Financial Optimization Briefs
For Physician Practices
https://www.mgma.com/articles/financial-optimization-for-physician-practices-assessment-and-improvement-opportunities
The following 12-part series is focused on optimizing medical group financial performance. Each brief in this series takes 2 to 3 minutes to read and identifies specific actions medical groups can take to achieve sustainable financial improvements.
Please make an opportunity to read these briefs and use this information to move forward in your quest for financial strength and sustainability.
1. Improve Contract Rates:
a. Assessment: Recurring contract negotiations with payers are necessary to make sure you are receiving appropriate rates for your services. Multiple factors play into the success of these negotiations, including the payer’s and the provider’s market leverage. Provider operational excellence demonstrated in service and quality metrics typically lead to greater market leverage and improves your negotiating position. An assessment of this opportunity involves comparing commercial carrier allowable schedules to Medicare rates. Each group of services; E&M Visits, Medicine Services, Surgical procedures should expect to see different percentages of Medicare. These rates will also vary by geographic region. Accordingly, an accurate evaluation of the magnitude of this opportunity will require a good understanding of your market and your service mix. Also, some commercial payers do not provide allowable schedules. In the absence of these schedules, the assessment will involve subtracting contractual adjustments from charges to identify allowed amounts. Under this second type of analysis, you must insure you have a disciplined revenue cycle accounting system where only allowable based reductions are coded as contractual adjustments.
The amount of this opportunity can be projected by identifying the percent of Medicare allowed for each service group and comparing it to industry benchmarks. The percent difference multiplied by the total allowed charges in each service group will identify the revenue opportunity for each commercial payer.
b. Improvement Action: Initiate contract negotiations with each commercial payer where there is a revenue opportunity. The projected opportunity level for each payer should help in setting priorities for the contract negotiations. Determining the magnitude of opportunity for each payer and the commercial payer mix are the first steps in preparing for these negotiations. You must also understand your market leverage relative to the payor’s. Additional preparation steps include agreeing on a range of acceptable results, establishing your negotiating tactics, and agreeing on how far you will take the negotiations to achieve your goals. You must make sure you have sufficient managed care resources within your own administration or from the hospitals with whom you are affiliated to successfully conduct these negotiations. If not, there are a few vendors that provide this service who likely have better insight into appropriate contract rates.
2. Insurance Revenue Cycle Management:
a. Assessment: Flawless revenue cycle management is essential for financial sustainability. Success in revenue cycle management is dependent on the effective execution of a wide scope of functions before, during and after the episode of care. These functions include provider credentialing, registration and authorization, time of service payment resolution, coding and documentation, charge posting, and claims management.
The insurance net collection rate is the outcome metric utilized to assess this opportunity. This metric is equal to the amount collected divided by the amount you expected to collect based on contractual allowables. If you do not know your allowables you can approximate these values by subtracting contract adjustments from gross charges. In order for this approach to work you must insure only allowable based reductions are considered in contractual adjustments.
A conservative value for the revenue opportunity on this factor can be identified by subtracting the actual insurance net collection rates from 98.5% and multiplying the difference by the total insurance portion of allowable payments.
b. Improvement Action: A data driven approach is required for effective revenue cycle management. Goals should be established on basic revenue cycle metrics including net collection rates at 180 days, denial rates, charge lag days, percent of accounts receivable (AR) over 90 days and days in AR. More detailed analysis is required on each of these metrics when goals are not being met to determine the cause of “below standard” performance. Only by understanding the cause will you be able to pursue an effective solution. For example, denials may be due to flaws in credentialing, missed authorizations or coding errors. Each of these errors require a different solution.
A first key step toward developing a flawless revenue cycle management system is conducting a Supply-Input-Process-Output- Customer (SIPOC) analysis of the internal revenue cycle process. The SIPOC analysis will identify the inputs and outputs required by each participant at each step of the process to have a flawless service. Next, the SIPOC analysis will support the collaborative establishment of Service Level Agreements (SLAs) between revenue cycle participants, including the clinic departments, access services and the billing office. In these SLAs, each department should commit to the standards, roles, and responsibilities necessary to optimize every operational interface (handoff) between the departments. The participants must also agree on disciplined systems to continuously identify reasons for substandard performance each month and then hardwiring system fixes that prevent further errors. Adopting the principle of stopping to fix problems is an essential element in achieving flawless revenue cycle management.
