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Today! Wednesday, November 18, 2020 | 1:00 PM Eastern (NYC)

Automating Excel to Drive Timely Reporting, Accuracy and Efficiency During COVID

Reporting in the healthcare industry relies heavily on Excel; however, automating report production can be difficult and time-consuming. Today, organizations are struggling to keep up with weekly and monthly reporting in light of additional requirements brought on by the pandemic. Without automation, managers and analysts may be spending more time creating and populating reports than using them to improve financial or operational performance in hospitals and practices.

In this webinar, learn about the common challenges with Excel and how to use the automation and dashboard design features in PDS DASH to maximize Excel's visualization and customization features. Understand how this powerful tool can reduce user errors, improve overall accuracy, and increase staff productivity by 20-60%.

Discover how to leverage your current Excel skills using PDS DASH to blend data on the fly, update designs and produce timely dashboards that handle today’s unique reporting requests. See proven template designs that can be automated and implemented rapidly to identify performance improvement opportunities.

Webinar highlights will include:

  • Understanding the advantages and challenges of using Excel for dashboards
  • Demonstration of Excel’s powerful visualization capabilities
  • How PDS DASH can blend data from disparate sources to leverage Excel capabilities
  • Utilizing PDS DASH to automate the creation of visualizations at multiple levels of an organization

Join us on November 18, 2020, at 1:00 pm Eastern (New York), for this relevant and timely discussion.

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What Do the Changes to the Medicare Proposed 2021 Physician Fee Schedule Mean for Your Practice? ~ A PDS Article

On August 3, 2020, CMS released the proposed rule for the 2021 Physician Fee Schedule (PFS) for the Public Comment Period. Every year, practices can expect to see small changes to the RBRVS scale and the expected budgetary modifications to the RVU Conversion Factor, but the 2021 proposed changes to the PFS are significant.

RVU values for some of the highest volume codes were increased substantially. However, to maintain budget neutrality, the RVU conversion factor utilized to determine the approved payments to providers for services rendered was decreased at a proportional level. These changes could have significant impacts not only on practices with high Medicare and Medicaid patient panels, but also practices that rely heavily on the CMS RVU calculations for anything ranging from provider productivity reporting and benchmarking, to utilizing RVUs to determine physician compensation. The proposed changes are significant enough that practices should start modeling these changes immediately to be able to plan for the impact they will have on their bottom line.

2021 Medicare Proposed CMS Fee Schedule ChangesOn the positive side for physician practices, there was a revaluation of the RVU values for common Evaluation and Management (E/M) procedures – particularly the New and Established Patient Office Visit codes. In most practices, these are the most commonly billed codes by a fairly significant margin. The highest-level New Patient E/M Codes (99203-99205) increased by an average of approximately 10%. The Established Patient Outpatient E/M Codes increased by an average of 30% to 35%. Because these codes are so commonly billed in most practices and RVU values are universal across all patients, many providers will see significant RVU increases in their productivity reports.

These RVU increases are offset from a budgetary standpoint by CMS proposing to drop the RVU conversion factor for all codes from the 2020 value of $36.08 to $32.26 in 2021. This equates to approximately a 10.5% decrease.

To understand what this means, we will use an example of billing code 99213 - Established Patient Office Visit:

  • In 2020, the Work RVU value for this code was .97 and the Total RVU was 2.11.
  • When the 2.11 is multiplied by the 2020 $36.08 Conversion Factor, it led to an approved payment of $76.13.
  • In 2021, the Work RVU component for the same code increases to 1.3, and the Total RVU increases to 2.44.
  • When multiplied by the 2021 RVU Conversion factor of $32.26, the approved payment amount is $78.71 – an increase of $2.58.

Most codes, however, will not see similar increases.

For example, a New Patient Office Visit Level 5 – CPT Code 99205 – which does have an increase in the Work RVU component, will not see an increase. This particular code projects a decrease from the 2020 approved reimbursement of $211.07 to $199.37; the RVU increase is not enough to compensate for the decrease in the conversion factor. Of course, other codes, surgery, radiology, etc., will not see an RVU increase at all, so the reimbursement will decrease.

Modeling the Medicare Reimbursement impact can help practices better understand how this rule will affect their bottom line. By taking the utilization of the seven impacted E/M codes, modifying the RVU, and then repricing their Medicare Total RVU values – including the E/M increases – at the Proposed 2021 RVU Conversion Factor, a practice can predict the change in Medicare reimbursement that will be realized by the proposed changes. This may need to be done at a division, specialty, or even provider level depending upon the organization and the level of Medicare in the organization’s payer mix.

