“If you can’t measure it, you can’t manage it.” – Peter Drucker
The goal of most medical practitioners is to provide outstanding health care quality to their patient population while maintaining a financially sound business model. Organizations typically prepare business plans that include operational goals and strategies along with financial goals and strategies. Oftentimes, processes are not put into place to define mechanisms for measuring performance against these core business goals and strategies. This can lead to unexpected and undesirable results.
Performance Management in Healthcare
Performance management strengthens an organization by defining meaningful metrics that are regularly measured and analyzed to determine efficiencies, areas requiring improvement, and best practices. Performance management can apply to a single physician practice, to a group practice, or to a larger physician’s network. The key to successful performance management is to define meaningful metrics that can, in fact, be measured. For example, a goal to provide the best diabetes care to your patients may include strategies regarding patient monitoring and A1c testing, LDL-C control, and control of high blood pressure. A good performance management implementation would develop and implement metrics for tracking these measures. Tracking the percentage of patients whose most recent hemoglobin A1c was greater than 9%, percentage whose most recent LDL-C level was less than 100 mg/dl, and percentage whose most recent blood pressure control was less than 140/90 may provide helpful insights regarding effectiveness of treatment, best practices, and/or areas where changes in general treatment for diabetes patients may be required. Similar metrics may be established for other treatment areas such as heart failure, stroke, AMD, or any other treatment area in which your practice specializes. Financial metrics may also be established to take the pulse of your business operations. Revenue and profitability metrics by treatment type and age group are two common metrics that are used to identify trends or best practices that can be applied in other treatment applications. Such metrics may be applied at the individual practice level, or can be rolled up and summarized at group practice levels to monitor overall performance and gain insights. CMS has implemented requirements for metric reporting through the Physicians Quality Reporting System (PQRS) and Accountable Care Organization (ACO) metrics. CMS’ goal is to improve the quality of patient care while controlling costs. The CMS implementation of these requirements is somewhat of a double-edged sword. Report the metrics and you are entitled to incentive pay; don’t report the metrics and you will be penalized. Although this forced implementation may not be well received, physicians generally find the introduction of performance management into their organization helps them to achieve their overall healthcare and business goals while providing new insights into practice operations. Performance management, when implemented properly, is non-disruptive and offers a tool to further strengthen the foundation of your organization.