key performance indicators for pediatric practices paul d. vanchiere, mba
TRANSCRIPT
Key Performance IndicatorsFor Pediatric Practices
Paul D. Vanchiere, MBA
Important Business Lesson from Melville…
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
How Many Do I Have To Sell To Recover The One Missing Bottle of Coke?
• Revenue $1.00• Cost $0.98• Margin $0.02• Margin % 2.04%
Calculation: $0.98 / $0.02 = 49 Units
Does not include labor, floor space, utilities and credit card fees.
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Administrative Costs
Clinical Costs
Front Office Staff
Information System
Ancillary Lines
•Office Manager•Admin Assistants•Square Feet Allocation•Equipment Leases
•Clinical Staff•Clinical Supplies•Vaccines•Medications
•Receptionists•Clerks
•Networking•Billing System•EMR
•Staff•Supplies
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
What reports do you see on a monthly basis?
Within 3 days of the month’s close
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Minimum Reports
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
• Revenue Generated– By Provider
• Practice Costs– By Location
• Labor Cost– Regular Wages– Overtime– Benefits
• Supply Costs– Vaccines– Medial Supplies
Key Performance Indicator Options
Gross Collection Ratio
Total Collections / Total Gross Charges
$690,000 / $975,000 70.769%
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Net Collection Ratio
Total Collections / (Total Charges –Total Adjustments)
$600,000 / ($650,000 – $25,000)
96%
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Charges per Encounter
Total Charges / Office Encounters $975,000 / 4,000
$243.75
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Net Collections per Encounter
Net Collections / Office Encounters
$725,000 / 4,000 $181.25
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Cost per Encounter
Total Operating Cost / Office Encounters
$300,000 / 4,000 $75.00
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Profit per Encounter
Revenue per Encounter – Cost per Encounter
$125.00 – 75.00 = $50.00
Will need to examine sick and well child since vaccines skew data.
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Monthly KPI
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Monthly KPI
Labor Cost Labor Cost Item Direct EmployerWages - Staff X Wages - Physicians X Wages - Overtime X Bonuses - Staff X Bonuses - Physicians X Severance Pay X Employer FICA XEmployer Medicare X
Workers’ Compensation Insurance XFederal Unemployment XState Unemployment XVacation Pay XHoliday Pay XSick Pay XParking X
Employer Provided Health Insurance X
Employer Provided Life Insurance X
Employer Provided 401 K Contributions X
Employer Provided IRA Contributions X
Employer Provided Pensions & Retirement X
Labor Cost Allocation
1. Clinical Staff2. Clerical Staff3. Billing Staff4. Administration5. Physician Salary & Bonus6. Ancillary Services
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Labor Cost Tracking
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
www.PediatricManagementInstitute.com-Calculators/KPIs-
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
www.PediatricManagementInstitute.com-Calculators/KPIs-
Key Performance Indicatorsfor Pediatric Practices.
Presented by: Paul D. Vanchiere, MBA
Information about Specific Calculation
Online Calculator
Net Collection RatioDescription:Shows total collections as it relates to expected contracted reimbursement rates from payors.
Why Is This Important?While a practice may charge $300 for a series of CPT codes, the managed care company may have a contract to pay you $210 when you add up the combined allowable for the billed CPT codes. As such, many practices use the Net Collection Ratio to examine the amount of payments compared to the negotiated rates.
PMI Recommended Frequency to Run this KPI:Monthly
Formula:Total Payments / (Total Charges - Contractual Adjustments)Show the Math:$600,000 / ($900,000 - $75,000) = 72.73%
How Should I track This?This can be tracked using an Excel spreadsheet by Practice and/or Department.
Online Calculator: (Replace The Numbers Below With Your Numbers)