3. Personal Pay Revenue Cycle Management:
a. Assessment: There are two groups of patients covered within this opportunity. The first are patients with insurance who owe a share of the fees through co-pays, deductibles, and co-insurance. The second is the self-pay patients who have responsibility for the total fee. Establishing a functional personal pay net collection rate metric for both groups of patients will depend on the organization’s financial resolution system. Based on best practices, payment expectations should be established for patients prior to receiving services and, if applicable, the patient should also be offered a pathway to seek financial assistance. Under this optimal system each patient’s net collection rate would equal the amount collected divided by the cumulative amount agreed to during the financial resolution process.
A conservative value for the revenue opportunity on this factor can be identified by subtracting the actual self-pay net collection rates from 92% and multiplying the difference by the total expected patient net revenue (direct personal pay plus charges transferred to patients)
b. Improvement Action: Patient financial resolution should be made a pre-service requirement when possible. Pre-service resolution provides for price transparency and sets payment expectations for the patient prior to receiving services. As a first step, make sure policies and procedures for physician service payments are addressed in the Organization’s Financial Assistance Policy. Next, establish standard processes for the pre-service assessment of patient insurance and benefits, projecting the services to be provided and the patient’s costs for those services. You must also develop policies and procedures for agreeing with patients on payment amounts and methods. Clear pathways for helping patients to seek financial assistance must also be established. With the above system in place the clinic managers should set performance standards on daily Time of Service (TOS) payments and monthly patient collections. To meet these standards daily TOS and payment plan goals should be established in advance by reviewing the patients, their balances, and the expected services to be provided each day. Next, variations in actual performance compared to the goals should be evaluated and serve as individual performance factors for your registration staff.
4. Improve wRVU per Encounter:
a. Assessment: Compare wRVU per encounter to MGMA benchmarks for each specialty. If your practice is below benchmark on this ratio there are two possible causes. One cause is under coding and/or inadequate documentation. This problem is particularly evident for E&M encounters as you can compare the percentage of visits at each level to MGMA benchmarks. A second cause is a service mix that is less intensive than your physicians’ peers. This intensity differential could play out in a higher proportion of visits to procedures or a procedure mix that generates a lower value of wRVU’s per case.
The amount of opportunity on this factor can be determined by calculating the difference between the actual wRVU per encounter and the MGMA benchmark for each specialty and then multiplying that value by the number of encounters. Next, multiply the total WRVU shortfall by the dollar collected per wRVU to identify the additional revenue opportunity for each specialty.
b. Improvement Action: Improving a low wRVU per encounter ratio first requires identifying the cause. If the cause is driven by coding and documentation issues the corrective action will involve focused coding and documentation audits to address those providers generating below benchmark ratios. These audits can be conducted by in-house coders if your organization has the required resources and expertise. Alternatively, several vendors offer this service.
Improvement actions are more complex if the cause of the low wRVU to encounter ratio is driven by a less intensive service mix. Determining your improvement actions will require a deeper dive to get to the root cause. Areas to investigate for surgeons and proceduralists may be their utilization of advanced care practitioners (APCs) to perform screening and post-op visits. Utilizing APCs in these roles will improve the physician’s wRVU per encounter if there is sufficient demand.
A second area for surgeons is the percentage of their workload coming from the emergency department compared to specialty specific benchmarks. Studying the Emergency Department’s outsourced rates and developing mutually beneficial working relationships between the Emergency Department and specialty physicians are potential corrective actions for low emergency department referrals. Other factors having an impact on service mix are market demand and competition. Market development and primary care physician outreach activities are steps to increase physician and patient awareness of the organization’s physician expertise. Each physician’s scope of practice may also be a determinant of wRVU per encounter. The provider compensation system should address this factor. In summary, once the causal factor has been identified the organization will be better able to deploy the strategy that most appropriately addresses the problem.
