Generating Practice EfficienciesPresentation Transcript
Practice Management Series 2004 - 2005 ASCO Clinical Practice Series
Practice Management Curriculum 1. Adapting to Changes in Medicare 2. Generating Practice Efficiencies 3. Organizing for Service Expansion
Generating Practice Efficiencies
Streamlining work flow
Increasing patient flow per physician
Maximizing charge capture
Managing expensive inventories
Who should attend
Physician Leader of the Practice
President of the PA, Founder
CEO, Executive Director, COO
Contract Administrator, Director of Billing
Medical Director, Nursing Team Leader
After this session, you will be able to:
Understand the need for assessment and benchmarking.
Perform a simple assessment to identify areas where cost savings may be found.
Develop plans to implement beneficial changes based on this assessment.
Describe cost savings and efficiency techniques to assist your practice as reimbursement changes.
Ability to produce the desired effect with a minimum of effort, expense or waste
Webster’s New Twentieth Century Dictionary, Unabridged
Why is efficiency important?
The oncology world has changed….
…life as you know it is over
Medicare Prescription Drug Improvement and Modernization Act (MMA) 2003
It’s not personal!
Medicine is being impacted just like every other industry in our economy
It’s all about…
The Old Days Median Per FTE Medical Oncologist Compiled from MGMA Cost Survey through 2004 Report on 2003 Data. 2004 trending by third order polynomial by Oncology Metrics, LP
MMA Impact Per Oncologist with projections by Oncology Metrics Then Now
Practice Efficiency: Focus on Largest Expenses First AOHA/MGMA 2003 Report on 2002 Data
Set Your Priorities
1. Drug Management
2. Physician Efficiency
Benchmark your practice metrics to discover potential work flow and/or staffing efficiencies
Lower the cost of practice operations
Better inventory control
Improved patient scheduling
Streamlined work flow from clinic to billing office
Informal – conversations, visits with colleagues, oncology practice list serves
More formal – use a standard such as MGMA’s Cost Survey for Hematology Oncology Practices
Most important to benchmark against yourself over time
COGS Benchmarking Using the MGMA AOHA Hematology/Oncology Cost Survey: 2003 Report Based on 2002 Data #1 Cost $ 2,165,165 $ 1,387,087 $ 1,053,518 $ 751,859 $1,133,798 45 Total Chemo Med Surg. Costs 90 th 75th Median 25th Mean Count Per FTE Physician Table 1.8b 2003 Report Based on 2002 Data
COGS Benchmarking Using the MGMA AOHA Hematology/Oncology Cost Survey: 2003 Report Based on 2002 Data
Write down your COGS for 2004
Divide it by $1,250,000 (2004 trend based on 2002 data from MGMA/AOHA survey; median COGS per physician)
Result is the number of physicians that your COGS would support
Compare this to actual physicians and if it is much higher or lower, keep asking why
Drug procurement and inventory management processes must be tight
Monthly reports - compare inventory levels to billed units
Who is managing this process for your practice?
Look at how you add new drugs to your practice formulary to assure financial feasibility
Practice standardization, pharmaco-economics review
Start simple - hydration, anti-emetics
Then look at treatment protocols by disease, one disease at a time
Knowledge is power, you can’t control what you don’t measure
OSHA fines are expensive
Errors are expensive – charge capture errors, chemo preparation errors
In 2006, CMS is proposing a Competitive Acquisition Program (CAP) for drugs
Providers will choose between CAP and ASP + 6%
Do you understand your pharmacy costs?
Are you managing inventory, controlling shrinkage, collecting co-pays on drugs?
If you can buy drugs at or below ASP…and you can collect all of your co-pays…can you run your pharmacy on 6%?
Know your costs - get ready for 2006
Physician Productivity Benchmarking Using the MGMA AOHA Hematology/Oncology Cost Survey: 2003 Report Based on 2002 Data #2 Cost 442 345 231 185 308 39 Consultations & New Patients 90 th 75th Median 25th Mean Count Per FTE Physician Table 1.8b 2003 Report Based on 2002 Data
Physician Productivity Benchmarking Using the MGMA AOHA Hematology/Oncology Cost Survey: 2003 Report Based on 2002 Data
Write down the number of consultations and new patients (99241-99255, 99201–99205) in 2004
Divide it by 231, the survey median of consultations per physician in 2002
Result is the number of physicians that your new patient service volume would support
Are you above or below the actual number of physicians in your practice?
1. New Patients and COGS are both greater than the actual number of physicians and yielding about the same physician count
Indicates good physician utilization and pharmacy control
2. New Patients about right but COGS shows higher number of physicians
Indicates potential savings for COGS management
Increasing Patient Flow Physicians Should…
Communicate with referring physicians – this drives practice growth
See new patients – this drives practice growth
Be seen at the hospital, participate in medical staff life
See follow-up patients on a regular, clinically appropriate basis
Delegate some follow-up visits to other providers as appropriate – PA, NP, RN
Ensure quality of care throughout practice
Increasing Patient Flow Physicians Should Not…
Routinely be late for clinic
Spend time filling out forms (ex. disability, tumor registry)