FAQ: The Data-Driven Practice: 10 Stats to Track in Your Therapy Organization

Earlier this week, WebPT President and Co-Founder Dr. Heidi Jannenga, PT, DT, ATC, teamed up with WebPT Vice President of Innovation and Product Management, Russell Olsen, to discuss the ten trackable metrics that can help you turbo-boost your practice past the competition. They tackled as many audience questions as they could during the post-webinar Q&A, but there just wasn’t enough time to get to all of them. So, we’ve compiled—and answered—the most frequently asked ones and posted them below as fuel for thought! If you can’t find the answer you’re looking for, leave us your question in the comment section at the end of this post, and we’ll do our best to respond.

Outcomes

What’s the benefit of using the OMTs available in WebPT Outcomes versus FOTO measures?

If you’re presenting your data to any entity outside of rehab therapy—think insurance companies or referring physicians—then you’ll want to use data-collection tools that are meaningful to those entities. And while FOTO provides very specialized measures that are meaningful within rehab therapy, the OMTs offered through WebPT Outcomes are not only meaningful to therapists, but also widely understood and appreciated across the entire healthcare spectrum. After all, the whole point of outcomes is to have a common language that speaks to care value. With the right outcome tools, you can objectively demonstrate to insurance companies and referring providers the value you provide your patients. And because they will actually understand that data, they will be more apt to act on it (i.e., increase your reimbursement rates or send more patients your way). To learn more about the how and why of outcomes tracking, check out this guide.

Which OMTs are included in WebPT Outcomes?

Every OMT we mentioned in the webinar is included in—or will soon be added to—WebPT Outcomes. (Keep an eye out for more details on our upcoming release!)

Are there free versions of the OMTs you mentioned during the webinar?

A majority of the OMTs we covered are available online at no cost, although some—like the DASH (Disabilities of the Arm, Shoulder and Hand)—are considered proprietary and require payment. All the OMTs mentioned in the webinar are available in WebPT, though—and while you can track OMTs and follow patient progress by hand, the most accurate (and efficient) way to measure progress is to use an automated software.

Where can you find the free OMTs online?

When you Google the OMTs we mentioned, the free PDFs are typically the first results that appear.

NPS^®

At which intervals should we send NPS^® surveys?

Initial evaluations, re-evaluations, progress reports, and discharges are all perfect times to administer NPS^®. You’ll want to send NPS^® surveys multiple times throughout an episode of care so you can gauge whether patient loyalty and happiness is trending up, staying same, or declining.

What is the baseline NPS^® score for a healthcare facility?

According to this resource, as of January 9, 2019, the average NPS^® for an organization in the healthcare industry is 76.

Who should administer NPS^®? How do we avoid putting patients on the spot?

One of the benefits of NPS^® is that it’s really easy to digitize, which means you can ask your patients for their feedback via email after they’ve left the clinic. (In fact, WebPT Reach automates the entire process, so every patient automatically receives the NPS^® survey without you having to lift a finger—and no one falls through the cracks.) That way, you can avoid putting pressure on your patients to answer on the spot—or skew their responses because it’s harder to provide an honest assessment when you’re in front of the person you’re assessing.

What kinds of follow-up questions can you ask your patients after they answer the NPS^® question? Could you ask something like, “How could we get a 10 from you?”

When you create a follow-up NPS^® question, you want to keep it broad enough that it encourages patients to leave all kinds of feedback. The specific question, “How could we get a 10 from you?” would work perfectly.

WebPT Analytics

How does WebPT help its Members measure these metrics?

If you’re interested in learning more about how WebPT can help you track these metrics (and you’re already a WebPT Member), you can check out these videos and these articles in the WebPT Community. We also offer analytics certification training for those who would like to become more comfortable with our analytics product. To register, simply connect with your Success Manager or email success@webpt.com.

How does WebPT track dropout?

