Many medical practices make the mistake of tracking only financial performance. To be sure, a medical practice will not be able to continue its important clinical work without assuring financial health. But focusing on finances alone only gives you a singular snapshot of your practice’s performance. What if quality outcomes are not at their level best? What if service is out of sync with patient expectations, causing patients to seek out other options for their care? Remember in today’s environment, quality is becoming as important as Quantity.
Quality measures are becoming the norm, as medical practices align for accountable care and value-based purchasing. Most practices use evidence-based clinical protocols and measure patient outcomes to ensure quality care. Obviously, these are important to measure for your practice. However, there is a single quality benchmark that is applicable to all specialties: the number of avoidable emergency department visits and hospital admissions. This measure allows you to assess the quality of your patient access and continuity of care efforts. This measure is now receiving scrutiny by payers, who are expecting medical practices to extend 24/7 access and care outreach to patients, thereby providing care in less costly venues.
Preventable or possibly preventable emergency department visits and hospitalizations include those that involve ambulatory care sensitive conditions that could have been managed in the outpatient setting; these include asthma or diabetes. Avoidable hospital admissions also include patient readmissions within a defined period.
Take a sample 1-month period and calculate the number of emergency department visits and admissions that were avoidable or potentially avoidable. Action Plan: If your practice has a high level of preventable visits and admissions, create a quality plan to expand patient access, care outreach, continuity of care, and transition management. Track this benchmark over time by sampling your data on a quarterly basis, with the goal of reducing your practice’s rate to zero.