pediatric benchmarks

[Quick segue - come see the likes of me, Susanne Madden, Richard Lander, Rick Oken, and more speak at the VA AAP and Pediatric Alliance 4th Annual Meeting in March.]

Igor has been really, really busy lately and it's great!

Hey, check out frequent Chip's Blog poster Brandon Bettancourt making a splash on the AMA WWW site in a piece about chosing a PM system during this age of EHR purchasing.  I have to say that I can't argue with the list of questions everyone should ask any potential PM vendor.

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:

Igor and I have continued to follow up on the recession and its impact on our pediatric clients and have discovered some interesting results.  We published a formal interview with the two of us here, the teaser follows:

Igor and I have been working tirelessly on the various pediatric benchmarks we track for our customers (and the rest of the world). In fact, we've been focusing on developing a single PCC financial benchmark figure, with a clinical one to follow.

As a result of building this page, we have had to do a lot of thinking about normalization of scores, benchmark "ranges" and more. I thought I'd share a quick review of a tiny part of what we've seen so far. Here are three interesting changes in the values of key measurements from 2006 to 2007:

Year	Median A/R Days	Revenue / Visit	Revenue / Visit (no imms)
2006	32.28	$90.83	$72.52
2007	30.03	$100.87	$74.58

First, I like seeing that 7% drop in the median A/R days! It's particularly notable when we realize that even more PCC customers dropped capitation this year (bye bye, BCBS HMO of NJ).

Also interesting is the "Revenue Per Visit" data. For the first time ever, PCC clients have passed the magic $100/visit line - an increase of over 10% - good news. Great news, actually. Until you pull the immunizations out of it...and realize that nearly 80% of the increase our customers saw in their revenue last year got plowed straight back into the pharms. No wonder they have such bad reputations.

Still, no need to sneeze at a 3% increase in per-visit revenue when report after report shows things moving in the opposite direction.

Meanwhile, some of you may want to check out this blog/podcast, the Pediatric Pearls Show. In an ideal situation, I envision a practice getting a call from a mom about, say, wanting care for her kid with a cold, but not having the time to bring him on - perhaps the nurse could direct the mom to the episode about The Common Cold? Of course, you have to vet these for yourself, but it's an overdue idea.

A note over on an MGMA mailing list reminded me that I haven't done any good benchmarks in a while, so why not quickly publish our latest pediatric E&M distribution results. Here's a comparison of PCC's pediatric E&M distribution, 2007 vs. 2003, when we started pushing our clients on this issue...

 

For those scoring at home, the data:

Last week, Igor and I were looking at the usage of -25 Modified E&M codes as the information about them is a bit of an unspoken subject in our business. I can't find any good, definitive sources so, as usual, we have to create our own.

Need proof that this is the best pediatric practice management resource on the planet? Check it out.

 

Oh, first: major drama at PCC's office last night. Let's hope this post is the closest I come to being a war correspondent. I don't like the proximity of the event to yesterday's message about flooding.

 

I've had a request to post some information about the 2008 RVU impact, but I've decided to wait a day or two for the dust to settle about the latest news. Hope you don't mind.

We've been working on it for a long time (toooo long), but we are just about to officially release our Practice Vitals Dashboard service to PCC customers.

"Dashboard?" you ask. "What's a dashboard?"

You'll know them as soon as you see them. In fact, here's a quick sample of a piece of one:

This is a quick snapshot of just the initial graphical display of one of six benchmarks we hope to display to them at first (Revenue-per-Visit, E&M Distribution, RVU-Per-Visit, Pricing, Sick-to-Well ratio, A/R Days). The example above shows that the E&M distribution for this sample customer is 18.7%, putting them at the lower end of the "Good" scale.

Each of the benchmarks, like the one above, is "clickable" for more detail. Thus, you could log into pcc.com using your special login and would be immediately presented with your most important management measurements, complete with detailed explanations of the benchmarks, comparisons to other pediatricians around the country and in your region, and an historical view. It's really cool to click on a PCC customer and watch their Revenue/Visit rise every year. Actually, here's what it looks like!

Pretty cool, eh?

I mention all this for a couple reasons:

• We are going to make some very simplified versions of these benchmarks public as part of our new pediatric resources WWW site (more about that later). You won't be able to find this information anywhere else.
• P CC customers will have access to more than I am describing here - super cool.
• PCC customers who are also part of our "Practice Advancement Plan" will receive the Advanced Practice Vitals Dashboard, which will include many more benchmarks as well as the ability to drill down like crazy. You want to know your RVU-Per-Visit for Doctor X in 1999? Click it!

Obviously, all of these reports are available in our system and our clients can run them at any time on their. This service exists for the majority of physicians who don't have the time or inclination, however, to do that. We think it will go over pretty well!

Any suggestions for benchmarks welcome!