WebPT offers a handful of different reports that can help you assess dropout in your practice. Members should go through Analytics training classes to learn how to effectively use these reporting features. But, here’s a quick preview:

In a perfect world, all patient cases should end with a discharge summary. Identifying the ratio of “quick discharge” patients to those who have a discharge summary is one of the key ways you can use WebPT to determine whether patients are completing their episodes of care.

To do this, navigate to the Patient Visit Report. Then:

• Filter by Discharged Status.
• Group by Last Note Type.
• Select the option to Aggregate: Count by Patient Name.

Add up the non-discharge note types (these represent quick discharges), and compare that to discharge note type count. It may be helpful to exclude the detail row (located under the Group section of the gear icon menu) to more easily calculate your ratios.

If a patient initially found our clinic via social media—or if the patient was referred by a friend—how do I account for that in WebPT?

In WebPT, there’s a field to enter in a patient’s referral source—and clinic administrators have the option to make this field required so that front office personnel must collect that information from patients during the intake process. Once entered, the data will flow into WebPT Analytics and be available for you to review.

Is there an additional cost for WebPT Analytics?

Nope; Analytics is already included in every WebPT Membership.

Do you have to discharge patients to accurately calculate your dropout rate in WebPT Analytics?

Yes; if your patients aren’t discharged, the software assumes the patients are still active and won’t include them when it calculates your dropout rate.

Do WebPT Analytics reports differentiate between cancellations and reschedules?

There are a few spots in Analytics where you can view this type of information. On the Analytics KPI Dashboard, you can view cancel and no-show rates for the last 12 months. You can also see how your practice is trending against the goal you’ve set. This is great for a quick visual glimpse into arrival rate performance.

For more details on cancellations and no-shows, you can check out the Analytics Grids in the Reports section of Analytics. From here, you can apply functions, group, filter, and dig into nitty-gritty details—including the types of reasons that are driving cancellations as well as which specific therapists have higher or lower arrival rates than other therapists.

To view reschedules, we’d recommend reviewing the Scheduled Visits report. Reschedules will display under the Appointment Type. If you want to unmark a cancellation and reclassify it as a reschedule, you can do so in the scheduler—or the patient’s chart—and run a new Analytics report to view the updated data.

Does Analytics show cancellation, no-show, and dropout statistics that are specific to niche practices—pediatrics, for example?

There isn’t a “specialty” field to sort by, but you can filter by case title and case therapist. So, if you name your case titles in a way that helps you easily identify them (e.g., precede each pediatric case with PED), then you can pull reports according to those labels. Or, if a certain therapist treats only pediatric cases, then you can pull reports for that specific therapist.

Financial Metrics

Do you have any tips for tracking optimal billing—or units per visit? We perform spot checks in our billing system, but are there any other methods we could try?

There are plenty of metrics you can track to keep a pulse on your financial health, many of which we cover here. But to truly optimize your billing, you need to make sure your therapists are documenting as accurately and completely as possible—and that your billers (or whoever is responsible for coding and submitting claims) are using CPT codes to their fullest. For more advice on how to maximize your billing, refer to this blog post.

How do I calculate the average amount collected per visit?

Add up the total amount of payment collected from both patients and insurances during a specific time period, and divide that by the total number of visits that occurred during that same time period.

For Days Sales Outstanding (DSO), should we calculate by business days or calendar days?

When calculating your DSO, you’ll want to multiply by the total number of calendar days in the given timeframe.

Should I include my business development costs (e.g., training, one-time legal fees, etc.) when I calculate my total daily practice costs?

Technically, yes. You should include all costs—regardless of whether or not they are recurring—when you calculate your total daily practice costs, especially when you’re determining your overall profit. That said, you shouldn’t include one-time costs outside of the time frame during which they occured.

For example, let’s say you’re calculating your overall profit for January, and during January, you paid the bulk of your annual business costs. You would include those costs when you calculate out January’s overall profit. But if you were looking to determine the overall profit for February, you wouldn’t include those single-time costs in your calculations. This is actually a great example of how metrics can fluctuate and be a little misleading if you’re not carefully watching—and trying to understand—where they all come from.

When we calculate Days Sales Outstanding (DSO), should the total current AR fall under the same timeframe as the total gross charges (e.g., one month)?

