Background
Over a three-week period, HSG performed a complete audit of an employed physician network consisting of over 120 providers, 90 of whom were physicians. It was operating at an annual loss of approximately $18M. Based on the assessment, the largest contributors to that loss were:
- Low physician productivity as measured by Work RVUs (wRVUs)
- Failure to enforce provider compensation provisions tied to production, and wide variation in provider base wages
- Operational inefficiencies stemming from many small practices, often in adjacent locations
- Ineffective use of technology
- Inadequate management of the revenue cycle
- Inability of management to meaningfully impact the issues above
- Over-dependence on licensed nursing staff
How HSG Helped
HSG found seven opportunities to improve the bottom line performance of the network and reduce physician practice losses by an estimated $5M over two to three years:
| Provider Productivity |
$ 1.8 to $2.5M |
| Physician Compensation |
$ 2.6M |
| Site Consolidation |
$ 800,000+ |
| Revenue Cycle Improvement (Collections) |
Range $2 – 9M |
| Revenue Cycle Improvement (Chargemaster) |
$ 1.2M |
| Nursing Staff |
$ 560,000 |
| Meaningful Use |
$2.1M |
Several major recommendations were made to reach this goal. When providing dramatic and sometimes long-term change, HSG is available to work with a client to prioritize and/or implement recommendations.
Results
Client satisfaction with the operational assessment was so high, it resulted in a request for a proposal to implement the assessment recommendations.
HSG divided the implementation process into three phases over a twelve-month engagement:
- Address revenue cycle issues and update the current manpower plan;
- Address the functional and strategic structure of the physician network, adopt needed changes to the data environment and develop solutions for the low productivity of network physicians; and
- Assist with the introduction of operational enhancements and monitor results.