But the Reimbursement changes are not the only impact. The RVU changes are universal, regardless of payer. This will have an impact on Provider Productivity reporting and benchmarking. Depending upon the benchmarking service a practice uses, new benchmarks incorporating the E/M changes will not be available for 6-months to a year. As such, the provider’s RVU productivity compared to the benchmark may be artificially inflated by the E/M RVU modifications for all payers. Practices may want to adjust the benchmarks or productivity reports to take these changes into account.

RVU based physician compensation is also a key area to monitor when these RVU changes go into effect. Organizations will see RVU increases across the board for most physicians, even when reimbursement remains flat or decreasing. This can be a significant financial hit for many organizations. Often, there is not a lot that the organization can do about the compensation plan; however, modeling the expected compensation increase based upon each provider’s E/M utilization can be a huge benefit to finance and payroll departments looking to plan for the impending financial impact and adjust the budgets and projections accordingly.

The 2021 proposed rule for the Physician Fee Schedule is the most significant change in Medicare reimbursement in a single year that I have seen in my 20+ years in Healthcare. Organizations should take heed and look into the impact, model the expected changes, and plan now in case all of these changes are adopted so that they will not be caught off-guard.

Written by: Scott Everitt, MBA, VP of Healthcare Solutions at Practical Data Solutions

Modeling Medicare 2021 Proposed Changes ~ Webinar

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Anyone who manages Revenue Cycle, Reimbursement, Physician Compensation or Productivity will find the content of this webinar extremely beneficial.

On August 3, 2020, CMS released its annual proposed rule changes to the Physician Fee Schedule for 2021. The changes include an increase in RVU valuation and payments for common E&M Codes, and an expanded list of approved telehealth services. However, due to budget neutrality requirements, the proposed RVU conversion factor decreases. Medical groups and practices need to understand – now – the potential impact these changes will have on their financial health and viability.

Learn how data analytics can predictively model the proposed changes and assist practices in forecasting and planning for 2021 and beyond.

Topics include:

  • Understanding the practice’s Medicare population by volume and service mix
  • Illustrating the impact of the changes in E/M Services vs. other procedures
  • Modeling the revised Physician Fee Schedule against historic utilization by Specialty
  • Predicting how the revised CMS fee schedule could modify rates from commercial contracts

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Using Analytics to Manage Chronic Conditions with Today’s Challenges

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Watch on YouTubeHow can providers ensure that patient populations have their chronic conditions promptly checked and treated now that practices are reopening for routine and non-critical care?

Learn how to use visit data, structured with Hierarchical Condition Coding (HCCs), to focus efforts, organize care teams, and close the gaps created by the pandemic. We will discuss how the strategic use of data analytics can assist in identifying chronic condition patients in need of visits. We will also show how analytics can manage provider availability, and identify potential efficiency improvements utilizing in-office, phone, and telehealth for improved access and minimized exposure for patients. Through a better understanding of patient populations - and a planned, proactive outreach - practices can more effectively provide quality care, treat at-risk patients, and ensure appropriate reimbursement.

Originally presented on July 29, 2020, by Practical Data Solutions’ Russell J. Hendrickson, President & CEO and Kelly Constantinetis, Senior Business Intelligence Analyst.

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Timely Excel Visualizations for Evolving Healthcare Challenges ~ Webcast

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Learn how to design impactful, user-friendly Excel visual dashboards in hours.

Healthcare organizations need the power of data analytics, adaptable reporting, and visualizations now more than ever. PDS will show proven approaches that leverage your current Excel skills and pave the way to providing timely, dynamic visualizations to meet the current – and rapidly evolving – needs of today’s challenging healthcare environment. When needs are critical, and resources are constrained, see how Excel’s flexibility can be enhanced using simple design techniques to produce new cost-effective, insightful reporting. This Webcast will showcase proven Excel dashboard designs that can be implemented today to identify financial and performance improvement opportunities in hospitals and practices.

Originally presented on June 17, 2020, by Practical Data Solutions’ Scott Everitt, MBA, Vice President of Analytic Solutions and Michele Perry, Vice President of Service Delivery & Web Analytics.

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Driving Bottom-line Revenue: Leveraging Visual Analytics ~ Webinar

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Managing your revenue cycle is critical to the financial health of your organization. The goal is simple—ensure that all entitled revenue has been accurately captured, billed and collected. The revenue cycle creates massive amounts of data transactions which require appropriate staging and modeling to uncover lost revenues, understand denials and identify performance improvement opportunities. Learn how visual analytics can help identify performance gaps and focus leadership to drive and improve your organization’s financial performance.

Topics Include:

  • Understanding measurable revenue drivers
  • Concisely communicating the cost of poor performance
  • Visualizing opportunities and successes
  • Techniques to visualize data quickly
  • Best practices that drive actionable results

Originally presented on March 18, 2020.

