Ahh, the Productivity Matrix awaits…
I ran through the first part of the questionnaire in the last post. Let’s continue on through the Productivity Matrix of the MGMA spreadsheet. Admittedly, this is the part that requires the most prep work and number crunching. But hopefully, you already have the compensation, encounter, and wRVU data requested here from your reporting sources.
Wait! Some of you now want to kill me. “It’s not that easy!” you stammer. OK. Let me just say that I’ve been in the position of trying to crunch all this data myself. It can be daunting! I fully realize, from past experience with some organizations, that many hospitals can’t provide you with accurate reports of productivity measures. And, in some cases, they could, but won’t?!? (Yep, how’s that for an alignment problem. If you haven’t seen it out there, you’re a lucky hospitalist or hospital administrator.) Many others can easily pinpoint all of the data and download it to you in a matter of hours.
Let’s just face the fact that the survey is only as good as the data provided. “Garbage in, garbage out.” If your numbers people are giving you garbage, I’d posit that you cannot complete that portion of the survey. You can complete the portions for which you have accurate information. If need be, please provide this post to the data gods at your venerable institution.
Tell them that I said, “We need accurate data on which to base difficult decisions and to make accurate judgments regarding our priorities for the future. I don’t want contrivances and guesstimates. I just want the best data we can provide to all of our colleagues be they administrators, policy wonks, bean counters, or clinicians. More pointedly, if you can’t give me accurate data on what I do Mr. Big Hospital Administrator, how can you do so for anyone else?” THH-WHACK!
Such statements at meetings generally get me kicked under the table by a partner… HARD!
Ouch. Bite lip. Whimper. I’m a quiet and composed little hospitalist again.
The PROVIDER MATRIX Walkthrough:
Column 2 – Hospitalist specific codes are 24.2, 24.3, 24.4, and 24.5
Columns 3 & 4 – See definitions in the guide. The numbers to be included are strictly defined.
Column 7 – Numbers 8, 9, & 10 reflect reality for most Hospitalists. But many still fit into 1-7.
Column 8 – Years as a Hospitalist only. Previous practice doesn’t count. (I screwed this one up last year.)
Columns 11-14 – See the first post on calculating FTEs. Do the best you can to divide time between clinical and other responsibilities. One should be able to get within 5% or reality overall, and I personally think 5% increments are close enough here. Columns 12, 13, & 14 should add up to 100%.
Column 16 – MGMA has specifically defined weeks as “total days worked per year divided by seven”. It includes clinical and NON-clinical time spent on work activities. It does NOT include vacation, sick-leave, conferences, CME, or other personal educational time.
Columns 17 & 18 – See the detailed description in the guide.
Column 19 – Hospitalists generally don’t have Technical Component (TC) revenue. If your practice does have that for hospitalist providers, it would be included here.
Columns 20-25 – See the specific definitions in the guide on reporting encounters
Columns 26-27 – RVUs have specific definitions. See the guide and the November 25, 2009 CFR applicable to CMS. (Here’s the direct link. You’ll need broadband for this 32MB CFR with 2010 RVUs file as a PDF .) Most Hospitalists think in Work RVUs (wRVUs) which are reported in Column 27. One can then go back and add in the other components, practice expense RVUs and malpractice RVUs, to come up with Total RVUs for Column 26. Most of you should use the “Non-Facility” Total RVUs for #26.
Column 29 – If PA or NP providers had their productivity supervised and billed out under the physician providers reported here, enter “1” to denote that such productivity is included in the physician’s total. If you have PA or NP providers working independently, they should each have their own row in the matrix. (If PA/NPs only report independent activity rarely to maintain NPI and billing numbers, then they are NOT reported on separate rows given nearly all of their activity falls under a supervising physician provider in the matrix.)
Finally, remember that one questionnaire and matrix should be completed for each separate hospital-based practice in your organization. Some of you will face a circumstance where some providers work at multiple hospitals. One can still report these providers entire productivity, in the matrix, as a sum from multiple work sites. However, be aware that the questionnaire sections dealing with practice revenue, financial support, number of FTEs, compensation methods, etc. will then ONLY reflect the primary hospital practice reported on the survey. In other words, numbers for provider FTEs and other areas on the spreadsheet Provider Matrix may NOT exactly match the questionnaire for the primary hospital site in this case. That’s OK. Just make sure the numbers in the matrix for providers and the answers to the questions on the web portal reflect reality for each provider in the matrix and for the primary hospital site reported on the web survey.
Also, feel free to call MGMA (877-275-6462) for help completing multiple surveys if you represent a large hospital, MSO, IDS, PPMC, or other such organization with multiple organizations in your fold. They can provide you with the multiple group survey.
Wow! One more post to go. Thankfully, we’ve already done the lion’s share of the work.