Healthcare KPIs (key performance indicators) every practice should look at to measure success and plan the road ahead …
If you talk to any chiropractor about what they need more of, most of them will say new patients. I have always joked about this for years with my wife to the point that when she asks me what I want from the grocery store, I will respond with “new patients.” It’s our little inside joke. While I agree that new patients are the lifeblood of most practices, this should not be your only metric for healthcare KPIs (key performance indicators). Unfortunately, most practice owners spend more effort on finding new patients while ignoring conversion and retention stats.
Pay attention to collections
After new patient stats, most chiropractors obsess about weekly visit totals. Still, if your goal is more revenue, you should also track your collection-per-visit average.
This is a simple calculation of total revenue divided by total visits, which is not perfect. Still, if you must calculate it by hand, this is the easiest way to arrive at a number. It won’t be ideal if you take insurance, personal injury or prepay. This is because you collect revenue on a prepay for visits you haven’t delivered and will deliver insurance and personal injury (PI) services long before payment. You may have performed a service without collecting that revenue for months or years afterward with insurance or med-legal cases.
Some doctors get hung up on that being a problem. Still, healthcare KPIs and statistics should give feedback about trends. One statistic on any given day shouldn’t be critical when making business decisions. For example, trends of collection/visit dropping combined with declining new patients, revenue and office visits tell a story about a dying practice. Still, a high collection-per-visit average for one month doesn’t make your practice desirable or undesirable. Because some large PI checks could significantly affect that number.
Utilize your EHR and software
That’s why I prefer to use software to calculate this collection-per-visit average. It can get a more accurate number by looking at revenue collected on each patient visit, and it creates an aggregate average of all those visits. It allows you to view that number by type of insurance, provider and more. If you have a heavy insurance practice, you can also look at older data to determine an accurate number.
Another number I like to look at is the patient drop-off analysis in practice. I know many doctors who like patient visit average (PVA), which is a good number to provide a general idea of patient longevity. Still, it doesn’t show you the specific area to fix in your practice.
To calculate patient drop-off, you would create a bar graph indicating when patients drop out of care. For example, you would tally up a total of patients who dropped out after a single visit, a total of patients who dropped out after two visits, a total of patients who dropped out after three visits, etc.
If you can determine when patients drop out of care, you can put measures in place to increase the average amount of visits you see a patient. Remember, if you want to increase your net revenues, you can:
- Increase your collection-per-visit average
- Increase your volume
- Reduce your accounts receivable
- Reduce your operating costs
We discussed how new patients increase your volume, but increasing the average amount of visits is an easy way to improve your volume. If you notice that most of your patients are dropping after six visits, getting them to stay on average for three more visits would potentially increase your revenue by up to 50%. Think about going from six to nine visits on average.
If you notice that most of your patients drop off before their subsequent re-examination, it may be time to start scheduling a re-examination before that dropout point. During your re-evaluation, you can look at their functional progress and revisit their treatment goals on that visit. Their symptoms may be reduced, but they probably don’t have functional improvement, which would warrant more visits. In addition, this would be an excellent time to remind them why they started the treatment in the first place.
Utilize all patient education avenues
Are there pieces of education you could drip on the patient after they start? These could be emails, texts, videos or handouts to help educate the patient about the importance of spine health.
When I was in practice, I used to have regular workshops where I discussed the importance of daily spinal hygiene exercises. It was my posture, pain and wellness workshop where I educated my patients about functional movement, fascia, posture and what the exercises accomplish. If I was a subluxation-based practice, this would be a great forum to discuss subluxation.
The beauty of practice is that it’s called a practice for a reason, and you can improve it if you wish. Your practice today is the one you built, and if it’s not where you want it to be, it’s because you tolerated the problems for too long — but you could start changing that tomorrow if you wish. Patient drop-off analysis, in my opinion, is a great way to measure when patients are dropping off, so you know where to put your time, energy and focus in regard to healthcare KPIs and measurement.
PVA and type of visits
I would also look at the patient visit average (PVA), which can be calculated in two ways. Still, I always preferred the method of total office visits divided by the total number of patients who started a treatment plan. That way, if you had an influx of new patients from a spinal screening or Facebook that may be of lower quality, it wouldn’t lower this number dramatically.
I always looked at the type of visits with my weekly patient visits. I tracked how many were from our active care, wellness club or reactivation effort. Since we collected on 100% of our office visits, I could afford to bonus my team on office visit statistics.
If you’re not bonusing your team on stats and critical healthcare KPIs, you are missing out because it’s one of the easiest ways to boost production. If you don’t want to commit to a long-term bonus structure, you might consider doing a quarterly team bonus. For example, if we reach 180+ visits for five out of the next 12 weeks, the entire team will get a new pair of shoes, and every week they hit their goal, you can buy the team lunch.
Measuring your success
EMR/EHR systems are great for many things. Still, billing, ledgers, documentation, record storage and scheduling are the focus.
Obscure reports like these, plus patient management reports and practical reactivation campaigns, are an afterthought. However, that’s not a dig on the EMRs. They have a long list of things to do, like all of us. Unfortunately, sometimes the government gets involved with something like the CURES Act that hijacks the road map with new regulatory changes.
Now you must figure out how to find these metrics in your system. Look at the trends in your practice. You can make sound business decisions based on actual trends rather than a gut feeling, which is how a business should operate. I prefer using software to generate these reports over hand calculations because they are consistent, so you have real trends. Further, if you are wasting hours of staff time gathering stats, they could be spending their time growing your practice.
NAOTA HASHIMOTO, DC, is the co-founder of TrackStat, a practice automation software that integrates with your EHR/EMR to get the most out of your practice. You can reach him at email@example.com.