About the Speakers:

Scott Everitt, MBA, has spent over 19 years in the healthcare industry, holding key leadership positions in finance, clinical operations, revenue cycle management, patient access and physician practice management. Scott has achieved significant success in his role as Vice President of Healthcare Solutions by helping clients improve operational and financial efficiency.

Kelly Constantinetis started in August of 2014 as a Senior Business Intelligence Analyst with PDS. Starting her career in hospital finance over 18 years ago, Constantinetis has since served in a variety of roles within the healthcare industry including physician practice finance, operations, application support and analytics. Constantinetis has a bachelor’s degree in Finance from Castleton University.

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Healthcare Practices: Navigating Through Turbulent Times ~ A PDS Article

iStock 485523139Managing medical practices is challenging even in the best of times. But what happens when situations outside of our control force temporary but significant changes upon us? Health systems, hospitals, and clinics need to be among the most stable of businesses no matter what the circumstances in order to best serve patients and the community’s urgent needs. The recent events of COVID-19 have illustrated the need to be adaptable in times of crisis. External changes may force us to modify how we do business for several days, in the case of extreme weather or natural disasters, to several months, in the case of the current pandemic. As leaders in these organizations – and indeed, in our communities – how can we best position ourselves to navigate through these turbulent times?

The key to being able to lay out a path forward, and to predict the obstacles that lie ahead, is leveraging analytical tools to help understand the wealth of data contained within a practice’s systems. Good strategy comes from good information and through analysis of just a few key metrics, we can forecast the road ahead and plan the most effective route. The following is a discussion of the key measures to understand when formulating your strategy.

Scheduling Statistics:

Critical events will likely cause a great deal of variability in your schedules. In many cases, no-shows and short-notice cancellations will spike as patients are unable to get to the clinic. In other cases, emergency demand for care will go up. Often, different specialties will see widely varied impacts. Understanding each provider’s availability per session, or in some cases, even by hour, is the key to setting clinic staffing ratios to maximize throughput while minimizing exposure, understanding which non-urgent appointments can be delayed to free up emergency appointment time, and maintaining that critical and comforting presence for patients who depend upon your services.

Key patient access metrics to pay attention to include:

  • Percentage of provider’s templated time booked and time available by hour
  • Provider frozen/held time by hour
  • Upcoming counts of scheduled appointments by visit type
  • Same Day cancellation rates and no-show rates
  • Average clinical cycle times (to minimize waiting room exposure)

Cashflow and Reserves:

No matter the impact crisis situations have on patient volumes, these events almost always place a strain on the organization’s cash position. Cash can be impacted by events preventing patients from getting to their scheduled appointments and impacting the practice’s monthly productivity. Extreme high-volume events may require immediate cash outlays for supplies and staff for services which will not be reimbursed for 30-60 days. Whether the crisis increases or decreases volume, the financial footing of the practice needs to be strong.

Key Cash metrics executives and management need to be aware of to maximize their financial position:

  • Fixed expenses and the volumes required to meet those levels
  • Variable expenses and the impact of spikes or dips in demand
  • Available cash and current assets in hand available to meet these needs.
  • Accurate AR valuation
  • Current cashflow trends and timelines:
    • Charge lag
    • Claim drop lag
    • 1st Insurance payment lags
    • Zero balance lag

Expected Reimbursement:

It can be difficult to predict the full financial impact of these critical events, but with a strong set of analytical tools, it is possible to model what a practice can expect to be paid for any spikes in services rendered, forecast lost revenue from services canceled or delayed, and even predict the impact of anticipated denials from the payers. Moreover, good analytics will highlight if more will be required from the standpoint of patient collections from deductibles and coinsurance, higher true Self-Pay or Medicaid volumes, and overall reimbursement trends by individual payer. Being able to model this information with a high level of detail will assist the finance team in dynamic budgeting and forecasting the overall financial position of the practice once things return to normal.

Key metrics for the reimbursement team to focus on include:

  • Payer mix by provider
  • Expected reimbursement by procedure or payer
  • Anticipated denials common during times of crisis:
    • Registration denials due to the inability of patients to provide current insurance
    • Authorization denials
    • Additional information denials due to lack of documentation time by providers
    • Recovery rates for stated denials
    • Self-pay collection rates at the time of service and through the billing office
    • Probability of collection by balance, age, and payer

What is predictable about the business of healthcare is its unpredictability. When a significant crisis occurs, leadership cannot rely on the same monthly management dashboards and reports to drive them successfully through a rapidly changing world. Using strong analytical tools, an organization can use their data in a new way in order to plan for challenges and implement a strategic plan of action. Strong, thoughtful leadership in difficult times is what will keep an organization on solid financial footing, allow physicians and staff to provide excellent care, and inspire the confidence in your patients that you will be there for them when they need you the most.

