Keying in on KPIs

Data analytics isn’t only for large health systems. Small and midsize practices, too, must measure performance to ensure they are operating at peak effectiveness and efficiency.

St. Claire Regional Medical Center in Morehead, Kentucky, and Consolidated Health Services in Cincinnati both track key performance indicators (KPIs), for instance, though each takes a slightly different approach.

“The titles of the KPIs explain why we use them,” said Leigh Anne Stiltner, St. Claire Regional’s director of patient financial services, who detailed the list of KPIs the medical group regularly tracks:

  • Registration error rate
  • Upfront collections
  • Discharged not final billed (DNFB)
  • DNFB > than 30 days
  • Insurance verification rate
  • Pre-registration rate
  • Scheduled and cancelled visits
  • Record completion
  • Unbilled accounts receivable (AR)
  • Days in AR
  • Percent of AR > than 90 days
  • Credit balances
  • Underpayments identified
  • Underpayments collected
  • Average daily revenue
  • Percentage of AR by payer type
  • Provider scorecards
  • Late charges
  • Self-pay conversion rate
  • Cash collection
  • Cash collection by payer
  • Uninsured adjustments
  • Charity care
  • Bad debt
  • Denial rate
  • Claim submission rate
  • Scheduled visits with no insurance listed

Consolidated Health Services in Cincinnati uses a somewhat different mix of KPIs (listed below). Joseph Ruark, director of home health/hospice revenue cycle, provided a brief explanation where the KPI title does not reasonably explain its purpose.

  • Days sales outstanding in total and by payer
  • Days sales unbilled
  • Days sales in credit balances
  • AR agings (Percentage at 90 days and 360+ days in total and by payer)
  • Cash receipts by payer
  • Adjustments as a percentage of sales
  • Cash receipts as a percentage of sales
  • Cash received on sales greater than 120 days old (An indication how effective staff is following up on aged AR)
  • Denials as a percentage of sales in total and by payer

“Analytics like KPIs enable you to make quick, smart decisions, prioritize resources, assess your financial health, and plan better for the future,” explained Kim Labow, vice president of marketing at ZirMed, a healthcare information connectivity and management solutions company.

Which KPIs do you use at your practice and how do they help you gauge financial and operational health? Add to the discussion in the Comments section below.

Keying in on KPIs

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