Physician Data Analytics – Impact on Revenue


By Richard Howe, PhD, Executive Director of the North Texas Regional Extension Center

Over the last several months, I discussed some basic rules of the road for improving use of your electronic health record (EHR) and how your EHR could support a clinical research project. So, how does your EHR relate to physician analytics, and what could be the impact upon practice revenue? In fact, why should I even bother with data analytics in the first place?

Change in Payment Models
The U.S. Department of Health and Human Services (HHS) is moving from a fee-for-service payment model to a “value-based” payment model. Instead of paying for each office visit, HHS will be paying for improving the overall health of your patients, regardless of the number of office visits. The HHS goal is to tie 30 percent of fee-for-service payments to value-based payments by 2016, moving to reach 50 percent by 2018.

This means that physician practice groups will have to start now to migrate toward a value-based care model in just a few short years.

So, what role does physician analytics play in this migration?

1. First, the analytics tools can help you unlock the data within your own EHR. For example, the analytics tool can look across all your patients and, based on various quality indicators, identify those patients that fall into a “high risk”/ “high cost” group for some of the more difficult chronic conditions;

2. With the list of these high risk chronic patients, your care team can then contact each patient pro-actively and work with each patient to improve their adherence to medications, weight loss, exercise, etc., which will lead to overall clinical improvement;

3. Long-term, the analytics tool will then provide you with key information and data on how well your interventions have improved the clinical outcomes of these patients, and lowered the overall cost of care at the same time. That is true “value-based” care.

What are the benefits?
The most significant benefit of a physician analytics tool is to help you discover problems related to quality, safety and efficiency. You can then redesign your workflows to address these problems and directly show improvement in patient care. Again, value-based care is all about showing improvement in patient care outcomes. By having access to this information, you can then participate in many of the value-based programs that are available – and get paid for participation!

So, if you can improve the clinical outcomes of your patients while at the same time reducing the number of office visits, you can not only get paid for this improvement, but you will also have more time to add additional patients into your practice. Thus, a secondary benefit occurs that can improve your overall revenue, while improving the quality of patient care for all your patients. This is a win for your patients and a win for your practice!