Digging below the surface for vital data can help you get what your physician group is worth in VBC contracts.
Value-based payment programs demand involvement from everyone, including physician groups. Contracts often include metrics and targets designed to improve specific performance.
Baseline emergency department data — such as the number of patients who leave without being seen (LWBS), or the number of 72-hour returns and 30-day readmissions — reveal extraordinarily little about what is really going on in an ED.
Physicians need to be able to capture deeper data to explain the why behind scorecard numbers. While issues may be understood anecdotally by the group, Emergency Medicine Performance Analytics can provide credibility, support physician claims, and identify what actions can be taken to improve performance.
Common VBC metrics and the previous year’s performance are sure to be part of the conversation when negotiating next year’s contract. To be prepared for negotiations, physicians must:
- Understand metrics that contribute to hospital VBC incentives
- Track the right causal metrics to demonstrate the department’s contribution to achieving hospital goals
- Identify appropriate comparable benchmarks within a network
Physicians can use data to their advantage by digging into less-than-stellar numbers to understand root causes. For example, studies have shown that high LWBS rates may reflect high ED utilizers, understaffing due to physician shortages, or department crowding due to boarding. In fact, LWBS is often a symptom of systemic throughput problems having little to do with physician performance.
Ensuring Data Is Accurate
Physicians should not accept hospital data as accurate without understanding the metric specifications and how the data is collected or abstracted. For example, length of stay (LOS) for ED visits is a complex measure requiring the calculation of many points in time, such as door-to-doc time and the time between decision to admit and the actual admission time. If an EHR is not set up to easily capture this data, the various time increments and the LOS may be misleading. Hospitals of all sizes struggle with the accuracy of these numbers.
Before being held accountable for certain metrics, physicians should be sure that the data is trusted, transparent, and timely.
Physicians should find the best comparative data to characterize performance. Comparing a small, rural hospital with a large Level I trauma center does not paint an accurate picture. Factors that define how a hospital operates include size, patient demographics, community resources, staffing situation, and location. It is the responsibility of physicians to question benchmarks and ensure that comparisons are as fair as possible.
Getting a handle on the data, collection methods, drill-down, and benchmarks not only provides negotiation power but also helps explain prior performance and gives actionable areas for improvement. If physicians get summary data only, it’s extremely hard to determine how to improve processes, change behavior, and improve results.
d2i provides customized data solutions that drill down to root causes, offering insights into individual and group performance. Contact our domain experts. With the deep understanding offered by our performance analytics applications, your physician group will be armed with the data necessary to prove your value and improve performance.