The COVID-19 pandemic has changed key metrics tracking revenue, production and costs, according to experts who spoke at panel session titled The 2020 LUGPA Practice and Provider Benchmarks at the LUGPA 2021 annual meeting in Chicago.
“While 2021 benchmarks won’t be published until next year, we are tracking the data to see what 2021 will show in trends. We anticipate a greater volume of revenue and work Relative Value Unit (wRVUs) from the increase in value for evaluation and management services,” said panelist Cass Schaedig, vice president of provider analytics at IntrinsiQ Specialty Solutions in Springfield, Missouri.
As we move into 2022, Schaedig said, urologists will need to be prepared for decreased revenues due to the Medicare Physician Fee Schedule conversion factor dropping 3.7% as well as the return of sequestration on Medicare payments. The 2020 benchmarks represent a study of data from LUGPA practices of all sizes around the country. The key metrics tracked include revenue, production, and cost. Practice demographics are also compiled. “The purpose of each year’s benchmarks is to allow practices to assess their performance to practices around the country,” Schaedig said.
These benchmark findings can be highly beneficial because they clearly show how practices and individual providers are performing. “A urologist can see how his or her practice is performing as well as he or she individually,” Schaedig said. The benchmarks normalize practice level data to account for varying practice sizes, “so a smaller practice can still compare their performance against larger practices.”
As a result of the COVID-19 pandemic, urology practices overall experienced a decrease in most metrics. Significant drops in patient volume and evaluation and management visits were mitigated by expanded guidelines for telehealth. “These telehealth services are typically less costly to deliver and are paid the same rate at an in-person visit,” she said.
Panelist Daniel A. Schonwald, a practice administer at Comprehensive Urologic Care, SC in Chicago, Illinois, said allowing urologists and their administrators to have insight into how their peers are performing on a wide array of metrics, from cost to productivity to coding patterns, can be quite valuable. “With profit margins becoming slimmer, the reports give an enlightened user the barometer of how they compare to other urology groups and providers, Schonwald said. “It is a gut check that can help a practice grow to or maintain peak performance.”
The biggest trends currently are the effects of the revaluation of the evaluation and management codes from 2020 to 2021 and the use of telehealth from the beginning of the pandemic. Schonwald said there was great adoption of telehealth during third quarter of 2020, but it quickly dropped off in the fourth quarter and has continued to plunge. “Telehealth can be an efficient means to deliver care in some urologic episodes of care, especially when evaluating test and imaging results. Used properly, a provider may be able to increase access for patients who are in need of treatment,” Schonwald said.
The panel session covered practice level reports focused on urologists only, telehealth metrics, and the impact of COVID-19. Panelists reported on updates to revenue and expenses. In terms of chronic care management (CCM), the LUGPA 2020 benchmarks showed that one-third of practices provided CCM. The median annual revenue per provider services was $8,636.
The next survey begins in February 2022. Clinicians can participate at any time and compare themselves to existing benchmarks from prior years.