KPI development and visualization for a healthcare provider

Our client is a leading U.S. healthcare provider with a vast network of clinics across the country, for which we previously developed a data warehouse to unify data spread across multiple sources.

Based on this foundation, they enlisted our expertise to take the next step toward leveraging their data: identifying and implementing relevant key performance indicators (KPIs) and enabling their visualization through an integrated dashboard for continuous monitoring.

In response to this challenge, our team first developed a set of relevant KPIs that would provide meaningful insights into the company’s performance. We then designed and implemented a dashboard to effectively visualize and monitor these KPIs, enabling stakeholders to make data-driven decisions and identify areas for improvement.

Development of KPI categories

Our team of business analysts conducted an in-depth study of the clinics’ operations to identify inefficiencies and areas for improvement. This enabled us to identify four main categories of KPIs.

Membership KPIs

This set of metrics focuses on the total number of members in different groups, particularly those at risk. This is vital for adequately allocating resources and avoiding additional costs associated with complications and hospitalizations. Membership KPIs include:

• total at-risk membership
• Medicare Advantage (MA) membership
• other types of membership (Medicare ACO, commercial exchange, Medicaid MMA, commercial private)

Visit KPIs

To overcome visit scheduling inefficiencies, develop a better scheduling strategy, keep clinical records up to date, and reduce the number of no-show visits, we established indicators to collect data on various categories of visits and other visits-related information. Indicator examples include: at-risk and non-risk patient visits percentage of canceled visits percentage of rescheduled visits telehealth visits

Scheduling KPIs

This set of metrics was established as a solution for poor ER and hospital workflow organization. These KPIs help effectively allocate resources, control patient flow, and assist with population health management programs. Metrics included:

• new members onboarded within 30 days
• visit count of ED discharge
• visit count of hospital discharge
• number of cases when the time between visits is more than 30/45/60/90 days

Productivity KPIs

The organization has several lines of business, each with its own National Provider Identifier (NPI). We used NPI-related metrics to track the number of hours worked on each business line, as this provides valuable information on productivity and resource use. Additionally, monitoring NPIs for different business lines assists with analyzing expenses and profitability and helps keep billing and reimbursement under control. Productivity KPIs include:

• total number of providers
• MA providers
• MA provider’s days
• visits per provider’s day

Dashboard development

Leveraging Power BI, our team developed a custom dashboard to facilitate effective monitoring of the selected KPIs. We integrated the dashboard into the existing data warehouse infrastructure to enable real-time KPI visualization. The dashboard displays metrics over various periods in the form of a table, helping to analyze trends, track progress, and obtain data-driven insights.

Based on the company’s needs and problems, our business analysts selected 40 relevant KPIs. The implementation of the selected KPIs into the client’s data warehouse through an advanced dashboard allowed the business to promptly assess and improve the efficiency of its daily operations, gather accurate data for decision-making, and build a long-term optimization plan.