Yes! Whenever you calculate your metrics, keep your timeframes consistent.

Patient Cancellations, No-Shows, and Dropouts

We already have a no-show fee, so besides overbooking, how can we minimize no-shows and the negative impact they have on our practice?

First off, if you don’t already use automatic appointment reminders, start doing so—pronto. It’s a well-known fact that automated reminders help reduce no shows—whether those reminders are delivered via email, phone call, or text. Additionally, when Jannenga worked in private practice, her clinic had patients stop at the front desk after their appointment so the front office staff could remind them to schedule their next appointment. That way, the patient was involved in selecting the date and time—making them more likely to actually attend (the same logic goes when scheduling appointments over the phone). For more great tips on reducing cancellations and no-shows, be sure to read this blog post.

How do reschedules factor into a practice’s cancellation rate?

In Jannenga’s practice, a patient who canceled but rescheduled within the same week was not considered part of the overall cancellation count. However, consistency is key. So, decide what definition makes the most sense for your practice, and stick with it.

How do we distinguish churned patients from those who self-discharge early because they met their goals?

If a patient leaves therapy before receiving a formal discharge, then technically, he or she would be considered a churned patient. If you suspect that patients are churning out because they feel that they have met their goals, take a look at the average number of visits those patients are completing before they self-discharge. If it appears that the majority of them are leaving later in their care episodes, you may want to reassess the length of your care plans—or increase patient communication efforts during the later stages of the care plan to ensure patients understand why they should continue attending their appointments until they receive a formal discharge. If, on the other hand, the majority are leaving early in their care plans, take a hard look at the quality of education and communication your patients are receiving at the onset of care. Do your therapists set clear expectations about the patient’s functional goals—and how long it will take them to reach those goals? Are therapists thoroughly and effectively communicating the value of progressing through the entire course of care? If not, your patients may stop coming to therapy as soon as they start to experience improvement—especially if they have a high copay, coinsurance, or deductible.

Is it legal to charge a no-show patient a fee if you have a credit card on file?

In most cases, yes—as long as you have clearly communicated your cancellation policy and fee information in the new patient paperwork and obtained a patient signature of acknowledgment. However, as we explained here, “you should only keep patient credit card information on file if PCI guidelines—and your payer contracts—allow for it.” Furthermore, keep in mind that slapping a patient with this sort of surprise charge—even if he or she agreed to it as part of your payment policy—could lead to the sort of disgruntlement that prompts people to leave negative online reviews and otherwise damage your practice’s reputation. So, we recommend taking this sort of action only as a last resort.

How do you handle no-show Medicaid patients for whom you can’t legally charge a cancellation fee?

Beyond late fees and appointment reminders, the best way to improve your patient arrival rate is to set clear expectations with your patients at the onset of care. That means clearly communicating the importance of showing up on time for all appointments—or at least calling ahead to cancel, so you and your staff are available to help other patients.

How many collection letters or past-due balance statements should we send before we take further action?

According to Charlotte Bohnett in this post, “send more than one letter, but not more than three.” To learn more about how to send collection letters that work—as well as what steps you should be taking to collect past due balances before it comes to this—check out her blog post in full.

How do you recommend collecting co-insurances when, at the time of service, you’re not sure what the payer is going to adjust off?

Depending on the payer contract, you may be able to collect a portion of the estimated charges—and then either bill the patient for the difference or refund the patient for an overpayment. To learn more about verifying financial obligation and collecting payment, check out this FAQ.

Miscellaneous

Which stats—other than patient satisfaction—should we track to measure the quality of our care?

Outcomes tracking is the most direct way to measure the quality of your care. By administering outcome measurement tools (OMTs) at various intervals throughout the course of care, you can monitor the progress—or lack thereof—that patients make throughout their treatment. If patients aren’t consistently improving as a result of your therapeutic intervention, then it may be time to reevaluate your treatment approach. But, not all outcome measures are created equal, and you’ll want to make sure you’re using ones that are objective, risk-adjusted, and widely understood and respected outside of rehab therapy.

