Driving $16.2M in Provider Productivity and Patient Access Improvement
Due to accelerated growth and acquisition activity, a large, single-specialty organization experienced challenges in setting consistent patient access standards and optimizing provider schedules and templates to appropriately meet patient demand across its 100 clinics.
Impact Advisors worked to identify the root cause of these challenges and uncovered over $15M in revenue-generating opportunities through improvements to provider productivity and patient access. The teams then collaboratively drove transformational changes across the entire provider enterprise.
Impact Advisors worked together to establish the following strategic goals that were supported by everyone across the organization, including clinical staff, clinical leadership, and providers:
- Balanced provider preferences with scheduling standards.
- Made it easy for providers to meet patient access standards.
- Improved schedule utilization in areas with low demand.
- Set minimum work standards and upholding standards set in provider contracts.
- Maintained 100% provider retention – no providers left the organization because of this work.
Identify High Performers and Learn the Secret Sauce
Impact Advisors brought together a diverse group of high-performing providers to learn the “Secret Sauce” that makes them successful. One of the goals of this team was to address barriers to high performance and create tools and options to help lower-performing providers achieve success.
The outcome of this Best Practice Provider Team was not a stringent one-size-fits-all best practice that all providers needed to follow. Instead, the team worked to create a menu of tips and tricks to help lower-performing providers be successful within the organization’s current operating model. Then, the team launched a comprehensive training program to bring the “Secret Sauce” to all providers in the organization.
Develop Minimum Work Standards
A key component of this work was setting appropriate standards for all providers. The team utilized best practice benchmarks, industry knowledge, and an internal high-performing benchmark to determine the appropriate number of patients to be seen per day per provider and to set consistent appointment slots across the organization. The goal was to help providers see at least 30 patients per day and to consistently set appointment slots to 10 minutes for new and existing patients (yes, even for newer providers!).
Additionally, as part of the assessment, Impact Advisors identified that 75 percent of providers were not meeting their contractual obligations around hours worked per week. This data was also not easily accessible and there was a lack of accountabilities as to who should manage the process of holding providers accountable to their minimum work standards. Impact Advisors helped the client’s IT department build a dashboard that compiled all relevant data points to report and track the providers’ actual performance. The team also set up an accountabilities process. The dashboards enabled the client’s regional managers to have more meaningful conversations with the providers, and the accountabilities processes ensured minimum work standards continued to be met.
Optimizing Schedules and Driving Change
Optimizing schedules and templates is one of the most critical levers for improving provider productivity and patient access. Impact Advisors worked to ensure all schedules utilized 10-minute appointment slots and adjusted provider schedules to align the right types of appointment slots with patient demand.
A key component of success was elbow-to-elbow support from Impact Advisors’ clinical subject matter experts (SMEs), which helped establish trust with the providers as the team worked through barriers to patient access and provider productivity excellence. Although the team’s objective was to arrange systems and processes to make it easier for providers to see more patients efficiently, some providers adapt to change more easily than others. Impact Advisors worked collaboratively to ensure providers were willing to change and were agreeable to meeting the patient access targets set. Every appointment slot that was added to provider schedules was one that the provider agreed to add.
For providers who resisted change initially, the team worked through their fears and doubts and gained their buy-in to the improvements. Typically, a dialogue was needed to understand the challenges of the current workflow and share different options for improvement.
In some cases, getting providers comfortable with shorter appointment slots required helping them work more efficiently with their care teams. Other providers needed help decreasing their documentation time by helping them use the EMR more efficiently. And other providers needed help learning how to effectively manage complex patients to ensure they stayed on schedule.
Create a Patient Culture of Yes
To embed this work into the fabric of the organization, the team encouraged a patient culture of “yes,” with a key theme being “always find a way” to meet patient
needs. Everyone from the leadership team to the front desk staff was tasked with working together to find solutions to meet patient needs and never turn a patient away. By shifting the mindset of the organization, the team was able to effectively foster a culture that embraced innovation and change.
Sustaining Behaviors
Impact Advisors blended best practices across the organization and worked individually with providers to tailor plans and gradually eliminate tension so that providers could comfortably meet productivity targets. In addition, the team worked to roll out a comprehensive training program for providers and engaged regional managers so that they could learn how to have tough conversations with providers and effectively drive change. Dashboards were created to assist with tracking progress and managing appropriate accountabilities.
Results
Impact Advisors’ approach considered each individual provider and what their specific challenges were to meet the established patient access standards. Developing
individualized plans for each provider made meeting patient access and minimum work standards easy for the providers.
Over the course of the 12-month engagement, Impact Advisors helped the client achieve $16.2M of EBITDA impact as compared to a $15.0M goal. Although the organization experienced normal levels of provider turnover during the year, no providers left because of the changes made during the engagement. Improvements included:
- Aligned provider schedules and patient demand.
- Increased patients seen per day per provider from 30 to 38.
- Added 4,900+ weekly visit slots.
- Added 157 weekly hours to providers’ schedules.
- Achieved 10-15%+ increase in revenue per provider per day and a 15%+ increase in medical group total patient visits.