ENHANCING PHYSICIAN
PRODUCTIVITY
AAOS Practice Management Symposium
San Francisco February 7, 2012
ADSoyerDO
 AAOS Practice Management Committee
DISCLOSURES
 Definition of Productivity
 Uses of Measuring Productivity
 Areas to Improve Productivity in the Office
-Patient Access to Practice
-Office Operations/ Clinical Workflow
- Management
- Technology & Data
 Ancillary Revenue
 Investments
Goals
 Measure of physician work
WHAT IS PRODUCTIVITY?
 Determine Compensation
reliable, consistent & objective
To Be Effective:
- must reflect the compensation environment or payer mix
- must allow for improvement
 Compare physicians
 Determine staffing requirements / office resources
More Productive Physicians spend more time in direct patient contact,
generate more RVUs, consume more practice resources
Therefore, Productivity generates more practice expense
Resource Allocation can thus be adjusted by Physician Productivity
USES OF MEASURING PRODUCTIVITY
How do we Measure Physician Productivity?
 # of office visits/ patient encounters
-traditional measure of productivity limited by patient demographics
-should include time as unit of measure
 Collections
-more accurate than charges in fee-for-service environment
 RVUs
-better measure in fee-for-service environment where multiple CPTs are
generated
 Ancillary output
PRODUCTIVITY
 New Era of Patient Centered, Proactive
Healthcare
 New Models for Physician Productivity
incorporate:
evidence-based medicine,
cost-effective practice
and continued improvement of outcomes.
ENHANCING PRODUCTIVITY
 Office Operations
 Ancillary Sources
AREAS TO IMPROVE PRODUCTIVITY
Increase Online Presence
- Web 2.0 compliant website
- Social Media Campaign
Facebook, Twitter, Blog,YouTube
- Marketing
Google Ads (Adwords)
AAOS Primer Social Media in Healthcare
PATIENT ACCESS TO PRACTICE
 Front Office
Patient Direct Access-alleviates burden on front desk at
time of appointment
-patient portal via website
-online appt scheduling
-demographic/ insurance forms email &
downloadable
Technology to enable efficient data entry
- electronic signature capture
- scanning documents
OFFICE OPERATIONS
 Clinical Work Flow
TIME IS MONEY!
Efficient Time Management makes money
Use technology
-EMR (templates)/Scribe / Voice Recognition (macros)
Efficient Time management saves money
Reduces staff hours (less overtime)
OFFICE OPERATIONS
 RVU value to your work
 Low or ‘no value’ services should be delivered by
non-physician extender
- postop S/R, global fx f/u , etc…
 High value services should be delivered by MD
-US guided injections
- In-office procedures
OFFICE WORK FLOW
 Internet phone
-cost-effective upgrade with numerous options
 Skype Business/ Teleconferencing
-efficient time management for regular business meetings
 Livestream
-Orthopedic channel to live broadcast (e.g. lecture, community outreach)
 Mobile
- text
-google chat
OFFICE COMMUNICATIONS
 Billing & Coding
Code for everything you do
Maximize every potential RVU
EMR charge entry and PM software should be
integrated
Prepare for ICD 10 changes NOW!
OFFICE OPERATIONS
 Management
Understand Overhead in terms of Cost per
month, day, hour
Convert to RVU per month, day and hour
Set realistic RVU goals for each physician
Use Benchmarks for comparison
OFFICE OPERATIONS
Six Step Approach Migliore 2002
 Develop a Budget
compare actual results to expectations monthly
 Monitor Practice Overhead
compare to previous year and use benchmarks for FTEs
 Monitor Cash Flow
have reserve on hand
 Monitor A/Rs
should be monitored monthly, < 20% @ 90 days
 Monitor Collection Rates
should have high net collections
 RVU Analysis of Practice
provides data on higher reimbursing services to increase marketing, identifies unprofitable
services, analyze contracts and negotiate higher reimbursement
Management
http://www.physiciansnews.com/business/502migliore.html
 Use your Technology to your advantage
 Website tools enable you to track &
plot demographic data
 Google adwords / Bing campaigns improve
your web presence
 Maximize your marketing potential to
ePatients
 Engage in social media
TECHNOLOGY & DATA
 Examine all ancillary revenue streams
 Consider eliminating options that require
continual investment with low ROI
 Invest in services that compliment practice
 Expand practice portfolio to include nonclinical
revenue streams
ANCILLARY REVENUE
 Your Space
Consider offering per diem lease when the space is not
occupied
Complementary services that will generate potential
referrals such as Rheumatology/ Pain Management
 Setup ancillary services to have daily production in
your absence
EMG/NCS, DME, Xray/ MRI, Urgent Care
OFFICE SPACE
http://www3.aaos.org/member/prac_manag/enhancing_revenue_primer.pdf
 13 ‘Hot’ Areas in Healthcare
Becker Aug 2011
 Hospitals & Health Systems
 Hospital-based Specialists
 ASC chains
 HIT & mobile Health (mHealth)
 Chronic Disease
 Cancer & Hospice
 Wound Care
 Physical Therapy
 Revenue Cycle Companies
 Overseas Markets/ Addiction/ Rehabilitation/ Dental Practice Management
CLINICAL INVESTMENTS
http://www.beckersorthopedicandspine.com/news-analysis/item/9027-private-equity-investing-in-healthcare%E2%80%94-13-hot-and-4-cold-areas
Latest Trends are in Social Media Companies
& Internet Marketing
Real Estate –buyers market
NON-CLINICAL INVESTMENT
 Evaluate Individual & Practice Productivity
 Benchmark with RVUs
 Use Productivity to re-evaluate practice costs & resource




allocation
Evaluate Clinical Workflow for Efficiency
Use Technology to improve Efficiency
Evaluate Ancillary Revenue Streams – eliminate low profit
ancillaries and consider new investments (both clinical &
nonclinical)
Determine Need for Practice Executive if anticipating growth/
expansion
SUMMARY
ThankYou
Resources:
www.beckersorthopedicandspine.com
Email: ADSBONES@gmail.com
Twitter@ADSoyerDO
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