Unit 1: Essential Elements
Unit 1: Essential Elements

Section 2. Key Principles

Tracking Productivity and Performance

The bottom line in assessing the sustainability of a safety net dental clinic is that its revenue from all sources is greater than or at least equal to the sum total of all of its expenses. However, every clinical and business office activity contributes to this bottom line, so there are a myriad of measures of efficiency and effectiveness that can be made on the way to the bottom line. The only way that a clinic manager can know if a clinic is heading for success or failure is through the ongoing and systematic collection and analysis of program data.

Every clinic should develop a specific set of indicators and data elements that make the most sense for it to track over time, in order to measure changes from the baseline. Developing key indicators that measure productivity and performance for the clinic and individual health professionals is only possible if the appropriate data elements are available in a timely manner and the accuracy of the data is tested and verified on a regular basis.
Key indicators should be selected based on:

  • Available data
  • Purpose
    • Board reporting
    • Grant applications
    • Engagement, empowerment, and accountability of team members
    • Determining the impact of decision-making (changes in operations)
    • Identifying problems early
Key Data and Indicators
  • Patient visits*
    • Total
    • Per health professional
  • Gross charges*
    • Total
    • Per health professional
    • Per visit
    • Per payer type
  • Collections*
    • Total
    • Per health professional
    • Per visit
    • Per payer type
  • Broken appointments*
    • By health professional
    • By payer type (e.g., Medicaid, self-pay, sliding fee)
  • Procedures*
    • Total
    • By CDT code
    • By health professional
    • Per visit
  • Revenue*
    • Total
    • Per visit
    • Per health professional
    • Percentage of federal grant per cost center (for FQHCs)
  • Expenses*
  • Cost per visit*
  • Average length of time that the clinic is fully scheduled in advance
  • Relative Value Units*
    • Total
    • Per visit
    • Per health professional
    • Per payer type
  • Payer mix
    • By charges
    • By encounters
  • Days worked
  • Treatment plan completion rates
  • Patient satisfaction
* Monthly, quarterly, and annually

With data such as these, managers can develop a variety of key indicators specific to their dental clinic’s operation. The development of these key indicators will be impacted by the clinic’s ability to retrieve data accurately and in a timely manner. Key indicators should be calculated on a regular basis, usually monthly, but for some key indicators that require more effort related to data retrieval, quarterly may be more appropriate. Indicators should be chosen that are in keeping with the preparation of a multidimensional analysis that helps management not only understand what is happening but also understand why it is happening.