Using non-physician providers (NPPs) can be an effective way for practices to prepare for the expected influx of 30 million new patients receiving health care coverage through the Affordable Care Act’s new Health Insurance Marketplaces and expanded Medicaid programs. But, for the use of NPPs to work, you must benchmark NPP performance by identifying performance metrics that reflect your practice’s critical success factors and then using these metrics to set goals and measure progress toward them.
In a typical practice, NPP performance metrics fall into five categories:
1. Day-to-day practice. Does the NPP meet deadlines? Is he or she up to date and accurate with charting and dictation? Are billing forms completed promptly and fully? Does he or she prepare effective referral letters and other correspondence?
2. Practice development. How effective is the NPP at attracting new patients and retaining existing ones? Is he or she a source of ideas for practice improvements, and willing to assist with administrative matters?
3. Practice style. The ideal is a strong, production-oriented work ethic. Does the NPP work efficiently, being sensitive to the cost of resources he or she utilizes? Does he or she demonstrate enthusiasm and flexibility during the daily work routine?
4. Clinical performance. The NPP must have appropriate knowledge and skill, and maintain them through continuing education. Can he or she ensure patient compliance with directives and coordinate care effectively?
5. Interpersonal skills. Does the NPP interact well with patients, clinical staff, management, referral sources, vendors and suppliers?
All of the above characteristics should be measured objectively — quantitatively whenever possible, otherwise qualitatively.
The Medical Group Management Association (MGMA) has looked at the deployment of NPPs by physician practices and collected data that can help you benchmark effectively. Among the MGMA’s members, there’s an average of 0.31 NPPs for each full-time physician, with NPP costs of 4.05% of practice revenue and total provider (NPP and physician) costs of 41.75% of practice revenue. See the chart “Key practice metrics involving NPPs” for more metrics you can use for benchmarking.
Focus on the numbers
The best-managed physician practices employ NPPs. To get the greatest benefit from them, thoughtfully supervise their performance using appropriate benchmarks.
Key practice metrics involving NPPS
|Median||Nurse practitioner||Physician assistant|
|Work RVUs||2,692 wRVUs||3,180 wRVUs|
|RVUs||5,730 RVUs||6,139 RVUs|
|Salary||$93,977||$92,635 (primary care)|
Source: 2013 MGMA Physician Compensation and Production Survey
For more information on this topic or with any questions, please contact Darrin Spitzer at [email protected]