In a previously published story, Brian Brown, regional vice president of operations of Meridian Surgical Partners, identified five ambulatory surgery center physician statistics to track and benchmark ("5 Physician Statistics ASCs Should Track and Benchmark"). Here Mr. Brown identifies five more physician statistics ASCs should monitor.
1. Physician satisfaction. This is a statistic Mr. Brown says is critical for ASCs to monitor closely. "It's very important to try to keep a finger on the pulse our physicians," he says, and that's for both physician-investors and physician-users. "Along with patients, they're your major customers."
Physician satisfaction is a challenge to track, which is why ASCs should, at least annually, send out a formal survey to all physicians. Mr. Brown says Meridian asks physicians at its surgery centers to rate the following 10 areas of their ASC's performance:
- Efficiency of business office.
- Ease of scheduling.
- Availability of operating room time.
- Procedure start time as scheduled (did the physicians procedure start when it was supposed to).
- OR turnover time
- Availability of equipment to do your cases.
- Quality of equipment.
- Adequacy of nurse staffing.
- Nursing staff knowledge and expertise.
- Staff morale.
The Meridian survey offers five categories of ratings: excellent, above average, average, below average and poor. "Anything that gets less than an above average rating, you want to follow up first with the administrator and then team management and identify what's going on in those areas and how you should respond," Mr. Brown says.
He says it's also worthwhile to have physicians rate, in those five categories, the quality of patient care delivered by the staff by department: pre-op, OR, PACU, anesthesia and administration. On the bottom of the survey, provide a comments section where physicians have the option to share additional thoughts.
If an ASC undergoes significant changes, Mr. Brown says it might be worthwhile to conduct the survey more frequently.
2. Top five CPT codes by physician. In all patient accounting/billing systems, Mr. Brown says you should be able to track CPT codes by physician. What this information will allow you to do is analyze the subspecialty mix of your physicians. "For example, does your ASC have an orthopedic physician who focuses on shoulders or a physician who is doing heavy cases like ACL repairs," Mr. Brown says. "[That data] will let you be able to prepare for that physician's patients in a unique fashion, whether it be scheduling time, looking to see if that physician needs more block time, the cost of doing those cases and it will let you be able to examine your physician base at the ASC and identify what could be a nice compliment through recruiting a new physician."
For example, if you have several orthopedic surgeons but none focusing on hand surgery, that's a very efficient orthopedic subspecialty you can work to add to your ASC, he says.
3. Physician payor mix. Mr. Brown says this is a very important statistic from a top line perspective as it will allow you to determine your net revenue per case (i.e., the specific reimbursement). "For example, if you're managing an ASC in South Florida, the payor mix is probably heavy Medicare and Medicare HMOs, which are mostly paying Medicare rates," he says. "You've got to manage block times, staffing and your costs well because you know you're in a very low reimbursing area of the country."
While you do not want to make any changes which will compromise patient care, understanding your payor mix will allow you to identify areas you should focus upon to increase efficiency and bring your ASC to a place where it can operate effectively while still delivering profits.
4) Collections by physician. This statistic can reveal a number of areas for your ASC to focus on for improvement, Mr. Brown says. Looking at it from an operational perspective, are you struggling to collect for one physician versus another? Can you identify a particularly difficult payor who is paying you at a slow rate or at a rate that you need to get paid? If so, do you need to go back to the negotiating table to renegotiate some of these contracts with these payors based on the mix that physicians are bringing to your ASC (looking at payor mix by CPT codes)? Do you have carve-outs on all of our payors, which might be critical if, for example, your surgery center focuses heavily on podiatry?
This statistic, like many you should track, can help your ASC improve its ability to cater to your physicians' needs. "We want the ASC to serve primarily as an extension of the physician's practice," Mr. Brown says. "If we're not able to accommodate a physician's cases and he or she has to jump all over town to do cases because the ASC can only allow them do some of the cases, the physician's practice efficiency is affected negatively.
"Can we funnel this down to where we can take this information — the collections, payor mix, CPT code — and create a more efficient operation for physicians, their practices and also physicians' patients," he says. "As we all know, outpatient cases are best served in an efficient surgery center."
5. Hours per case by physician. This is a statistic which should be noted for every case in the OR record. Your ASC should then go the extra step and have a staff member enter it into your patient accounting system. "Now you can compare it to physicians doing similar or the same cases," Mr. Brown says. "This will help you identify how you can be more efficient and productive for the care you provide."
You can benchmark this statistic against industry averages and identify if there is a physician you can work with to achieve a better time per case. Or perhaps your ASC can conduct a quality study using the data you gather.
Just be careful not to jump to conclusions if one of your physicians is taking longer on similar cases than other physicians. "There may be nothing wrong with what the physician is doing," Mr. Brown says. "Make sure you accommodate all physicians appropriately. There are some times where a physician may take longer and you might just need to manage the cases differently and make sure your staffing is scheduled appropriately. For faster physicians, do the same thing — move those cases through the system to accommodate the pace that physician is operating at."
Learn more about Meridian Surgical Partners.
Read more from the leadership of Meridian Surgical Partners:
- 5 Ways to Incent Good Behavior With Staff Bonuses
- 6 Ways to Collect Full Payment More Often
- 5 Ways to Improve Post-Operative Processes in Surgery Centers