $14,044.20 $6,500.00 $118,481.04 $82.28Month 19‐24 High Producer (30 billable hours per week) $54.00 120 $38,880.00 $1,080.00 $6,480.00 $270.00 $1,200.00 $648.00 $48,558.00
In addition, we produce a list of milestones the employee should reach between month 1 to month 24 with incentive opportunities and everything is tied to metrics. After 24 months, variables get readjusted based on financials. Run a “P&L” on each employee
annually.
Top Tools For Making Your Metrics Matter:• Electronic Medical Record System (EMR) –
Example: “Web PT EMR”
• Clearinghouse – Reports May Be Through EMR Or Direct Through Clearinghouse – Example: “WayStar”
• Task Management / Project Management Software – Example: “Kanban Flow”
• Phone System – VOIP – Phone Call Metrics –Example: “8X8”
• Key Performance Indicator Platform – Example: KPI Fire
• Clinical Outcome Tracking – Example: FOTO
• Custom Pivot Tables, Spreadsheets, Etc. –Example: Microsoft Excel
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The Private Practice Survival Guide & Workbook Available Today!
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Additional Resources: • 10 Module E-Learning Course:
“Private Practice Survival Guide Course”
• Podcast: The Private Practice Survival Guide With Brandon Seigel
• Blog: The Entrepreneur’s Plumber www.wellnessworksmp.com/blog
• Articles & Webinars:www.brandonseigel.com
• Consulting & Management Services: www.wellnessworksmp.com
• Twitter: @wellnessworksmp
• Facebook: /wellnessworksmp
• Linked In: /in/brandonseigel/52
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