Written by: Scott Everitt, MBA, VP of Healthcare Solutions at Practical Data Solutions

MGMA20 | The Financial Conference

MGMA Corp LogoThe Financial Conference is always a great opportunity to connect with healthcare professionals to share the latest in analytics and the challenges organizations are facing today. This conference always sparks great discussions on strategies to run a more profitable and efficient organization. During these great discussions, PDS was able to share how our solutions can help with financial management, payer contracting analysis, business intelligence and revenue cycle management best practices.

Designing Reusable Data Models—Evolving Your Data Warehouse

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Learn about a data mart approach to building healthcare data warehouses to optimize data analytics and reporting without needing a long-term plan or large capital investment. Following best practice data modeling, “data mart” designs can help you build leverageable data sets to optimize reporting, blend data and correlate answers efficiently. Webinar will discuss the pitfalls of poor data modeling and the advantages of following best practice structures to build data marts that can be joined and reused to drive higher-level thinking. Results come from staging data effectively.

Webinar covers:

  • A best practice incremental approach to data modeling
  • The importance of designing data correctly
  • Understanding effective strategies for data modeling
  • Challenges and costs associated with poor data design
  • Delivering results through best practice data marts

Originally presented on Feb 26, 2020 by Practical Data Solutions’ Scott Everitt, PDS Vice President of Healthcare Solutions, and Sean Phipps, PDS Senior Programmer.

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MicroStrategy World 2020: Learning, Success, and a PDS Presentation

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MicroStrategy World is always one of our favorite conferences. Michele Perry, PDS VP of Service Delivery & Web Analytics, enjoyed the opportunity to collaborate with Ronald Lettieri, Associate Director of Finance & Analytic at SUNY Stony Brook Medicine. Michele and Ron hope that by sharing how powerful organization-wide self-service analytics can be, they’ll inspire other organizations to embrace the benefits of federated analytics. Beyond their presentation, Michele, Ron, and all attending members of the PDS team greatly enjoyed learning valuable information about what’s happening at the forefront of analytics technology during their attendance.

 

Merging Data From Multiple Systems: When 1 + 1 = 3

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Learn about the challenges of merging healthcare data from multiple software systems and about the need to build robust data models from the ground up so that users have full access to slice, dice, and drill to detail-based data with a few clicks.

Most organizations facing the challenge of blending data have either merged with a healthcare entity that uses a different billing system or are in the process of switching systems while concurrently reporting on the old system for a period of time.

During this webinar, you will see examples of data analytics reporting, blended data visualizations, as well as gain insight into PDS’ best practice, incremental approach, to ensure data is modeled appropriately for short-term and long-term success.

Originally presented on January 22, 2020 by Practical Data Solutions’ Russell Hendrickson, CEO, and Michele Perry, Vice President of Web Analytics.

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PDS Client Exchange Forum 2019 a Success!

PDS Client Exchange Forum 2019

November 12th-14th, clients joined us at Disney's Coronado Springs Resort | Orlando, FL for 3 days of focused healthcare analytics training, discussions and networking. Our motto is “Your data empowered…” but for 3 days, it was all about our clients empowered. The one-on-one time with customers…invaluable.

Our first day was all about PDS iMPower and PDS Dash – an exchange of best practices and keys to success. Tuesday evening, we enjoyed a networking reception.

We decided to take a more collaborative approach in 2019; after all, “Exchange Forum” was in the name. The second day of the conference focused on round-table discussions; clients learned from each other while PDS staff added their expertise to the conversation. Wednesday night we enjoyed Epcot and the spectacular evening fireworks.
This morning, we continued the round-table discussions and then forum wrapped up after a delicious lunch together.

The 2019 PDS Conference was all about sharing our ideas, our time, and an experience. Our clients and the PDS Team truly made the magic happen, and Disney’s beautiful Coronado Springs Resort was surely a plus.

We hope to see you at a future PDS user conference!

Denials: An Ounce of Prevention

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Learn how to analyze denials to determine causes, complications, and costs associated with the most common healthcare denied claims.

Claims denial rates in recent studies range from 6% to 21% of revenue collections within physician practices. While many of these denials can be effectively appealed and recovered, it's time-consuming, expensive, and can have a dramatic effect on cashflow and reimbursement rates.

In this webinar, we discuss data analytics techniques and how the visualization of data can provide a focused, insightful view of denials. We show how the use of strategic reporting and dashboards can prevent denials caused by in-house staff, documentation issues, and common charge entry or coding errors. Using initiatives brought into focus with data analytics tools, practices can realize substantial cost savings and improve operating efficiencies.

Originally presented on October 30, 2019 by Practical Data Solutions' Scott Everitt, MBA, Vice President of Analytic Solutions, and Becky Cook, Executive Consultant.

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