Key Performance Indicators in Healthcare

The current healthcare landscape poses unique revenue challenges for small-to-mid-sized practices and outpatient facilities. Key performance indicators (KPIs) can fill in important pieces of the revenue puzzle while also giving you the insights necessary to optimize patient journeys. 

However, step one to using key performance indicators in healthcare involves identifying which metrics to track. Here’s everything you need to know about key performance indicators in healthcare so you can determine the data points that are most relevant to your business.

What Are Key Performance Indicators (KPIs) in Healthcare?

Key performance indicators in healthcare are quantifiable measures that you can use to evaluate different aspects of your practice’s performance. Each data point can help you identify areas for improvement and implement new strategies to better serve patients. Key performance indicators in healthcare also let you track your progress over time.

Top Healthcare KPIs for Small-to-Mid-Sized Practices

What are the important key performance indicators in healthcare? Examples of crucial healthcare KPIs for small-to-mid-sized practice include:

Financial KPIs

Important financial metrics you should track include the following:

• Net Collections Rate: Assesses the percentage of your potential revenue that you actually collect
• Denial Rate: Tracks the percentage of claims that payers deny
• Cost to Collect: Calculates how much money you spend on collection efforts, including calling patients and filing appeals
• Revenue Per Patient Visit: The average revenue you generate per patient visit
• Days in Accounts Receivable (AR): Tracks the average number of days it takes to collect payment

Roughly 50% of healthcare leaders consider timely patient collections to be their organization’s biggest revenue cycle management challenge. Cumulatively, the financial KPIs outlined above can help you better understand and optimize your revenue cycle.

Operational KPIs

Operational metrics help you gauge the overall efficiency of your organization. Some data points to watch include the following:

• Claim Processing Time: Calculates the time taken to process and submit claims
• First-Pass Resolution Rate: Gives the percentage of claims resolved/paid on the first submission
• Appointment No-Show Rate: Tracks missed appointments and helps you identify trends that may impact revenue, such as a high no-show rate
• Staff Productivity: Evaluates the number of patients each staff member sees or how many tasks they complete
• Patient Flow Efficiency: Analyzes patients’ progression through the care process to identify and eliminate bottlenecks

Use these data points to identify what you are doing well and how you can get better. For example, if you see a sudden jump in no-show rates, you need to figure out why. To do that, you can look at metrics like patient flow efficiency to determine whether long wait times are causing patients to skip their appointments.

Patient Experience KPIs

The patient experience can be tough to measure. However, it is possible with the use of metrics such as:

• Patient Payment Compliance: Monitors the percentage of people who pay their estimated costs on time
• Patient Satisfaction Scores: Gathers feedback from patients via surveys to better understand their satisfaction levels
• Average Patient Wait Time: Tracks how long patients wait in waiting areas and exam rooms
• Follow-Up Care Compliance: Assesses the rate at which patients adhere to recommended follow-up care

The better the patient experience, the higher your odds of achieving positive outcomes and stable revenue.

Compliance KPIs

The most common compliance-related healthcare KPI examples include the following:

• Good Faith Estimate Accuracy: Ensures that the estimates you give patients are accurate and compliant with the No Surprises Act
• Audit Success Rate: Tracks the outcome of internal or external audits
• Regulatory Compliance Score: Tracks your adherence to payer or federal requirements for claims and billing

Compliance is an integral component of healthcare. Without a strong compliance posture, your organization is at risk of fines and other penalties from regulators.

Common Challenges Practices Face With KPI Tracking

Small-to-mid-sized practices often encounter obstacles in tracking effective KPIs. Some hurdles you should be aware of include the following:

• Data Fragmentation: Disparate systems can make it difficult to access and centralize performance data
• Lack of Resources: Limited staffing may hinder dedicated analysis tasks
• Regulatory Complexity: Tracking performance while complying with industry regulations adds to your administrative burden

Technology partners like Rivet Health can help ease these challenges by providing revenue cycle management (RCM) tools for your healthcare practice. Explore our library of ebooks and download one today to learn more about the value of RCM tools in KPI tracking.

How to Effectively Track Healthcare KPIs

To track key performance indicators in healthcare, you’ll need to:

Leverage Technology

Tools like Rivet Health’s Revenue Diagnostics platforms offer a real-time glimpse into your income. You can explore revenue data on your terms and obtain granular insights to promote steady cash flow.

Integrate Systems

You’ll also need to tear down data silos by integrating your KPI tracking tool with your existing electronic medical record system. Rivet Health readily integrates with EMR/EHR systems, making it easy to unify your data.

View an on-demand webinar or sign up for an upcoming live webinar with Rivet Health. You can learn more about how our solutions will help you unleash the power of your data. 

Set Benchmarks and Goals

One of the main benefits of KPI tracking in healthcare is that it allows you to measure your progress toward key organizational goals. However, it’s vital that you set realistic targets based on the size of your practice and your specialty. Setting overly ambitious goals can crush morale and leave you chasing unattainable performance thresholds.

Best Practices for KPI Optimization in Healthcare

As you integrate KPIs into your business strategy, make sure that you focus on metrics that directly influence cash flow and patient care. These categories of metrics are the most useful for driving meaningful improvements. 

Educate your team on the importance of KPIs and how they can help you serve patients better. When everyone understands the benefits of your initiative, they will be less prone to resistance. Lastly, conduct periodic reviews of your KPIs to assess the organization’s progress. Take steps toward solving any problems you’ve observed.

Simplify Healthcare Performance Measurement With Rivet Health

Effectively tracking key performance indicators in healthcare is critical to the long-term success of your organization. By leveraging solutions like Rivet Health, you can measure metrics that matter and better serve your patients. 

Schedule a demo with Rivet Health to unlock the power of healthcare KPIs.