When it comes to building a successful palliative care program, it is essential to have a clear strategy, measurable goals and the systems in place to effectively monitor the progress towards those goals. As the saying goes, what gets measured, gets managed. This is part one of a two part blog where we’re breaking down The Top KPIs Every Palliative Care Program Needs for Managing Growth.
Understanding who you are serving (patients and providers alike) is important because it will allow you to tailor your marketing message and strengthen your relationships with similar referral partners. Developing specialty programs and serving complex patient populations will allow you to formulate your own niche and tailor your message accordingly. Leveraging data to study your patient demographic and how effectively you manage the care for different subsets of patients will help you identify and grow your niche.
As with any provider, it is important to understand your volume of referrals by provider, provider type and location to see where you have the biggest opportunities for growth.
By tracking how many referrals you get compared to how many of those referrals you admit, your referrals to admissions conversion ratio, you will be able to properly diagnose gaps in your organization to improve those conversion and grow your patient census.
Because many palliative care organizations also have a hospice line of business, tracking referrals and admissions from palliative care to hospice is another important metric for understanding how effectively you are managing the patient’s health journey.
In order to effectively manage operations within a palliative care organization, including planning and preparing for appropriate levels of staff, monitoring census, length of stay and discharges by reason are imperative.
While palliative patients may vary in visit complexity and the corresponding billing codes used, there is a dotted line between census and revenue. Effectively maintaining a consistent patient census will give you the latitude to implement systems and processes which will prepare you to scale.
Looking at average length of stay (ALOS), median length of stay (MLOS) and total patient days (ADOS) will provide a starting place for where there may be operational gaps whether that is in processes, communication or care. By further stratifying this data by diagnosis and/or other patient data, you will be able to further identify opportunities for improvement and even create new programs or processes to deliver more value.
Monitoring and understanding discharges by discharge reason will allow you to develop greater insights to the patients you serve and potentially make process changes up the line to eliminate unnecessary discharges. For example, if patients of a certain diagnosis are consistently being discharged to another provider, it may be cause for introducing a specialty program specific to that condition. Or if you have a high percentage being discharged due to death, consider the conversations that are had upstream with that patient. Could they be referred earlier? Could the evaluation possibly be enhanced to determine if they are in fact hospice appropriate making the hospice referral sooner? Or could there be more communication with the patient and family that could prompt these transitions?
When it comes to operations, data is your friend. Digging into the specifics and drilling down to subsets of data will allow you to diagnose areas of weakness so that you may start to ask questions and get to the root cause of operational breakdowns.
When it comes to billing, there are your standard billing reports such as AR Aging and Revenue vs Expenses that are essential for managing cash flow. However, with palliative care specifically, understanding the Visits by Visit Type and the CPT codes you are billing for as it relates to the complexity of your patients being served is imperative to being properly reimbursed for the care you provide.
So often palliative care teams are treating patients with multiple co-morbidities. The visits may also entail advanced care planning. It is common for the care that is delivered and corresponding documentation to support CPT codes with higher reimbursement rates. However, staff may not use the appropriate codes, thus the provider leaves money on the table. By digging into this data via chart audits or billing reports, you may identify opportunities for staff training and education to shore up any lost revenue.
To effectively manage a palliative care organization during a time where standards are yet to be defined and the regulatory landscape is shifting is tricky. It’s important to select measures that matter based on your organizational goals which will enable you to strengthen your mission. Building a data driven organization from the ground up will establish a culture of performance improvement that will serve you as regulations are formalized and required.
Curantis Solutions offers an end-to-end palliative care solution that is fully integrated with our hospice software to create a robust platform for hospice and palliative care providers.
Schedule a demo today to see how easy it can be to run an efficient palliative care program!