30 Mar Important KPIs You Need to Measure for Behavioral Health

Whether yours is a for profit or nonprofit facility, behavioral healthcare is ultimately a business. Your facility needs to operate in a financially responsible manner and pay its expenses based on revenue. It also needs to achieve its mission and provide excellent outcomes for its patients.

While behavioral healthcare traditionally followed a fee for service model, this is rapidly changing. The industry is increasingly moving to value based payments in which insurers pay for successful outcomes. There is also a lot of competition, especially as states have started to hire managed care companies to run programs such as Medicaid. To retain your contract, you must be able to show your success.

The Importance of KPIs

How do you know if you’re doing a good job, and how can you demonstrate success? KPIs, or key performance indicators, are an objective, quantifiable way to measure outcomes over time. Operations and finance go hand in hand, with strong operations leading to good financial outcomes. For example, increasing the number of patient rooms in use brings in more revenue while better utilization of staff members lowers costs allowing you to invest in your agency and better achieve your mission. 

Likewise, poor financial metrics can indicate a problem with operations. If you aren’t reaching your financial goals, you need to be able to analyze your operational metrics to find out why. Therefore, it’s important to measure both operational and financial KPIs simultaneously.

Sample KPIs

Behavioral health businesses come in many forms, so the first step is to identify which unit is most important to you. It might be the number of beds that are filled in your agency, the total number of cases you have in your outpatient clinic, or the number of patients you see each day in your private practice. Whatever that unit is, you need to know the cost per unit and how much revenue each unit brings in.

Likewise, you need a clear picture of how much each piece of your operation costs. For example, what is your customer acquisition cost? How much do you spend on marketing to acquire the number of customers you desire? If yours is an inpatient facility, the amount of time you can keep a patient is most likely limited by managed care. How much money do you need to spend and how should it be allocated to achieve your desired outcomes in that time period?

To get the answers to these and many other questions that may be relevant to tracking your facility’s success, here are just a few KPIs you may want to track.

Operations

• Patient Wait Time
• Average Number of Patient Rooms in Use
• Staff-To-Patient Ratio
• Bed or Room Turnover
• Care Team Communication
• Overall Patient Satisfaction
• Internal Trainings per Department
• Incident Reports
• Medication Errors
• Patient Follow-Up

 
Finance

• Average Insurance Claim Processing Time and Cost
• Claims Denial Rate
• Average Treatment Charge
• Employee Wages
• Number of Partnerships

 
Data Pipelines

Once you have identified and started measuring specific KPIs, you can use them to track and analyze targeted data pipelines. Examples include, but are not limited to:

• Treatment: How much does it cost to treat the average patient, and are you achieving the desired outcomes?
• Hospital Readmission Rates: How many patients come back after discharge, and how can you improve this number?
• Patient Satisfaction: How satisfied are your patients, and what factors affect their satisfaction?
• Patient Safety: Which incidents are occurring in your facility, and how can you prevent them?
• Costs by Payer: How do different health insurance companies affect the rates you receive for each patient and each type of treatment, and is there an impact on treatment outcomes?

 
How an EHR Can Help

A robust EHR should be able to track every KPI you select, making it easy for you to analyze the relationship between outcomes and costs. For instance, you can negotiate a new contract with a managed care company or other payer if you can demonstrate that you need more funding to achieve the desired results. Your EHR should be able to do all the calculations to simplify the process for you. If you are over budget, detailed analysis can help you pick and choose where to focus based on the outcomes you want to achieve.

A particular challenge in substance abuse treatment is the high relapse rate. On average, patients in outpatient programs fail four times before finding success. An EHR can track your treatment methodology with each patient, demonstrating new techniques and continual improvement over multiple programs. 

Make sure the technology you use is able to support evolving, value-based and evidence-based behavioral healthcare. If it does not, it may be time to look for a new solution.