LBMC Healthcare Consulting

Healthcare management systems have come a long way and now come standard with a long list of reporting options … but having more data hasn’t translated to having more answers.

Current management reports can slice and dice the data in a number of new ways, yet still report in totals with prior period comparisons in a limited perspective. The numbers may look the same as last year or even have gone up, but is that good?  We need to purpose our analytics to tell us more, not just show us more so that we can use our reports instead of spending a lot of time just trying to understanding them. This is where a well-developed healthcare analytics-based report has raised the bar.

Unlike a canned system report, analytics-based healthcare reporting tells the story behind the numbers – the “so what” and “says who.” For one, analytics-based reporting uses benchmarks to compare the results to other, similar specialties, organizations, practice types, etc. Further, it can report a single metric in different ways because not every part of a practice/hospital/health system uses the same metric in the same way.

Let’s consider physician productivity reporting, as measured by work relative value units (wRVUs). In most standard management reports, total wRVUs by a provider are reported. For example, Provider A generated 15,000 wRVUs in 2017. Now, what if that is all you knew … that is all the report told you? A fundamental limitation is that wRVUs impact different groups in importantly different ways. Providers view wRVUs through a compensation lens, finance through an expense lens, compliance through a billing lens, counsel through a regulatory lens and so on. The provider might be pleased because it could result in higher compensation. Finance might wonder if collections exist to support the compensation. Compliance might wonder if the underlying coding and billing are accurate. Physician alignment might wonder about the sustainability of such a high-producing provider. Counsel might wonder about Stark implications. That’s a lot of wondering, and to get answers one must start asking questions, making phone calls, and looking through other reports.

Given the different interests, roles, and responsibilities of those relying on wRVUs, a report of total wRVUs by a provider is about as meaningful as trying to sell a car by its mileage. What brand/model is it? Does it have innovative features? How does its mileage compare to other cars like it? What is the “dollar per mile” value of similar cars nationally? Is it costly to insure? You get the point…

Now, what if the wRVU report also indicated the following:

  • Provider A’s productivity is at the 75th benchmark percentile,
  • At $40 per wRVU, Provider A’s compensation would be commensurate at the 80th benchmark percentile,
  • Provider A’s collections for the same period averaged $80 per wRVU,
  • 60 percent of Provider A’s wRVUs were generated from E/M visits, the coding for which is well-aligned with specialty peer code assignment,
  • Provider A scored 90 percent or better in the past four internal documentation and coding audits, and
  • A custom reporting algorithm assigned a green “low risk” icon to Provider A ✓.

THAT is the easy and immediate benefit of analytics-based reporting. The provider, finance, compliance, physician alignment, counsel, et al, now have a robust, cross-purposed understanding of provider productivity. Each understands from a single read of the enhanced reporting what the data means … whether it is at expected/desirable levels, where vulnerabilities or areas of risk exist, and more. Each can immediately use the data to drive decision-making towards their own efforts to successfully and sustainably support the business of rendering patient care.

Critical to analytics-based reporting, however, is working with a data analytics champion or firm that has operational consulting experience. Someone who isn’t just good at analytics, but who truly understands the influencers and impactors of the results … someone who can help your analytics-based reporting tell the true story of your data.

Content provided by LBMC Healthcare Consulting Services. LBMC is a Top 50 firm in the country and the largest professional service solutions provider based in Tennessee. The firm serves approximately 10,000 clients with diverse needs in financial, human resources, technology, information security, and wealth advisory services across a spectrum of industries.