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How To: It's Time to Conquer Basic Rehab KPIs

Estimated Reading Time: 7 Minutes
Last Update: 1/19/2018

Rehab KPIs Part 1: Definition & Examples of Key Performance Indicators for Rehab Practices

KPIs are metrics used to determine whether you’re meeting goals for specific outcomes. They are the metrics that best illustrate progress towards that goal.

Let’s use an example to take us through this process. Imagine you’re running Anytown Physical Therapy. Your overarching goals are to:

  1. Increase profit
  2. Provide quality care
  3. Increase awareness in your community (especially your target market) about who can benefit from physical therapy

There is more than one way to increase profit. You can increase revenue while maintaining costs. You can cut costs. You can change your payer mix to favor higher reimbursements. You can effectively implement care extenders. You can add a product line. You know your company – you’re comfortable with your payer mix and making a profit on most patients, but you haven’t maxed out your practitioners’ schedules. You decide to use vacancy rate as your KPI related to your profit goals.

You figure out how many open slots you had last quarter and divide that number by your total possible appointments. You find that you have a vacancy rate of 15%. Now you will come up with strategies to bring that rate down. You measure the effectiveness of these strategies with some ROI metrics, but these are not your KPIs. These are numbers you might look at to determine the most effective strategies and double down on them. Or find strategies that aren’t working or should be eliminated. Those strategies become your standard operating procedures and you can now just monitor your vacancy rate and watch it fall. If it stagnates or reverses, revisit strategies.

The important thing is that you’re creating a data hierarchy. Once you have an effective strategy in place, you can simply take a quick glance each quarter at one number to be sure things are on track and acknowledge those folks helping to make it happen! (Common sense check: be sure as the vacancy rate drops, your profits rise. If not, start investigating and troubleshooting.)

Change is inevitable, so your strategies won’t produce forever. But you can’t do everything all at once. Monitoring your KPIs tells you where you can have the biggest impact now and where you can take a breather and let your strategies work.

Let’s look at your second goal of providing quality care. Since Anytown PT is on the cutting edge, you’re tracking outcomes and patient satisfaction. You select two KPIs, 1) Improved functional outcomes for patients in your target market and 2) improve your net promoter score (NPS). These goals aren’t very specific yet. So, you do some more research.

Your target market is worker’s comp males between 35-55 with acute lower-extremity injuries. Now you pull a functional outcomes report filtered by gender, body region, and acuity to see how well your staff has performed with this population the past year. You pull a patient satisfaction report and see that your NPS is at 93%.

Now you have benchmarks from which to set goals for functional outcomes. You decide to pursue some strategies to see how fast you think you can move the dial in one quarter. From there, you get more specific on the kind of gains you think are realistic to make.

In looking at your functional outcomes report, you find Susie Mendez is well above the national average in functional change for this group. Unfortunately, Pat Schwartz struggles with this group. The rest of your practitioners are right on target. In talking with Susie about her success, she feels it comes from integrating more shared decision making and some manual therapy courses she has been taking. So, the strategies you consider are:

  1. Privately share each practitioner’s performance and work with them collaboratively to see how they might bring their numbers up
  2. Have Susie do a weekly in-service
  3. Have Susie mentor Pat
  4. Send Pat to the courses that have worked for Susie
  5. Review the Clinical Practice Guidelines in a staff meeting to be sure everyone is up to date
  6. Start administering the Fear Avoidance and Beliefs Questionnaire (FABQ) with this population to try and identify and intervene with the people most at-risk for transitioning into a chronic condition

You decide to start with 2 and 3 to see if they have an effect. You’ll return to the others if you don’t see a change in the number in the next two quarters.

As for the NPS, there is room for improvement for both the administrative staff and practitioners. In the spirit of shared decision making, you leave the strategies for this one up to the staff and practitioners and set your goal to reach 95%. You lead a brainstorming session at the next all-staff meeting and let them have a crack at it. The more you engage and empower your staff, the better buy-in you’ll get.

Now you just have increasing awareness in your community. I think you can take it from here.

If this feels like a heavy lift, peruse the next section. What’s most important is that you start SOMEWHERE. As long as you start, you’ll begin learning and the lift won’t seem so heavy.

See how your KPI strategy fits into a comprehensive content marketing plan

Rehab KPIs Part 2: Measure the RIGHT variables or black out on foofy pink drinks

This time I’ll start with the cautionary tale. I went to a pirate-themed running event/scavenger hunt. The next day laying very still in bed, I had a great deal of time to parse out my many measurement mistakes.

I started with the usual: Quantity/time.

This got a little blurry as we scavenger hunted a bottle of Kraken Rum out of the local pond. It’s hard to measure how many ounces are in a sip, especially after the first twenty. Last thing I remember is walking into a local bar. I’m told I allowed my very corrupting friend to buy me not one, but two pink drinks. I never drink that stuff. It’s a hangover waiting to happen. Now I can’t say never…

I will gloss over the reports of the rest of the evening, but there were random tears, and professing love and appreciation to my friends, telling everyone how wonderful they were and slipping from a crappy pirate voice to a crappy Irish accent.

Here’s a comparison of what happens when you measure the right metrics and the dangers of not measuring at all.

Effective equation to determine drinking rate Effective equation to determine drinking rate

So, lesson 1 is to measure the things that will really make a difference. Only you know your practice and your community. This is a learn by doing endeavor. Start basic and learn as you go. Here are some suggestions to start with quarterly:

  1. Financials & Productivity (available through your EMR/billing)
    • Profit per visit by insurance type – pull your reimbursement rates sorted by insurer and average them for each insurer. Calculate your cost/visit. From your P&L, add your operating costs + payroll and divide them by the average number of patients per month. Now you have your cost per patient. Divide your average reimbursement per insurer by your cost per patient. Now add your top insurers to the profile of your target market.
    • Vacancy rate – take the total hours available that are NOT booked and divide them by your total available hours. 
    • Net collection rate – divide your payments by charges. If this is less than about 90%, dig deep to profile what type of patient/insurer is causing problem.
    • Denial rate – add up the dollar amount of your denied claims and divide by your total claims amount. You should be under 10%.
  2. Performance. In the coming era of value-based care, you’ll need to prove your worth in terms of functional outcomes. Why not start now, since taking data to referral sources or payer negotiations is always valuable. With outcomes software, you can also evaluate staff and treatment sites.
    • Functional change by target market by clinic and/or practitioner
    • Number of Patients seen by clinic location and/or therapist
    • Completed plans of care or self-discharge rates
    • Net Promotor Score
  3. Marketing. If you’re spending time and money, you need to know if it’s worth it.
    • Customer acquisition cost (CAC) – this is how much it costs you to get a new patient. Just add up what you’ve spent on marketing and sales and divide it by the number of new patients. If you’re running your own show, assign a dollar amount to your time and include it. Run a new marketing initiative each quarter and see if you can bump the number down.
    • Traffic from Google Analytics – visits to your website over time. Are they going up or down?
    • Referral Sources from Google Analytics – where are people coming from? Your Facebook ads? From Google searches?
    • Website bounce rate from Google Analytics – this is the percentage of people that hit your site and run away. It’s a good way to start to see if your keywords and ads are communicating properly.
    • Anything related to your specific marketing efforts like top referrers, performance of Facebook ads, sign-ups from a community outreach event, etc. If you do it, measure it.

Now every month have your staff collect and give the data to you to review. Then you bring it to the staff meeting and set at least one goal as a team!

See how your KPI strategy fits into a comprehensive content marketing plan