Practice Notes

3 data-driven insights on designing the optimal care team

by Virginia Reid and Rachel Woods

Medical groups have long hypothesized that an expanded care team can improve financial and operational metrics while supporting patient care. And while there are countless case studies highlighting the success of team-based care, objective analyses that examine the benefits of adding additional care team members are few and far between.

Explore the benchmarking data collected this year with our Integrated Medical Group Benchmark Generator

To address this gap, we analyzed data collected from 15,000 providers in our Integrated Medical Group Benchmark Generator. Our research quantified the impact that one additional clinical support staff member—either an MA/LPN or RN—had on advanced practice provider (APP) and physician wRVU productivity, visits per year, and yearly provider revenue.

As suspected, our data shows that building out the care team creates ROI for the medical group. Across the board, deploying more MA/LPNs and RNs in primary care leads to gains in physician and APP productivity, revenue, and volumes. Interestingly, however, our data reveals that the key to getting the most ROI from the care team varies depending on the specific care team member and the medical group's business model. Looking at the data, we uncovered three insights on getting the biggest bang for your buck when it comes to deploying MA/LPNs, RNs, and APPs.

1. APPs: Position APPs as providers—and provide them with the same clinical support staff as physicians

The data: Deploying MAs/LPNs to support both APPs and physicians in primary care led to a $100,000 to $150,000 increase in provider (physician and APP) revenue.

Our analysis: This revenue growth is about twice the increase we saw when MAs/LPNs supported physicians alone. This increased ROI speaks to the value medical groups can tap into when they deploy APPs as autonomous providers alongside physicians. Allocating MAs/LPNs to support APPs and physicians allows both providers to work at top-of-license and generate more revenue for the medical group.

Your next steps: Harness this potential revenue growth by deploying APPs as autonomous providers and supporting them with clinical staff—just like physicians. In practice, this means deploying, training, and managing APPs at scale, as well as involving them in group governance.

2. MAs/LPNs: Deploy MAs/LPNs to boost care team productivity under fee-for-service

The data: In primary care, adding one additional MA/LPN led to an increase of 900 to 1,000 wRVUs per provider.

Our analysis: MAs/LPNs serve as the provider's right hand during the visit and are key to shepherding patients through the visit. Not surprisingly, deploying more MAs/LPNs is associated with higher provider productivity—twice that of staffing an additional RN.

Your next steps: If your medical group is in a predominately fee-for service environment, or if increasing productivity is your primary goal, there's a strong use case for building out your MAs/LPN workforce. Ensure they are working at top-of-license by reallocating tasks across the care team—and potentially invest in hiring additional MAs/LPNs.

3. RNs: The business case for using RNs strengthens as medical groups take on more value

The data: In primary care, adding one additional RN generated a $75,000 to $125,000 increase in yearly revenue for providers.

Our analysis: While MAs/LPNs generate more productivity and visits, RNs support a different-in-kind business need. Deploying RNs is associated with revenue growth because they often take on tasks that are below top-of-license for physicians. This results in time savings for providers that allow them to focus on more lucrative clinical tasks. Although these short-term revenue gains are important, groups stand to make the most of their RNs long-term by positioning them for value-based care.

Your next steps:  As the medical group takes on more value, flex your RNs into care management roles. RNs should spend more of their time on population health-focused tasks—including annual wellness visits, patient education, and chronic care management—to help the medical group meet its quality and total cost of care goals.

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A scalable APP model has four components. Each component plays a critical role in ensuring the harmonious use of APPs within your medical group.

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