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5. Decisions by Analytics
1.
Decisions By Analytics Duane
Reynolds, Senior Engagement Manager, Advisory Board
2.
©2017 Advisory Board
• All Rights Reserved • advisory.com 2 Pre-Session Prep Instructions to Enroll in the Text Message Survey 1 2 3 Open a New Text Message Send a Message to Join the Survey Get Ready to Vote! Vote by texting your selection when prompted Send the message DUANEREYNOLD015 to the phone number 22333 You will receive a notification from PollEverywhere.com that you have joined the survey session
3.
©2017 The Advisory
Board Company • advisory.com 3 The Access Metric Quandary Growth Metrics Financial Metrics Scheduling Metrics Patient Experience Metrics Contact Center Metrics Productivity Metrics CFOCEO/COO CSO CXO COOCOO ? What do I measure? Where do I take action first? What are my data sources? What is my measurement period? Who should see what data?
4.
©2017 Advisory Board
• All Rights Reserved • advisory.com
5.
©2017 The Advisory
Board Company • advisory.com 5 Proposing Fourteen Key Metrics of Access Access Executive Dashboard Metrics % of Patients Booked/Scheduled Average Time to Appt. (New patients) 3rd Next Available Appointment Realized Utilization (Patient Arriving) wRVUs/clinical FTE Capacity Profile Timeliness Profile Appointment Yield Profile Cancellations (Rate) No Shows (Rate) Percentage of Abandoned Calls Unique Patients (Panel Size - Primary Care only) Demand Profile Total Scheduling Volume Patient Satisfaction Telephony systemBilling system Scheduling systemPt. Sat. Vendor Legend % of Rescheduled Appointments % of Established Patients % of New Visits
6.
©2017 The Advisory
Board Company • advisory.com 6 METRICSHEREMETRICSHEREMETRICSHERE METRICSHEREMETRICSHEREMETRICSHERE METRICSHEREMETRICSHEREMETRICSHERE Capacity Profile METRICSHEREMETRICSHEREMETRICSHERE Focusing a Spotlight on the Right Metrics for the Right Audience Envisioning (Representative) Best Practice Dashboards Executive Dashboard Organizational Aggregate Service Line Dashboard Regional Drill-down Regional- Dashboard Service Line Drill-down Organizational & Regional Drill-Down • Panel Size (Primary Care) • Total Scheduling Volume • Abandoned Calls Timeliness Profile Appointment Yield Profile Demand Profile Regional Drill-Down • Panel Size (Primary Care) • Total Scheduling Volume • Abandoned Calls Service Line Drill- down • Panel Size (Primary Care) • Total Scheduling Volume • Abandoned Calls Regional Drill-Down • Appt. Utilization (Booking) • % New Visits • % of Established Patients Regional Drill-Down • Avg. Time to Appt. • 3rd Next Avail. Appt. • Pat. Sat.: Ability to Get Desired Appointment Regional Drill-Down • Realized Utilization • wRVUs/cFTE • Rescheduled Appts. • Cancellations • No-Shows Organizational & Regional Drill-Down • Appt. Utilization (Booking) • % New Visits Service Line Drill- down • Appt. Utilization (Booking) • % New Visits • % of Established Patients Service Line Drill- down • Realized Utilization • wRVUs/cFTE • Rescheduled Appts. • Cancellations • No-Shows Organizational & Regional Drill-Down • Realized Utilization • No-Shows Organizational & Regional Drill-Down • Avg. Time to Appt. • 3rd Next Avail. Appt. • Pat. Sat.: Ability to Get Desired Appointment Service Line Drill- down • Avg. Time to Appt. • 3rd Next Avail. Appt. • Pat. Sat.: Ability to Get Desired Appointment Red Yellow Green Thresholds & Trend lines MTD/YTD/Target Delineation (service line specific as appropriate)
7.
©2017 Advisory Board
• All Rights Reserved • advisory.com 7 Breakout Case Studies Patient Access Analytics in Action
8.
©2017 Advisory Board
• All Rights Reserved • advisory.com 8 Case #1 – Background Case in Brief: Elite Physician’s Network • A comprehensive, not-for-profit health system that provides care to residents of Whitby, NH • Newly established medical group with 215 MDs and 10 APPs led by administrative COO charged with improving access and financial performance Clinic schedules are defined and managed by the practices wRVUs per cFTE are at the 60th% tile of MGMA benchmarks Call management is de-centralized but it is estimated that the organization receives ~10,000 calls per day; Abandonment rate 9% Medical groups invests an average of $175,000 per MD FTE, before downstream contribution. The majority of providers are in primary care Population expected to grow by 5% over the next five years but your volume has declined the last three years Average time to appointment is 30 days for primary care and 70 for specialty care
9.
