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Kyruus Blog

Strategies for Outsmarting the Physician Shortage

Over the past several months, more and more healthcare analysts have started to raise concerns about an impending physician shortage. The argument is highlighted by the expected influx of new patients this year as Obamacare enables millions of people to obtain insurance and presumably begin accessing the healthcare system as never before. While ambulatory visits had already been increasing by an average of 2.1% per year since 2000, [i] this new demand is expected to push total outpatient visits to 812 million by 2020.

Topics: Information Access Physician Referrals ambulatory services Physicians patient outmigration physician shortage Personnel outpatient volumes Hospitals leakage Patient Access

The Patient Access Paradox

Why is that we as patients are told to wait weeks, if not months, to see a physician, when in fact many provider organizations are only operating at 50-60% capacity?

Our nation's healthcare system suffers from a mismatch between patient demand and provider supply, something that we refer to as the "Patient Access Paradox". Almost everyone has had a personal experience with the problem of long appointment wait times, which range between 3 and 30 weeks across the country for both primary and specialist care. Yet at the same time, our hospital clients experience as low as 50-60% physician productivity, struggling to "unlock" the capacity that is buried somewhere in their provider networks.

Topics: Information Access Physician Referrals capacity management nurse practitioners physician shortage patient access paradox doctors appointments Big Data Physician Network Strategy Hospitals Patient Access

The Cutting Room Floor: Doctor "Abridgement" and How to Fix It

I've been a fan of audiobooks for quite a long time, since the days when publishers preferred to publish abridged versions of books. That practice drove me absolutely crazy. I wanted to hear the whole book, but a publisher explained to me at one point that customers wouldn’t like the bulk and expense of all the cassette tapes needed for such a product. I could see their point, and yet I didn’t think they were looking at the big picture.

Topics: Information Access Physician Referrals Physicians capacity management physician shortage patient experience kyruus Concept Posts Hospitals Appointment Wait Times Patient Access

Transition Management: Where the population health management rubber hits the road

This post was written by George Pace, Kyruus' Director of Client Development

A health system CEO once told me that anyone who tells you she knows what “population health management” means is lying. While I wouldn’t use similarly strong language to make that point, I have had many conversations with health system and health plan leaders about “population health management”, and through those conversations have come to understand that we do not nearly have a uniform definition of what the term even means. The absence of a uniform definition for population health management can be attributed to market variability, i.e. my population is different from yours, and therefore implies a different approach to managing it.

Topics: Physician Referrals Transition Management population health Referral Analytics Physicians Population Health Management referral misdirection Referral Management kyruus Hospitals Affordable Care Act Patient Access

Docs in Translation: How Clinical Fluency and Volumes Affect Outcomes

This post was written by Dr. Lara Terry, Kyruus' Medical Director

Rapidly advancing technology is enabling the production and consumption of healthcare data in a way not previously possible. With so much at stake in medicine, can Big Data help us decide on the “right” doctor to meet our medical needs?

Topics: Physicians Analytics Data Big Data patient experience kyruus Hospitals

Can’t Get No (Referral) Satisfaction

In the event of a medical illness, we all want to feel that we will get to the “right” doctor – someone expert in diagnosing and treating our specific condition using the best and latest in medical knowledge. Not surprisingly, there is a large and growing body of evidence suggesting that the “right” doctor for a given patient is the one with the appropriate training and clinical experience in that patient’s condition. This is particularly true in specialist care where procedures are more common and conditions more narrowly defined.

Topics: Information Access Physician Referrals Referral Analytics Physicians referral misdirection Referral Management Big Data kyruus Hospitals Patient Access

Wait, Wait, Don't Treat Them

According to a survey conducted ­by healthcare consulting firm Merritt Hawkins [1], patients in major metropolitan areas can expect to wait an average of 18.5 days to see a doctor. In some areas and specialties, things were far worse than the study’s national average. For instance, in Boston, wait times for specialists in cardiology, dermatology, orthopedic surgery and obstetrics / gynecology averaged over 45 days; for a family practitioner, Bostonians can expect to wait more than 2 months (or 66 days) for an appointment. To make matters worse, the study was conducted this summer – before the Affordable Care Act’s coverage expansion took effect.

Topics: Physicians wait times physician shortage patient experience kyruus outpatient volumes Hospitals Appointment Wait Times Patient Access

A Patient A Day Keeps the Doctor In Play

[Originally posted on O'Reilly Strata Blog]

Topics: Physician Referrals Physicians Big Data Concept Posts Hospitals

PPSA's Final Ruling is Here: Now What?

This interpretation was written by Leon Goldman, Kyruus' Chief Privacy Officer and former Chief Compliance Officer at Beth Israel Deaconess Medical Center

The final rule of the Physician Payment Sunshine Act, commonly called “PPSA”, has been published in the Federal Register as of today, February 8, 2013. Anxiously awaited by the healthcare industry and the public alike, the final ruling means applicable manufacturers and group purchasing organizations will be frantically reviewing it, trying to ensure their organization’s processes and systems are ready and able to report the data to CMS by the deadline of March 31, 2014.

While there is anxious activity among the manufactures and GPOs, it is certainly less clear to hospitals and physicians what the PPSA will mean to them, and what exactly they need to be doing to prepare. Aside from providing the opportunity to review the data posted about them, PPSA does not place any statutory obligations on hospitals or physicians - it will, however, reveal a great deal of information about them to the public.

