What propels a group practice to fifteen-fold growth? At Westmed Medical Group, in New York's Westchester County, such growth can be attributed largely to care transformation driven by analytics.
Westmed’s achievement is extraordinarily impressive. The group practice grew from 16 physicians at the start in 1996, to 250 physicians caring for more than 250,000 patients today with $285 million in annual revenue.
“The fundamental nature of our management strategy is that we do not tell doctors what to do — we show them what they are doing,” Westmed CEO Simeon Schwartz, MD, told attendees at MGMA’s 2014 annual conference on Monday.
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The group operates five large ambulatory care sites (staffed by both primary care and specialist physicians) supported by centralized back-office services such as a call center, referral management, billing, IT and regulatory compliance.
[See also: 10 ways to boost patient satisfaction.]
Following what Schwartz describes as an “industrial model of care,” management analyzes data from more than 2,200 processes and procedures to drive accountability and results in several key areas: shifting clinical tasks from physicians to nurses; streamlining workflows to enhance patient care, closing care gaps, increasing patient satisfaction, reducing unwanted testing, and maximizing the scope of practice.
Dashboards reveal strengths and weaknesses in clinical staff performance.
“That allows us to get our arms around the care process,” Schwartz said. “If a neurologist is doing twice the number of MRIs for headaches than anyone else, we now understand why that's happening and we've put in a headache approval form. We’re not basing it on up-front rules; we're basing it on outcomes.”
Westmed believes physicians are highly data-driven and tend to aggregate around doing the right thing. And productivity rises when it becomes easier for them to acquire information via disease-specific guidelines and pre-populated forms.
“Whatever checklist you put in will reward you handsomely,” said Schwartz. “We are much more operationally efficient than most organizations.”
Results bear that out. Staffing numbers for multispecialty groups across the country typically run at 5.5 to six employees per physician. At Westmed, that number was 3.91 as of September 2014.
And despite being in one of the most expensive markets in the country for labor, rent and malpractice, Westmed operates at 12.8 percent below the AMGA median for practice overhead.
“Accountability has been the hallmark of everything we have accomplished,” Schwartz summarized. “If you don't empower doctors to make them more efficient, they won't have the time to talk to patients, which is what they need to be doing in accountable care models.”