Use statistics to grow your practice and find out what type of information can KPIs provide to bring in more patients
A well-run practice is managed by its statistics and not by the emotions of its leadership. What type of information can KPIs provide? Statistics, also referred to as Key Performance Indicators (KPIs), are vital for both practice leaders and team members to set performance benchmarks, analyze performance, and make targeted suggestions for correction and improvement.
Statistical analysis should play a significant role in goal-setting, troubleshooting and improving your practice. Statistics help to track the “ups and downs” and cyclic patterns of your practice.
Managing a practice without statistics is like driving without a road map. You won’t know when you are off-course or when you reach your destination. Without your practice statistics, your leadership and practice team are required to run your practice based upon emotions.
Start with initial monthly statistics
Monthly statistics enable you to measure the “heartbeat” of your practice. They serve as tools that can be used to predict, diagnose and expose the strengths and weaknesses of your practice.
They represent the facts, not your emotions, about how well your practice is doing. This data establishes a baseline for your practice. It is used to measure the productivity gains you can achieve by refining the systems you use in all areas of practice development.
Essential monthly data and what type of information can KPIs provide includes:
- Office Visits
- New Patients
- Reactivated Patients
- Missed Appointments
- Services Rendered
- Write-Offs
- Collections
Essential Monthly Benchmarks
Patient Visit Average (PVA) — measures the average number of visits patients are seen in your practice. Based upon medical necessity and wellness care, your PVA should be between 30-35 visits.
- PVA Formula: New Patients ÷ Patient Visits
Case Average (CA) — measures the value of the average case in your practice.
- CA Formula: Services Rendered ÷ New Patients
Office Visit Average (OVA) — measures the services rendered in dollars for each office visit
- OVA Formula: Services ÷ Office Visits
Missed Appointment Percentage (MA%) — measures how many missed appointments you have in relation to office visits. A missed appointment is defined as an appointment that was scheduled but not kept within the same day. If an appointment is rescheduled for another day, it is counted as a missed appointment. The maximum acceptable MA% is 10%.
- MA% Formula: Missed Appointments ÷ Office Visits
Services Write-Off Percentage (WO%) — measures the percentage of services rendered that are uncollectible. Examples include billing above the maximum allowable amount on a visit. The maximum acceptable WO% is 35-40%. The WO% will be higher in practices that see a lot of managed care patients.
- WO% Formula: Write-Off Services ÷ Total Services
Collections Percentage (CL%) — measures the percentage of services rendered that are collectible. The minimum acceptable average is 60-65%. A cash-only practice will have a CL% above 90%.
- CL% Formula: Total Collections ÷ Total Billed Services
Collection Office Visits Average (COVA) — measures the average collections generated from each office visit.
- COVA Formula: Total Collections ÷ Office Visits
Collection Case Average (CCA) — measures the collections generated from each case. It helps to predict cash flow based on patient volume.
- CCA Formula: Total Collections ÷ New Patients
Weathering the storms
With statistics, when considering what type of information can KPIs provide, you can measure exactly how well your management initiatives are being achieved. You can see highs and lows, peaks and valleys in the timeline of your practice.
If you know a “low” is coming, you can plan for it … and won’t have to weather the storm. Your historical practice data can be used to project long-term trends. For any given month, your percentages may fluctuate from normal. If your statistics are consistently abnormal it indicates a practice system that needs attention, as it may have broken down.
What type of information can KPIs provide? Monthly CPT analysis
Perform this important step monthly. This is vital to tracking the range of services you provide.
Trends and practice habits will emerge that you should be aware of. Commit to reviewing this data within five days after the beginning of the next month. The following examples are not meant to imply that each practice will be the same — they are general guidelines that allow you to track your trends against standard expectations:
CPT Analysis Procedure — Also, print a report from your practice management software that captures the CPT codes billed and the number of each for the prior calendar month. Sometimes this report is called “CPT Analysis” or “Practice Analysis” or “CPT Statistics.”
Chiropractic Manipulative Therapy (CMT) Code Analysis — These estimates are based on CMS data for relative usage by chiropractors. If your numbers are not within range, consider where you may be out of balance. CMT usage between the three spinal codes should be approximately:
- 98940: 35%
- 98941: 55%
- 98942: 10%
Extra Spinal Manipulation Analysis — The total number of 98943 codes should be approximately 20-40% of the number of spinal CMT codes. Rationale: Approximately 20-40% of patients in each population will require care for extra spinal regions.
Evaluation & Management (E&M) Code Analysis — The number of new patients E&M (9921X) codes should be approximately twice the number of reevaluation (9920X codes). Rationale: Following standard case management procedures, most patients receive at least two re-exams per episode of care.
Active vs. Passive Procedure Analysis — The total of active, therapeutic procedure codes 97530 + 97110 should be approximately twice the total of passive modality codes (muscle stim, ultrasound, etc.). Rationale: Passive modalities will typically drop off after the first 2-3 weeks of care.
Perform monthly comparison audits
Make commitments about what areas you want to improve on each month from the CPT analysis. Review last month’s commitments as you review this month’s CPT analysis and see if you improved in the areas you hoped to.
When stats are down-trending you must direct your focus to correct the problems. Find the procedures that can be improved and continually refine them. When stats are trending up, keep doing what you are doing. Find out why things are working and strive to better them.
It’s been said, “What gets measured, gets managed.” What gets measured also often improves! Use statistics and not feelings to manage your practice and measure your success and you’ll see your practice improve and grow.
MARK SANNA, DC, ACRB LEVEL II, FICC, is a member of the Chiropractic Summit and a board member of the Foundation for Chiropractic Progress. He is the CEO of Breakthrough Coaching and can be reached at mybreakthrough.com or 800-723-8423.