The process by which hospitals have monitored financial relationships with industry has long relied on individual disclosure, either on an annual or transactional basis triggered by specific events, such as seeking permission to perform research studies. Proactive review of publicly available information has not been part of standard review for most institutions - often because the perceived benefit of implementing such a process has not outweighed the cost of review, in both dollars and time. PPSA mandates not only the collection of a vast amount of information about “covered recipients” but also the creation of a vast database that must be downloadable, easily searchable, and aggregated. How and to what extent this will actually change the playing field is yet to be known.

This database will provide (relatively) easy access to vast amounts of information to the public, regulators, or the media for the first time. While some information is already available today via select states reporting and approximately 50 companies currently disclosing, PPSA will significantly increase the amount of information available to the public. We project the following:

  • Over 3 million public industry payment disclosures amounting to over $4 billion
  • Over 700,000 healthcare professionals indicated with public industry payment disclosures
  • Over 1,500 companies disclosing payments

At Kyruus, we have little doubt that agencies, such as the National Institutes of Health, will use the information as a way to “verify” what they are told by their applicants. The media, too, will see the data as an interesting source of information for investigative reporting. Lastly, individual patients and families will likely use the data to become more informed about their physicians and the relationships those physicians have with industry. Given all who will likely use the data, it behooves hospitals and covered recipients to be aware of the data.

Nevertheless, the presence of such a database will not relieve institutions of the need to gather information on their own as they have been doing up to this point. Factors for consideration:

  1. The annual posting of the data may not provide adequate information for organizations to fulfill their transactional obligations for events such as accepting payment from PHS for funded research.
  2. The PPSA database will contain nothing about non-physicians receiving payments or transfers of value about which the organizational policies require disclosure.
  3. There may be payments to physicians that need to be disclosed under an organization's policies, but which are exempt from reporting under the PPSA and can only be discovered through an active disclosure process.
  4. Consolidation of reporting by manufactures may make the information that is reported less useful to the institution for their assessment need. Again - the institution will need to continue to monitor data internally to understand what PPSA will mean for them, and what they need to do.

Kyruus believes that best practices will move organizations to develop policies and procedures that actively collect disclosure information from affected individuals and actively monitor publicly available information. This allows organizations to be in control of the information, to reconcile discrepancies, identify and eliminate problem areas, and to respond quickly to both public and regulatory inquiries.

Topics: Life Sciences Physicians Big Data Hospitals

What’s Your Gorilla?

This is a post by Dr. Tim Crowley, Vice President of Physician Network Services at Kyruus.

 

How important is perception? Prioritization? Taking a step back? Incredibly.

 

I recently attended a conference where the moderator presented a famous video of a group of people passing basketballs to each other. The group was asked to count the number of times the basketballs were passed back and forth. In the middle of the exercise, a person in a gorilla suit walks through the room in the video. Afterwards, when the group was asked about the number of passes, one person raised their hand and asked, “What about the gorilla?”

Over two thirds of the group asked, “What gorilla?” Some insisted there was no gorilla at all, and even accused the moderator of showing two videos!

The point, of course, is that if you are too focused on one thing, you could be missing the real threat to your organization. That’s your gorilla.

Personally, I have seen at least three classic examples of this in Healthcare over the last five years:

1. Large Academic Medical Center in the Northeast proudly announces opening of $400 million, state of the art Cardiovascular tower. Meanwhile, 1,000-provider physician group responsible for 17% of their discharges announces change of affiliation to competitor across the street.

2. Large National For Profit Hospital Management Company gathers its senior management to review 700 hours of physician interviews about “how they are regarded by their employed physicians.” Consulting firm opens the conference with the following statement to the eager crowd: “Let me give you the Executive Summary. Your physicians hate you and they think you suck.” If I hadn’t been in the room to hear it myself, I’m not sure I would have believed it.

3. Faith Based System in the Northeast turns around $50 million operating loss into $30 million operating gain in one year. Market crashes and old Defined Benefit Retirement Plan’s unfunded liability triples. Game over. Private Equity Firm buys system.

So, while you, the hospital administrator, are totally consumed by the installation of your new EMR, or your brilliant new E.D or your aggressive new quality improvement and cost containment projects, you might want to look around and see if there any gorillas are in the room.

Here are two “gorillas” that can pose an existential threat to your organization:

1. Lack of a dynamic, effective ONGOING Physician Network Development program. Our proprietary physician tracking data shows that over 1% of physicians move EVERY MONTH. 12-15% change location, leave their practice or move to a different system every year. In addition, a whole generation of Primary Care Physicians is approaching retirement in the next 5-10 years. Without the information to identify those likely to leave and a comprehensive succession plan to help recruit new physicians to care for those patients, you could lose significant market share. If you are not actively engaged with your physicians to build your physician network, you are probably already losing more than you are gaining.

2. Patient outmigration, or "leakage". There is nothing more exasperating to the senior management teams at healthcare organizations than to see huge numbers of referrals go out to other organizations by their own physicians. What’s the point of creating and supporting a physician network if they aren’t willing to support your organizations and keep the care of their patients at the hospitals where they practice? Understanding why they are referring out is critical to fixing the problem.

Kyruus Physician Network Services can help your organization with both of these challenges. We have the tools and services to help you build, train and operate an effective Physician Network Development program and a Referral Management System that will help you promote patient retention.

Topics: Referral Analytics Physicians Physician Network Strategy Hospitals