©2017 Advisory Board
• All Rights Reserved • advisory.com 9 Case #1 – Questions 1 2 3You’re the new VP of access. What are the first metrics you should evaluate to understand key drivers of performance? The CSO suggests that you need more physicians to grow volume. What is your response and what metrics should be evaluated? What data is missing that would help you further solve for the root cause of low patient volume? % Booked or Scheduled, patients per hour per provider, cancellation rate and type My vote would be “No, not yet.” However, she might consider augmenting MD providers with lower cost APPs. Volume, % of new visits, wRVU per cFTE, no show rate, fill rate A virtual bottle of wine to get you through this exercise!
10.
©2017 Advisory Board
• All Rights Reserved • advisory.com 10 Opportunity to Rethink our View of Demand Segmenting Demand to Inform & Right-Size Capacity (Growth) Requirements Market-Level Demand Organizational / Service-Level Demand Provider-Level Demand • Risk-Adjusted Panel Size • New Case Volumes (Proceduralist) • Referral & Patient Management • Patient Demographic Trending • Ambulatory Utilization/Volume Forecasting • Market Share Analysis (by Service) • Telephone Scheduling Volumes vs. Attempt/Abandon • Online Scheduling/Appointment Request Volumes • Payer/Employer Network Demand & Risk Arrangements Met vs. Unmet Demand Productivity Expectations Growth Targets versus True Capacity by Service & Region
11.
©2017 Advisory Board
• All Rights Reserved • advisory.com 11 Case #2 – Background Case in Brief: Centralized Call Center Woes for Gotham Clinic • Gotham Health System is not-for-profit, faith-based institution that provides care to a mostly urban population • The medical group is well established with approximately 1,500 MDs providing care across the network Alignment on the definition of 1.0 cFTE and session length wRVUs per cFTE are at the 75th% tile of MGMA benchmarks A centralized call center was established in 2016 but they continue to struggle with appointment availability and scheduling errors. The providers despise the call center and want to go back to decentralization Patient satisfaction is in the bottom 10th %tile nationally for their peer group. Ability to speak to the clinic is their lowest score Gotham’s no show rate has continued to climb from 10% to 19% in a two year period The average 3rd next available appointment is 55 Days across the network
12.
©2017 Advisory Board
• All Rights Reserved • advisory.com 12 Case #2 – Call Center Statistics Metric Target Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Average Speed of Answer 45 Seconds 0:00:24 0:00:27 :20 0:00:34 0:00:43 :50 :50 0:00:47 Abandon Rate 3% 2.55% 3.16% 5.76% 4.50% 4.00% 7.00% 10.00% 6.82% Handles 27,499 32,105 29,265 33,344 29,561 35,697 41,550 49,799 Arrivals 28,857 33,999 31,872 34,568 30,647 37,641 43,342 54,689 QA Accuracy Rate Simple 99% 98.91% 92.00% 87.00% 99.12% 97.59% 99.12% 97.00% 93.44% Intermediate 98% 97.71% 99.35% 98.51% 96.72% 98.56% 98.08% 87.00% 91.00% Complex 97% 97.73% 96.00% 85.00% 98.36% 96.84% 88.00% 88.00% 94.58% % Appointments Scheduled 34.18% 36.38% 44.40% 44.70% 43.51% 44.25% 38.86% 37.69% % Non-Scheduling Calls 43.00% 34.00% 51.00% 33.00% 26.57% 40.00% 27.37% 32.00% Call Metrics Accuracy and Quality Key Disposition Data Points Pediatrics Family Med Cardiology Urology Totals Non-Scheduling 329 616 350 139 1434 General Office Information 132 149 64 42 387 Speak to provider 69 151 79 24 323 Wrong Queue 15 80 66 27 188 Referral 9 58 30 11 108 Med Renewal 14 51 15 4 84 Returning Call from office (non-scheduling) 14 34 40 10 98 Medical Records and Patient History Requests 25 20 10 2 57 No Return call from office/haven’t heard back from office 14 26 3 3 46 Patient Form Inquiry 16 13 5 2 36 Patient Late for Appointment 12 8 17 6 43 Test Result 6 17 5 3 31 Wrong Number – Non-Einstein 2 8 13 4 27 Unable to Verify HIPAA 1 1 3 1 6 Non Scheduling Dispositions - Rollup
13.
©2017 Advisory Board
• All Rights Reserved • advisory.com 13 Case #2 – Questions 1 2 3Assuming a full complement of staff, what do you suppose is driving their call center performance problems? What other types of data might you need to understand the root cause of the issue? What role does the clinic play in terms of call center performance, if any? Alignment on management of general information calls, task management expectations, work queue design, etc. ACD structure Avg. Handle time & after call work time Process flows Agent skilling level Outsized call volume dependent on flawed workflow infrastructure Staff performance?
14.
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