BUSINESS

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Measuring Medical Volume

The need-to-know numbers for monitoring medical eye care

DAVID MILLS, O.D., M.B.A.

Optometric business managers must be keenly aware of the metrics generated from the delivery of medical eye care, so they can determine whether this part of their practice is thriving or languishing. This is especially important if a prior decision has been made to allocate resources in creating a medical segment emphasis within the practice. Examples include specialty contact lenses, dry eye management and/or AMD.

Often times, allocated resources not only involve revenue expenses, but also indirect expenses, such as staffing. Tracking these numbers may also highlight missed care opportunities for patients who have specific medical conditions.

How to Calculate

1 Compile a list of the medically related ICD-9 diagnostic codes the practice utilizes for products and services.

2 Query your EHR for both encounter and specialized testing revenues, filtering by each of the diagnostic codes identified in Step 1. Group all “related” ICD-9 codes together as one filter. For example, query the EHR for all related diabetic ICD-9 codes at the same time.

3 Assess your EHR for the number of patients in each related diagnosis code set.

4 Now, divide the revenues generated through a certain time period (See “Frequency to Review”) by the number of medical encounters to obtain your medical revenue per encounter.

Once completed, you will have determined revenue streams associated with each grouping of diagnostic codes.

Data interpretation

Unlike other metrics, there are no standards; you only will be comparing your current numbers to past numbers and your goals.

Measuring medical volume will determine whether the practice is generating the expected revenues based on the patient mix of different medical conditions.

Depending on the results of the patient census of the different medical conditions, capital equipment purchases should be investigated. For example, the purchase of an OCT might allow the practice to increase revenues when delivering more efficient care. Review peer-reviewed, evidence-based articles that outline recommended treatment protocols for specific medical conditions.

If the practice has previously invested in a specific medical care segment, patient volume and generated revenue should be evaluated for growth within as well as an increased return on investment.

Signs of under-performance or not meeting budget expectations should trigger a further evaluation of whether the previously chosen medical segment makes financial sense to continue. OM

DR. MILLS PRACTICES AT OCEAN STATE EYE CARE IN WARWICK, R.I., AND HOLDS A M.B.A. FROM PROVIDENCE COLLEGE. E-MAIL HIM AT MILLSD@NECO.EDU, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.