5. Encounters per Provider/Provider Production:
a. Assessment: An evaluation of provider production should include a comparison of both encounter volume and wRVU generation against industry benchmarks. Revenue opportunity number 4 addressed instances where encounters are meeting benchmarks but wRVU are not. The second revenue opportunity occurs when both encounters and wRVU fall below the industry benchmark.
The production-based revenue opportunity is determined by identifying each provider’s encounter shortfall from the organization’s specialty specific volume goals per provider full time equivalent (FTE) and then converting that encounter shortfall to wRVU shortfalls by using the actual provider’s wRVU per encounter ratio. Multiply the wRVU shortfall by the provider specific actual net revenue per wRVU to calculate the revenue opportunity per provider.
b. Improvement Action: The cause for a performance shortfall around this opportunity must be identified before establishing a solution.
A first step in seeking the cause will be to assess each provider’s time committed to direct patient care. A standard for comparison is typically no less than 36 hours of direct patient care per week for each full-time provider. The time assessment can be completed by reviewing the provider’s schedule template. The organization should get physician leadership consensus on this time standard to have an effective solution. With that standard in place the physician specialty leaders can work with the applicable physicians and their staff to expand schedules.
The next step in seeking the cause will be to identify the average number of weekly patient encounters scheduled to the provider. Benchmark variances found in this step can be attributed to several factors, including limited demand, restrictive scheduling, above average times per encounter and a high intensity service mix. Limited demand may be addressed through market development and referring physician outreach activities. If these activities do not generate the needed volume, actions to right size the physician enterprise may become necessary. Restrictive scheduling and extended encounter times can be addressed through provider-to-provider counseling and through compensation arrangements. The last factor, high intensity encounters, should take care of itself as the wRVU generated per encounter in a high intensity service mix should exceed the benchmark.
A final step in the assessment will be to identify the actual average encounters per week completed by the provider. Excessive no shows are typically the problem source when scheduled encounters meet the benchmark, but actual encounters do not. No shows can be effectively reduced through an in-depth analysis to identify the characteristics of the high no-show populations and then conducting focused pre-service calls to address those specific populations. Another reason for a low actual to scheduled encounter rate may be excessive clinic or encounter cancellations directed by the provider. As with restrictive scheduling this problem is addressed through provider-to-provider counseling and through compensation arrangements.
6. Focus on Value Based Care and Population Health:
a. Assessment: In recent years CMS has recognized the need to focus on preventing periods of acute illness as well as promoting health and wellness. As a result, they have added payments for services that support these objectives. One such service is the annual wellness visit (AWV) which is intended to update the provider on the patient’s health history and lead to a personalized prevention plan. Next, the chronic care management (CCM) code enables providers to bill for continuing support services outside of the face-to-face visit for patients with multiple chronic conditions. These CCM claims must be properly documented with time and services provided. Transitional care management (TCM) is a third service promoted by CMS involving physician follow-up with patients post hospital discharge. These follow-up calls and visits are intended to prevent gaps in care and reduce the probability of readmissions for the same illness. CMS also pays for remote Patient Monitoring (RPM) services. This service focuses on patients with chronic conditions such as COPD, heart failure, or diabetes and is intended to prevent periods of high acuity as well as increase the capacity of the physicians’ medical team. The reduced periods of high acuity will also result in a reduction in emergency visits and hospital admissions.
The opportunity for each of these codes can be assessed as follows:
• AWV: This value is projected by totaling the number of Medicare patients on your primary care panels and multiplying that total by the average reimbursement. The CPT codes are G0438 (initial) and G0439 (subsequent) and the average reimbursement is $132.
• CCM: To project this annual value, identify the total number of Medicare patients with two or more chronic conditions on your primary care panels. Then multiply that number by the average reimbursement per month and multiply the result by 12. The CPT code is 99490 and the average reimbursement is $42, assuming the patient services for each patient consume 20 minutes per month.
