Tracking key benchmarks is important for spine surgeons to ensure their practice is headed in the right direction in the changing healthcare environment. "Benchmarks can tell you whether you are providing patients with the best care they deserve," says Bryan Oh, MD, a neurosurgeon focusing on spinal surgery at BASIC Spine in Orange, Calif. "If you aren’t actually providing the best care, you are not doing your job as a doctor and you are undercutting the patients. Additionally, with the way healthcare and Obamacare is going, pay for performance will be coming down the pipe and you have to be able to demonstrate you are providing good quality care, so there is also a financial incentive."
Dr. Oh discusses five key benchmarks that will improve the quality of spine practices and lead the way to success in the future.
1. Patient outcomes. Track patient outcomes and readmission rates to see where you're at compared with national averages. If you're part of a larger group, you can also compare yourself to group rates or other individuals and see where there is room for improvement.
"I'm working on finding a way to put together 30-day readmission rates, surgical site infections and morbidities for our practice to see how we are doing," says Dr. Oh. "You don’t know how to improve if you don't have the benchmark. We are trying to compare ourselves to different practitioners in the group, but we are just beginning to gather data. Soon we'll have more readily available data to compare surgeons apples-to-apples. I really predict going forward, there will be pressure from a lot of different sources to do that."
Insurance companies are already looking at quality statistics during contract negotiations, and more payors are moving toward a "pay-for-performance" reimbursement model.
"I know of an orthopedic group that did careful benchmarking and were able to demonstrate they were better than the average practice, so they were able to negotiate a better rate from the insurance company," says Dr. Oh. "There is a financial incentive to track these benchmarks. Additionally, from a competition standpoint, you can demonstrate and market that you are providing better care."
2. Cost of care. In addition to quality care, insurance companies and patients will also begin considering cost of care as an important factor when choosing providers. Especially as patients take on high premium insurance plans and health savings accounts, demonstrating cost effectiveness will be key to bring in additional patient volume.
"If you are delivering quality care but it costs a lot of money, that isn't going to cut it today," says Dr. Oh. "Consider working with the hospital and making a plan to contain costs within your practice as a whole. I'm working with the hospital, and it's similar in the ASC setting, to look at how much it costs to deliver a DRT of care. Look at how long patients are staying and what it costs to deliver their care."
Figure out where costs could be trimmed in areas such as supplies or waste management and devise a plan to eliminate excess costs.
3. Patient satisfaction. Spine surgeons can track and benchmark patient satisfaction internally and compare their scores to outside benchmarks, such as Press Ganey. Gathering patient feedback is essential to detect any issues with the practice, which should be fixed as soon as possible.
"You can see what isn't right with the practice and focus on those areas," says Dr. Oh. "For example, if there is a long waiting time, you might need more clinic days. If you don't measure this, you won't know to fix it and it will continue."
Dr. Oh is currently working on a personal project to track patient satisfaction and make adjustments to improve those scores. "There are usually some patients in a practice that aren't satisfied, and we have to figure out why," says Dr. Oh. "Is it because the doctor wasn't very compassionate or because things weren't explained well? All of these things are important and we need feedback on them."
4. Patient complaints. In addition to tracking patient satisfaction, also catalogue patient complaints and address them. Recently, Dr. Oh's malpractice insurance carrier asked for feedback from his patients that would impact his insurance rate.
"They asked our office staff to pass out a questionnaire to 100 patients and wanted all responses back," says Dr. Oh. "If they didn’t get the responses, my malpractice premium would go up. Happy customers are less litigious."
If you fix issues early and maintain a positive patient experience, it could have an impact on things like malpractice insurance rates in the future.
5. Employee performance. Keep patient feedback about practice staff in addition to benchmarks about their overall performance to ensure employees are delivering appropriate value. You need hard working, friendly and compassionate staff at your practice to optimize the patient experience.
"When I benchmark these statistics, I get a better sense of control in my practice," says Dr. Oh. "If someone is consistently underperforming, it might be time to let the employee go. It's an indirect way of looking at the quality of employees. But you have to consider every possibility for issues first; for example, if there is a scheduling problem, there could be something wrong with the phones, which you need to fix."
Board Certified neurosurgeon Bryan Oh MD received his medical training at Stanford University with a residency in neurosurgery and fellowship in spine surgery at the University of Southern California.
Dr. Oh was a faculty member at the University of Texas at Houston Medical School and was Director of Neurotrauma for the busiest Level One Trauma Center in the United States.
He is a reviewer for the journals Neurosurgery and World Neurosurgery as well as a member of several prestigious societies, including the Congress of Neurological Surgeons and the American Association of Neurological Surgeons. Please follow him on facebook, twitter, and google+.
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