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?!