A long time ago, PCC came up with the concept of an important pediatric clinical measurement, the Sick-to-Well Visit ratio. The concept was straightforward: how could we encapsulate, in a single number, a practice’s focus on providing preventive care?
The ratio and another (intentional) use – it’s a really good indicator of the financial health of a practice. There are exceptions – queue Lynn Cramer – but unless a practice has a strong chronic disease management program in place, I can tell a lot about a practice based on this simple number.
Originally, we calculated the ratio the easy way: we added up 99201s through 99215s and divided them by 99381s through 99395s. There are all kinds of problems with this, though the results were better than nothing.
Today, we’re a little smarter. The big change we’ve made is recognizing the growth of -25 modified code usage. Obviously, when trying to measure the preventive care focus of a practice, we don’t want to count well visits with attached sick visit codes as sick visits. So, now we count all visits that have a well visit in them as a well visit (even with additional, modified E&M codes). The results are interesting. Thanks to Igor, as usual.
So, anyone want to tell me what happened on 2004?!