Additionally, you can also measure your clinic’s patient dropout rate (i.e., the rate at which patients fail to return to your clinic to complete their full care plan). If you notice that a lot of your patients are dropping out of therapy before they’ve met their goals, you probably have room for improvement in one or more aspects of the patient experience you’re providing.

Should PTs and PTAs have the same productivity expectations?

According to Jannenga, you should have different goals and metrics for different roles, because the job requirements aren’t the same for all of them. But consistency is important, so be sure you have the same goals for everyone in a particular role. Also, consider your payer mix when scheduling your staff. In Jannenga’s practice, her PTAs did the majority of Medicare follow-up appointments, thus freeing up her PTs to perform more initial evaluations. That way, it was easier to stay consistent with goal-setting based on role. That all said, there’s good reason to rethink productivity goals altogether. To learn why high productivity doesn’t necessarily equate to high performance, check out this article by Meredith Castin, PT, DPT.

Should we have a designated employee to track these metrics?

That depends on the size of your practice. If you are the owner, director, or manager of a smaller business, then you’re likely going to perform the bulk of your metric monitoring. That said, the metrics we covered during the webinar fall into different areas of the house. So, you could equip your front office staff to track some (e.g., patient arrival rate and patient payment collection rate) and your billers to track others (e.g., claim denial rate and days sales outstanding). But at the end of the day, it’s up to clinic leadership to look at all the metrics holistically and determine where and how to take action.

Should the person responsible for tracking metrics have business experience that enables him or her to make recommendations based on the data?

Again, the role responsible for tracking metrics may differ depending on the size of the business. That being said, the ability to use business intelligence to drive smarter business decisions is the main benefit of tracking metrics. Thus, it would make sense to ensure that someone in your office is comfortable analyzing the data, whether that be your office administrator or someone else on your team. But, that doesn’t necessarily mean this person has to have previous experience in this area. When we hire at WebPT, for example, we hire for culture first. While previous experience is great, you can teach data collection and analysis skills to someone who’s interested. However, you can’t teach character.

Why should we invest resources in marketing to referral sources we already get referrals from? I would think we’d want to focus on building relationships with new ones—or ones that don’t currently provide many referrals.

All relationships take time and energy to not only build, but also maintain. So while it is certainly worthwhile to seek out new referral relationships, the last thing you want is for a previously solid referral source to dry up because you’re no longer top of mind. Looking for advice on building your referral network? Check out this blog post.

We’re a small practice. At what point should we start tracking metrics?

It’s never too early to start tracking your data. But if you haven’t started yet, it’s not too late! Start with one metric, and work your way up to tracking more. If you’re a WebPT Member and you’re not sure where to start, contact your Success Manager to enroll in WebPT Analytics training. You may also find this blog post on WebPT reports helpful.

We haven’t been able to effectively negotiate with our payers to date. Do you recommend we drop those payers?

In many states, negotiating with payers can be challenging. And in some situations, it may be best to go out-of-network with a particular payer, especially if that payer isn’t at least covering the cost of your services. That said, there are a number of factors to consider when deciding whether to drop a payer—including how that decision will impact your patients and referral sources.

How often should I review these metrics in my practice?

It’s a good idea to review most metrics at least quarterly; however, some should be reviewed each month at a minimum. It’s best to create a schedule that works for your practice and then be consistent.

We use a billing software that doesn’t display the patient balance. So, how am I supposed to collect the amount due from the patient?

First off, make sure your front office staff are performing detailed insurance verifications and benefits checks for all patients so they estimate patient responsibility with the greatest accuracy possible (learn more about that here and here.) Additionally, we recommend implementing an EMR that pulls the patient balance directly from your billing software and displays it in the scheduler. That way, your front office staff know exactly how much a patient owes when that patient checks in.

After looking through all that information about data tracking, you’re probably ready to drive your practice into the financially-golden sunset! But if your mind is still spinning, leave your question below, and we’ll get your tires to the tarmac in no time flat.