june 1, 2009median practice size, patient caseloads highlighted in aap report

by Dr. Rickey Renner 9 min read

Median practice size, patient caseloads highlighted in …

33 hours ago  · Survey findings show a median practice size of 3.5 full-time equivalent physicians and eight non-physician staff including nurses. Staff-to-physician ratio increases with practice … >> Go To The Portal


How does panel size affect provider performance?

Panel size can be influenced by the number of patients seen per day, the number of days the provider is available per year and the average number of visits per patient per year. For example, a provider who sees 20 patients per day, 210 days per year, with an average of three visits per patient per year, could manage a panel of 1,400 patients.

Can family physicians estimate their panel size?

Just a few years ago, only a third of family physicians could estimate their panel size. 8 Now, perhaps because more physicians are employed, panels tend to be more clearly defined. Organizations often set a target panel size and expect physicians to manage their defined set of patients.

How many patients is a right-sized panel?

For example, if you have the capacity to provide 5,280 visits per year and your panel visit rate is 2.5 visits per patient per year, then your right-sized panel is 2,112 patients — or 1,584 patients if you have accounted for nonvisit work as described above.

What happens to patients who have seen more than one provider?

Patients who have seen more than one provider are assigned to the provider they have seen most often. The remaining patients who have seen multiple providers the same number of times are assigned to the provider who performed their most recent physical or health check.

What is AAP report?

An affirmative action plan, or AAP, is a document that certain employers must prepare annually to help them identify and remove barriers limiting the employment of people in these demographic groups.

What are OFCCP requirements?

OFCCP holds those who do business with the federal government (contractors and subcontractors) responsible for complying with the legal requirement to take affirmative action and not discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, or status as a ...

What is an AAP goal?

OFCCP's Executive Order 11246 affirmative action program (AAP) regulations require contractors to establish a placement goal for a particular job group when it is underutilized – that is, when the percentage of women and/or minorities is less than would be reasonably expected given the representation of women and/or ...

What is an example of an affirmative action plan?

Affirmative action aims to right historic wrongs by favoring defined groups of individuals that were discriminated against in the past. For instance, a company might post jobs in areas with high numbers of minority job seekers to reach these under-represented candidates.

What are the key components of an AAP?

By taking a deeper look into the essential components of a successful and complete Affirmative Action Program, you can decrease your risk of non-compliance and transform your AAP into a strategic asset....AAP Planning Process and Technology. ... Good Faith Efforts. ... Employee Awareness Training. ... Adverse Impact Analysis.

What is OFCCP compliance check?

A compliance check is a type of compliance evaluation in which OFCCP seeks to determine whether the contractor has maintained certain records: prior year AAP results, job advertisements (including state employment service listings), and examples of accommodations for individuals with disabilities.

What is AAP compliance?

An Affirmative Action Plan uses statistical analyses to ensure that an employer has created or is creating a workforce that is an authentic reflection of the demographics of their relevant, qualified labor pool by providing specific protected classes; including minorities, veterans, women and people with disabilities; ...

What are the four goals of affirmative action?

Historically and internationally, support for affirmative action has sought to achieve goals such as bridging inequalities in employment and pay, increasing access to education, promoting diversity, and redressing apparent past wrongs, harms, or hindrances.

Do I need an AAP?

You must develop an affirmative action program (AAP) if you have 50 or more employees and at least one contract of $50,000 or more, under Executive Order 11246 and Section 503 of the Rehabilitation Act of 1973.

What are the three elements of an affirmative action plan?

An affirmative action plan or program under this section shall contain three elements: a reasonable self analysis; a reasonable basis for concluding action is appropriate; and reasonable action.

What are affirmative action requirements?

Affirmative action requirements are intended to ensure that applicants and employees of federal contractors have equal opportunity for recruitment, selection, advancement, and every other term and privilege associated with employment, without regard to their race, color, religion, sex, sexual orientation, gender ...

