Does Your Schedule Support Production Goals?

I might be addicted to problem solving. There is a high in finding a simple way to break down a problem and expose possible solutions. Here is an interesting case study and the solution we developed. Names and numbers are fictitious.

Problem: We are not meeting our production goals.

Doctor Z: This is so frustrating Darla. I feel like we are doing all of the right things. We establish what I feel are achievable goals for our practice. We educate our staff. There are perks and bonuses associated with reaching the target. Emails are sent out every day letting everyone know our progress.

Darla: Those are all important points. Sounds like you have put a lot of thought into this. Maybe we need go deeper to find the cause. Let’s start with some basic math. What is your average revenue per complete exam?

Doctor Z: We’d like to increase it, but historically we are at $220. These insurance carriers are killing us.

Darla: I hear that every day, but let’s hold off on the insurance discussion. I would like to define which of your appointment types correlate to complete exams. For our purpose we are defining these as appointment types that result in an exam code (92002, 92012, 92004, 92014, 99204, 99214, S codes for well vision).

Doctor Z: Here is our list, now what?

Darla: I want to run your appointment statistic report to see how many of these types of appointments were scheduled.

Doctor Z: I’m surprised as I look at this list. We only had 100 appointments last month. Wow! Look at the no shows! I feel like I am working a lot harder than this.

Darla: What was the monthly goal?

Doctor Z: The goal was $34,000.

Darla: In order to produce $34,000 with your current revenue per exam you’ll need 155 kept exam appointments. That is only one piece of our puzzle. We need to review your appointment templates to see how many complete exam appointments were available.  Well, this is interesting. Your templates show available options of 130, which is significantly higher than the 100 you examined.

Doctor Z: It looks like I didn’t even give my staff a chance. There was no way to hit that goal.

Darla: It appears that way. Were you on vacation last month? I see some days missing?

Doctor Z: I did take a few days off and I didn’t think about the impact of that. 

Here are the steps we took:

  1. Reviewed the templates and made sure we were maximizing the number of revenue spots and limiting checks where possible.
  2. Added additional appointments to each day to compensate for the high no show rate.
  3. Educated the staff about booking patients who were check type appointments in exam slots. Added some additional controls to prevent this as well.
  4. Reviewed the appointment confirmation procedures and made changes to minimize no shows.
  5. Educated staff on the importance of keeping the schedule full. Started a “same day” list for patients who wanted to be seen sooner.
  6. Created a custom report for staff to use daily to track their progress and for management to use at month’s end to measure the effectiveness of the changes. (Click on the link to the left to see more details about this report.)

You’ll be glad to hear this practice is now up 20% over the same month last year. How did that happen? They set achievable daily goals and made the staff aware of the number of complete exams required to hit the goal. They kept the schedule full and they improved their confirmation procedures. It really doesn’t matter if you are booked 3 weeks in the future. What matters is today. The next step is to work on that revenue per complete exam number!

Sample Schedule Analysis

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