Business and clinical benchmarking is an essential tool to help practices stay ahead of the curve in growth, financial health, quality outcomes and patient satisfaction. Benchmarking is a process through which businesses identify potential areas for improvement by comparing their operations with other similar businesses. After all, how do you know if your performance is good or bad if you have nothing to compare it to?
On the following pages, we will take you through the process of benchmarking a cosmetic surgery practice and highlight the resources available to aid practices in comparing their operations with other practices across the country.
Let’s start with this scenario: A practice owner and a practice manager met to discuss the practice’s performance over the last two years. The owner asked the practice manager three key questions: Are we experiencing the same volume changes in procedures as other practices? Are patients spending longer than needed in pre- and postoperative areas, impacting our staffing costs? Are we getting good prices on our supplies? The manager knew that volume growth for some procedures had occurred over the past two years, but not for all. Revenue was up, but so were costs. She decided she would need to investigate further—both internally and externally—in order to answer
Where to Begin?
Internal benchmarking involves comparing practice data month to month, quarter to quarter and year to year. External benchmarking shows the gaps between your organization’s performance and the performance of other similar practices.
In the above example, the practice manager wanted to learn about procedure volume changes, supply costs and efficiency in pre- and post-procedure activities. For procedure volume, she accessed the practice’s own data from previous years as well as external statistics offered through memberships in specialty societies. To gauge efficiency in staffing and costs before and after procedures, she needed to reach out to other
1. Internal Benchmarks
The manager gathered reports on volume by type of procedure performed over the last two years, and she could see a fluctuation. Breast augmentation, for example, showed almost no growth, while hyaluronic acid filler treatments showed significant growth. Brow lift cases were flat, not showing a decrease or an increase in volume. Now she needed outside data to see if her practice’s volume changes were in line with what other plastic surgeons experienced.
After gathering information on costs per procedure and staff minutes per procedure in her own practice, she noticed that the costs per case varied among the different surgeons within the group, an internal benchmarking strategy that helped spot outliers. Based on this information, the practice manager offered two suggestions: one, streamline operations based on the protocols used by the most cost- and time-efficient surgery teams within the group; and two, purchase supplies through a smaller number of vendors for better pricing. The practice manager still did not know if they had poor pricing from vendors, poor supply management or inefficient use of staff since she had no outside comparative data.
2. External Benchmarks
For the second phase of her research on procedure volume changes, the manager looked at the most recent annual statistics from the American Society for Aesthetic Plastic Surgery (ASAPS), which provide data on volume by procedure type as well as a comparison to procedure volume from previous years. This allowed her to compare the growth in the practice’s own surgical and nonsurgical procedures to others. Specifically, it showed that breast augmentation had decreased 14.9% from 2018 to 2019, which was a larger decrease than the practice had experienced. Hyaluronic acid filler treatments were up 5% in the practice but down nationwide, according to the ASAPS statistics. And, while the practice’s brow lift procedures were flat, the ASAPS showed a 6% increase during the 2018-2019 period, but a decrease of -7.8% from 2015-2019. Now, the manager had information on the largest gaps in procedure growth and decline. Since the study also included information by gender and age, she could evaluate the practice’s local population and marketing efforts.
Comparing costs per case and staff efficiency was a harder task since very little information existed in the literature. What she could find did not give her sufficient data to gauge her practice’s performance. She needed an outside source to compare her practice’s staffing and supply expense details. To obtain this information, she reached out to other office managers across the country that she had met at educational meetings. Local competitors were not willing to share information, and she understood that issue. So, she contacted several other practice managers and, after a few conference calls, they formulated a plan for collecting information on staff hours by type of procedure in the three phases of patient care and the cost of supplies per case for six high-volume procedures. Once the data was collected, she could determine opportunities for improvement.
Sandra J. Jones, CASC, CPHRM, CHCQM, MBA, MSM, is the founder of Ambulatory Strategies in Dade City, Florida.