More Efficiently, and Effectively, Manage this Valuable Resource
A community Physician Needs Analysis (PNA) is a valuable asset for hospitals looking to meet the needs of their community through service line growth and physician and provider recruitment. But in order to successfully execute a PNA, you first need your physician database (or roster) to be accurate.
The details of a physician database—physician retirement dates, specialties, affiliation status, and so much more—provide a more complete understanding of what’s in your market. This database can help you answer questions such as: Where is there an oversupply (or undersupply) of physicians? What are the referral patterns of the physicians in my service area? Answers to these questions can directly impact your physician strategy.
Maintaining an up-to-date physician database can be a tedious, and often manual, process. The challenge? Collecting all the right information and ensuring that the data you have is current, since physicians are often moving or changing affiliations. In this post, we’ll share the sources we use, and strategies we employ, to make the process of maintaining an accurate physician database more feasible.
What’s Included in a Physician Database?
It’s a good rule of thumb to review and update your database every six months to ensure it stays current. A comprehensive physician database will include the following information. Additional details can be helpful as well, but consider this list to be a solid starting point:
- Specialty Group
- Name - First, Last, Middle
- Credentials - MD, DO, NP, PA
- Category - Physician, Advanced Nurse Practitioner (APP)
- Affiliation - Employed, Affiliated, Not Affiliated (based on research and assistance provided by Huntsville Hospital Health System)
- Birthdate (as provided by Huntsville Hospital Health System)
- Graduation Date
- Age (calculated by birthdate)
- Years Practicing (calculated by graduation date)
- NPI Number
- Address, City, State, ZIP
- FTE Calculation
Tips for Maintaining an Accurate Physician Roster
1. Utilize State Medical Boards AND the NPPES
The National Provider Identifier Database (NPPES) is a collection of physician NPI numbers. These numbers carry information such as the state where a physician practices, their provider type, and/or specialization. It’s required for all covered health care providers, health plans, and health care clearinghouses to use NPIs in their administrative and financial transactions, which is why this is often a go-to resource for physician database research.
Unfortunately, while this resource has great potential, if often falls short of being consistently current, as documented in this HHS study which found forty-eight percent of NPPES records to be inaccurate. Since physicians aren’t required to keep their NPI information up-to-date, this database can be incomplete or out-of-date.
Pros of NPPES:
- Includes individual physicians and organizations
- Provides specificity on physician specialty
- Provides specific provider location information
Cons of NPPES:
- There’s no incentive for physicians to keep their information up-to-date, so address information is usually out-of-date
A great companion to NPPES records are state medical boards. Since physicians have to apply to state medical boards annually, these databases are typically more reliable and include information that is missing in the NPPES.
As you review state medical boards, keep these pointers in mind:
- Some state information is free and online, while others require payment for access
- Most states will list if the information shown has been verified by the state
- The level of detail available can vary greatly by state
State medical boards often include listings of the physicians in your state who treat Medicare and Medicaid patients. They typically list the hospitals where physicians can practice and who they supervise. They also often share the current practice address, where the physician attended school, and their school specialty—all details important for a thorough physician directory.
2. Make Use Of the Base Provider Enrollment File
The CMS Base Provider Enrollment File is a point in time snapshot of enrollment level data for providers actively enrolled in Medicare.
Pros of this dataset:
- Updated quarterly to reflect market changes, so it’s usually accurate
- Provides affiliations: lists where physicians are able to accept Medicare each quarter
- Reliable physician specialty detail
Cons of this dataset:
- Doesn’t include mid-level providers
- Physicians not enrolled in Medicare will not be included
- Doesn’t include physician address detail
Over the years, Stratasan has worked with many hospital teams to help them populate or update their physician database. A commonly overlooked resource are the internal teams keeping physician records. You likely have other departments outreaching to physicians in your area and documenting valuable details. Don’t duplicate work! Over-communicate, if necessary, to ensure team alignment and utilize the resources collected by others if they align with the needs of your physician database.
Remember, there’s no substitute for local knowledge! So while outside resources are often necessary for keeping your physician database accurate, your internal team is a key source of intelligence.
A complete and up-to-date physician directory is a critical resource for hospitals looking to grow and improve their physician relations strategy. The tedium of this process, and the challenge of keeping current records, is often a deterrent to progress.
If you’re interested in updating your physician directory, in order to move ahead with a Physician Needs Analysis, click here to schedule a discovery call today. Our team of experts can help you create, or improve, your physician directory. We’ll then take inventory of the providers in your market, calculate a demographically adjusted demand model based on a weighted average of several models, and adjust for potential provider retirements. In the end, you’ll be better equipped to attract new patients, increase physician capability, and maximize in-network patient transfers.
By Morgan Atkins, Senior Director, Innovation for StratasanConnect with Stratasan on LinkedIn or follow Stratasan on Twitter and Facebook