There are two common questions every health professional asks, “How busy (productive) am I” and the corollary question “How busy (productive) should I be.” In many instances, these questions are answered anecdotally. Typically, days of heavy volume are readily recalled but, in contrast, slow volume days are less remembered.
For our healthcare application (and similar to other industries), productivity will be defined as volume (output) over time. More specifically, we will utilize encounters, or CPTs (refer to the Billing Inservice section) as the volume component. The time component can be expressed in many forms such as hours, shifts, days, months or years. Productivity can be presented with one number, a mean (or average), although the true distribution is on a continuum. View the productivity continuum as a bell graph. High and low productivity episodes occur but are less frequent and are the outliers on either end of the productivity continuum. With a sufficient data sample, the preponderance of productivity episodes occur closer to the mean and represent the high point of the bell curve.
“Productivity benchmarks” are the basis for the second question, “How busy should I be.” Benchmarks vary greatly based on the Place of Service (e.g. office, hospital, etc.), the type of service (e.g. primary care, specialist, hospitalist, etc.) and other parameters. One might estimate a primary care physician’s productivity at four (4) to six (6) encounters per hour. In contrast, a hospitalist might perform 1.5 encounters per hour. By norming activity on an hourly basis, disparate work schedules can be compared. Low productivity levels, compared to benchmarks, can indicate either underutilized capacity or inefficient activity. High productivity levels, in contrast, might indicate a practice approaching overflow and possibly unsustainable volumes.
The healthcare industry heavily utilizes Work RVUs (Resource Value Units) as a measure of productivity. Work RVUs are obtained from the Current Procedure Terminology (CPT) table as developed by the American Medical Association (AMA). CPTs define every recognized medical service (including, but not limited to exams and procedures). Also defined within each CPT are RVUs related to the provider Work component for the service as well as RVUs for Practice expense and Malpractice. Work RVUs are developed using the time necessary to complete the service along with consideration for the intensity of service. For the most part, Work RVUs are a measure of expected time for each service. The definition of the time component for the Work RVU has not been disclosed by the AMA, although time can be inferred based on CPTs that are defined by time minimums and limits.
The utilization of RVUs for productivity is a misnomer. Measuring Work RVUs in relation to time is effectively correlating two time elements. Also, the accumulation of total Work RVUs can vary materially based on the selection of different CPT code levels related to equivalent volumes. Work RVUs are predominantly a measure of intensity of service, not a measure of productivity.
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log in to utilize i.e. Practice’s volume and productivity accumulation tool to measure and benchmark your activities. We will provide blinded data to compare your activities to those of similar specialty and place of service.