What is the 80/20 rule in affirmative action plan?

The rule states that companies should be hiring protected groups at a rate that is at least 80% of that of white men. For example, if a firm has hired 100 white men in their last hiring cycle but only hired 50 women, then the company can be found in violation of the 80% rule.

What is the difference between EEOC and OFCCP?

OFCCP's mission is to work with federal contractors to proactively promote equal employment opportunities while the EEOC's mission is more reactive, investigating individual claims of discrimination.

What is the meaning of OFCCP?

the Office of Federal Contract Compliance ProgramsThe mission of the Office of Federal Contract Compliance Programs (OFCCP) is to protect America's workers by ensuring nondiscrimination and supporting voluntary compliance by federal contractors and subcontractors, promote diversity through equal employment opportunity, and enforce the law, with a particular emphasis ...

What is OFCCP audit?

The OFCCP monitors whether federal contractors are complying with their contractual affirmative action obligations. As an enforcement agency, it can check compliance through a compliance review process, otherwise known as an OFCCP audit.

What Does Executive Order 11246 require?

Executive Order 11246 requires affirmative action and prohibits federal contractors from discriminating on the basis of race, color, religion, sex, sexual orientation, gender identity, or national origin.

WHAT HAS CHANGED ABOUT PATIENT PANELS?

Since the last two panel articles were published in FPM in 2007, 6 – 7 we have seen a reemergence of interest in the topic. However, the focus has shifted from estimating panel size (i.e., the specific set of patients for which a physician is responsible) to adjusting panel size for patient acuity and workload complexity.

THE FOUR-CUT METHOD FOR PATIENT ATTRIBUTION

Patient panels have to be both accurately attributed and right-sized. 4, 13 In this first step (attribution), each patient must be assigned to only one primary care physician or advanced practice provider (i.e., one clinician in a like category).

THE RIGHT-SIZING PROCESS

While attribution reveals the size of the current panel, right-sizing shows what it should be. Once you complete the four-cut method for patient attribution described above, you can then use the panel-size spreadsheet to compare your current panel to the right-sized panel.

A PRACTICAL APPROACH TO PANEL ADJUSTMENT

The desire for panel adjustment relates to both patient visit acuity and nonvisit workload complexity. Acuity and complexity are euphemisms for more work. If the sum of visit and nonvisit workload is intolerable, the conclusion is that the panel is too large and requires adjustment. 4, 13 – 18

IN PURSUIT OF A MANAGEABLE WORKLOAD

Physicians want a fair panel size where the time required to care for their patients is manageable, given their capacity to complete the work. Accurate methods for panel attribution and adjustments for patient acuity factors and nonvisit complexity must be used.

Why is it important to define a panel?

Establishing which patients are assigned to which physicians in the practice is important for a number of reasons:

What is the current panel size?

Panel size is simply the number of individual patients under the care of a specific provider. Panel size is easiest to determine in practices that can use enrollment data to link patients to individual providers and capture that linkage in their information system. This is most feasible in “closed” systems, such as some HMOs.

What should the panel size be?

Practices and individual providers should not take on more work than they can manage. If a panel is too large, the excess demand results in a never-ending and ever-expanding delay in services in addition to constant deflections to other providers, resulting in discontinuity.

What are the limits to panel size?

There is a limit to practice and individual panel sizes. If a practice or individual provider keeps saying “yes” to new patients and exceeds the limit, the overage can initially be absorbed into a waiting time. However, patients' willingness to wait has a limit. At some point, patients quit.

What do you do with an over-paneled provider?

Once a provider's individual panel has been identified and all strategies for adjusting the panel have been dutifully applied, it might be found that the provider is indeed “over-paneled.”

The bottom line

There is a limit to the number of patients each provider can effectively care for. That limit depends on the system in which the provider practices, but it can be defined using the methodology described in this article. Having an appropriate panel size is key to managing clinical workloads and optimizing patient access to care.