Physician Advisors - Know thy Worth!!

Deb Banerjee MD, FACP, MBA/HC, CHCQM-PHYADV

“I feel helpless!! All my fellow peers are in the throes of a pandemic and all I am doing is trying to justify a status for the patient,” lamented my partner in crime.  
I have always felt that physicians should be at the helm of health care delivery. Unfortunately, while the intricacy of giving insulin and fluids and managing electrolytes are drilled into our very core, we have in the past been left to our own resources to imbibe the business of health care delivery, a trial by fire approach. It was to rectify the status quo in a small way that I decided to become a physician advisor. Let me be a liaison between the physicians and the administration, and put our issues on a common platform, speaking the same language to achieve a common goal of exceptional delivery of health care. 
As the old adage goes, “No Money, No Mission”, I embarked on a journey to find the value of a physician advisor. We are the grease that improves the efficiency of health care delivery, and while a lot of the administrators recognized this early, remembering they all attended business classes in some form, the impetus to a physician advisor becomes greater when we as advisors know our self-worth.  
A few of the examples below give a concrete value in terms of cost savings and revenues generated, but there is a whole segment of health care delivery which when made efficient delivers the goal, despite the Paradox, “Highest Quality for the Lowest Cost.” 
Let us look at what happens when you appropriately status an inpatient from outpatient. 
Revenue from an outpatient is approximately $2,500. 
Revenue from an inpatient approximately $6,500 (at the lower end). 
Difference $4,000 with a range of 4k-8k. If there are 3,000 such conversions made in a year then revenue generated is $12,000,000. 
Denial overturn is a significant revenue generator. Every denial which is overturned generates an average revenue of about $4,000-$5,000 additional revenue. So if there are 10 denials overturned per month, it results in a revenue generation of $40,000-$50,000 per month, giving an additional revenue to the healthcare facility of close to $600,000 per year! And this is only a small part of what a physician advisor does on a daily basis. 
What about cost savings? Every time you help with improving throughput efficiency whether by improving length of stay or decreasing observations hours, it is a cost saving to the health system and helps with decreasing the cost to patients. If the average cost per bed day is between $800-$1800/day, and you are able to decrease the LOS by 0.152 days, 10,000 discharges year gives the health system a potential cost savings of between $1.2-$2.7 million. 
The above are just a few of the examples how a team of physician advisors can help add tremendous value to a health care system.  
And why is it important to show the value? Understanding the value helps with getting our voices heard amongst the policy makers, and delivery systems, and gets us a seat at that table that makes a great health care delivery system. 
Whether it is improving the case mix index through improved clinical documentation, or educating patients and their caregivers, or guiding peers into following best practice processes, or challenging existing regulations, it creates a system of healthcare delivery that is optimal for the people, by the people, made up of the people that we serve as physicians. 
So, hold your heads up high my fellow physician advisors, you are priceless. 
Dr Banerjee is a Physician Advisor at Dignity Health.