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Accurately Assessing Quality Benchmarks for Medical Practice

October 19, 2017

Assessing Quality Benchmarks for Medical Practice.jpeg

You may feel that your medical practice is perking along fantastically, but if you’re not analyzing key quality benchmarks how can you be sure that your patients are happy and your staff are as productive as possible? There’s always the potential that even though business is going well now, there are some unidentified challenges that can erode long-term revenue and reduce overall patient approval — insidious problems that can take years of slowly declining revenue to identify and then resolve. Fortunately, if you’re paying attention to certain key quality benchmarks for medical practice and assessing them accurately, you can ward off these subtle issues as well as the not-so-subtle problems and restore your peace of mind. 

Review Revenue and Expenses

Financial considerations are critical to ensuring that your practice is healthy, and two benchmarks that will help you assess these areas effectively are your net collection rate and overhead values. Net collection rate is determined by discovering how much of the money that is owed to your practice is actually collected. If the number doesn’t equal 100 percent, then your practice is leaving money on the table. A healthy bottom line is when a practice is collecting approximately 97 percent or greater of what is owed, and should be analyzed by payer to determine if a particular organization is causing you to revenue to drop due to non-payment or reduced payment percentages. Additionally, it’s important to review front-end processes on a regular basis to ensure that all claims are submitted in a timely basis and are clean and free of errors or omissions that would cause a slower payment rate. 

Related Article: How to Benchmark a Medical Practice for Better Productivity

Overhead rate is another important metric for review, and can be calculated by dividing the practice’s total operating expenses by total medical revenue. While the averages vary by specialty from around 60 percent for a pediatric practice to less than 45 percent for orthopedics, it’s important to compare your overhead rate with the median rate for those of similar practices. 

Quality of Care

When your care practices align with patient needs, patients are more likely to stay healthy and avoid preventable trips to the emergency room or hospital admissions. These accountable care benchmarks allow you to determine whether or not ongoing patient outcomes are positive and continuity of care is successful. When your staff is available and able to answer critical questions in a timely manner, patients are much less likely to look for other methods of access to care, such as urgent care provided through an emergency room setting. Payers are also scrutinizing these benchmarks in an attempt to provide care in the least-costly method possibly while still maintaining a high level of quality and ongoing health for patients. Determining the systematic method for evaluating whether or not your patients are visiting an emergency room or even being admitted to the hospital can be challenging, but a short-term review that includes querying patients about their behaviors can be a good start to gathering these metrics. Consider quarterly sampling of patients to determine ongoing care levels. 

Net Promoter Score

The ultimate benchmark of health for your practice is whether or not patients would recommend your practice to others. This can be gathered in a relatively simple fashion, which can be easily reported upon. All that is required is asking each patient a single question: How likely are you to recommend this practice to others? Ask that they mark a score between 1-10, with 10 being the highest. At its core, this metric allows you to determine whether people are detractors from your business (those who score 6 or below), moderately pleased (scores between 7-8) or if they are true promoters of your business (those who scored a 9 or a 10). Focus on finding out what specific things the promoters of your business are sharing — and keep doing them! 

When you want to learn more about how to create cohesive billing practices to enhance your overall practice revenue, reach out to the professionals at M-Scribe by calling 770-666-0460 or via email to We will work closely with you to develop best practices that support your medical practice and ensure that your medical coding and billing are fully compliant with all required regulations. 


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