benchmark

Thanks to the impetus provided by an inspired comment on the previous blog entry, Igor and I got excited about the idea of analyzing the average RVU rate for all CPT codes, broken down by procedure type.  Are "well codes" paid at the same rate as "sick codes?"  What about hospital visits?  Imms Admin?

Well, we calculated it for you, and the results are fascinating.  

The other day, I posted our new Sick:Well visit benchmarks that take into account the -25 modifier usage.  I remarked that there appeared to be an interesting dip in the benchmark in 2004 and asked if anyone had an explanation. 

Turns out that Chipsblog Super Fan (my label) Dr. Suzanne Berman did a little research in her practice and may have come up with some of the answer.  At first, she wrote to me:

While I was at Skytop lecturing last week, I ran into JR Vought - actually, he literally ran into me on purpose - who proceeded to do what he usually does in my classes, which is ask me questions which are somewhere between really good and yanking my chain. 

A long time ago, PCC came up with the concept of an important pediatric clinical measurement, the Sick-to-Well Visit ratio.  The concept was straightforward: how could we encapsulate, in a single number, a practice's focus on providing preventive care?

The ratio and another (intentional) use - it's a really good indicator of the financial health of a practice.  There are exceptions - queue Lynn Cramer - but unless a practice has a strong chronic disease management program in place, I can tell a lot about a practice based on this simple number.

Let me preface this information with two important facts:

In a day or so, I'm going to do an interesting followup on our examination of the impact of the economy on pediatric practices, so something related to tide you over

For years, I have promoted the concept of doing more well visits in your pediatric practice.  I believe that it’s not only a clinically superior path, it also is more financially beneficial to the practice.

Among the many positions I take during these talks is that the visits most often missed in your practices are those visits between 6 and 11 - after the imms stop and before the sports physicals begin.  These visits tend to be among the faster well visits (when compared, say, to a teen girl or those newborns), but they are just as important.

According to CDC and The American Academy of Allergy Asthma & Immunology (check out THAT acronym!), children with asthma should be kept up to date with their flu shots.

Before I get into today’s info, I want to remind people of our AAP-endorsed Pediatric Coding and Practice Management conference in two weeks in Columbus and of our new audio conferences (starting next week).