Confessions of a Pediatric Management Consultant... Where fame and fortune await those who help keep pediatric practices alive and independent!

Brief Explanations!

Written by Chip Hart | Jan 22, 2008 4:38:16 PM

Gosh, a guy makes a couple statements in a blog and now people actually want him to explain the numbers so that they make sense. There's no satisfying the mercurial reader any more. My word isn't good enough?

Actually, my apologies for some confusing data. Let me explain yesterday's post in more detail and, perhaps, add some information. Igor and Susanne Madden pointed out that I accidentally cut off the Y-axis label/Title (d'oh!), which makes it confusing.

I decided to measure the average E&M reimbursement for PCC clients in a different manner than Physician's Practice for a variety of reasons.

  • First, they use absolute dollars and not a specific year as a yardstick. I think this makes it difficult to actually gauge any changes in relative terms without looking closely at the graph (and then guessing what the values really are) and then doing some math in your head.. If you look at their first graph, for example, Middle Atlantic seems to have gone from a $90 to a $70 average E&M payment, more-or-less, from 2004 to 2007. Wouldn't you rather know that this is a 28% decrease? I would, I guess.
  • Second, from what I can tell, PP doesn't take the code volume into account. That is:
CPT Volume Reimbursement
99213 10000 $100
99215 10 $500

...is the average E&M reimbursement here about $100.39 or is it $300? I say it's $100.39, and I think PP lists it as $300.

Therefore, the numbers from yesterday look at overall "average E&M reimbursement" and use 2004 as a base year for measurement. In our data, the Middle Atlantic group has seen their E&M reimbursement improve 16% since 2004 (vs. an estimated 28% decrease in the PP data).  I also took some care to make sure that the scale of our graph resembled theirs so that, even though we measure things differently, they approximate a similar message with different results.  The bottom line?  PP continues to measure a downward trend in E&M reimbursement and we measure an upward one.  Which is correct?

I've updated the graph so that the explanatory title is back.

More in a bit.