• TCM: Use historical data to identify the number of annual hospital discharges for Medicare patients on your physician panels. Multiple this number by the TCM reimbursement rate. CPT code 99495, at a reimbursement of $175, is charged on moderately complex patients if contacted within two days of discharge and a face-to-face occurs within 14 days. CPT code 99496, at a reimbursement of $237, is charged on highly complex patients if contacted within two days of discharge and a face-to-face occurs within 7 days.
• RPM: Four CPT codes apply to this service. The first code, 99453, is for equipment set-up and patient education. CMS pays $19 for this one-time service. Next, code 99454 is for the equipment and daily monitoring. The CMS rate for this service is $64 every thirty days of use. The intervention and treatment services resulting from the RPM pays $51 for the first 20 minutes and $42 for each additional 20 minutes each month. These services are assigned codes 99457 and 99458, respectively. Your revenue potential from this opportunity can be projected by working with your physicians to identify the patients who will benefit from this service and then applying the above reimbursement rates to the resulting volumes.
b. Improvement Action: Physician education is a foundational step toward pursuing the population health opportunities. Assigning a physician population health champion who leads by example is also essential. Next, the process of care must be clearly identified for each of the four services with key access points established and required actions defined to initiate these services.
Quantifying the opportunity at the provider level and instituting population health performance factors in the compensation system will also help improve participation.
7. Non-Provider Staffing Levels:
a. Assessment: Apart from provider compensation, workforce staffing is typically the largest single contributor to expenses in the physician enterprise. Accordingly, prudent management requires continuous vigilance over this resource. Two areas of resource management are required, staffing levels and pay per hour.
To determine the staffing level opportunity, identify the difference between the actual minutes per encounter and the benchmark for this metric. Then multiply the difference by the number of encounters to get the total excess minutes. Divide the total excess minutes by sixty and multiply the result by the average hourly rate to identify the dollar value of opportunity on this factor.
(Note: The benchmark for this metric is typically calculated by converting the industry benchmarks on FTE per 100 encounters to staff minutes per encounter. This conversion creates a more actionable KPI for the organization.)
b. Improvement Action: An initial step in managing staffing is to complete weekly clinic plans at least a week in advance. These plans should be in half-day units, identifying each provider’s expected encounter volume and room assignments, as well as the dedicated staff and shared staff needs. Applying a staffing to volume approach to planning will appropriately assign staff based on each provider’s volume. In addition, when providers are out of the clinic with PTO, education, or for other reasons the staffing plan should reflect a reassignment of personnel to other duties. The weekly clinic plans must also recognize the services provided for patients pre and post clinic to ensure adequate staffing. When scheduling staff it is helpful to distinguish between patient interactive work and business work. Patient interactive work, such as answering the phones and patient check-in, are driven by patient demand and involve windows of opportunity to meet the patient’s needs. Staffing must be adequate to consistently meet these opportunities. Meanwhile, business work such as obtaining authorizations and records also have a degree of time dependency but there is greater freedom to schedule this work. Staffing requirements can be smoothed through cross training and then distributing business work to periods of low patient interactive work demand.
A second step to optimize staffing is through the application of lean workflow and activity-based management tools. The lean workflow tool guides managers in identifying the process of care and all the activities required to serve the various patients seen by their providers. The activity-based management tool is then used to apply workload and costs drivers to the activities, leading to a quantification of full-time equivalent (FTE) staffing needs. The deployment of these tools gives managers a deep functional understanding of clinic operations and provides a framework upon which process improvements can be identified and waste can be continually removed from the system.
A last step to prevent overstaffing is to develop a staffing policy for the physician enterprise. This staffing policy formalizes the process of adding and replacing positions by inserting an evaluation of workload, staff minutes per visit and clinic cost-to-revenue before positions are approved. The policy should also set limits on overtime utilization as well as establish internal controls to monitor and address negative variations from the standards.
8. Non-Provider Staffing Payment Levels:
a. Assessment: The last brief identified tools for effectively managing staffing levels. A second opportunity for reducing staffing expenses is to effectively manage the rate of staff pay per hour. The value of this opportunity is calculated by multiplying the difference between the actual average pay per hour & the benchmark pay per hour by the total number of labor hours.
b. Improvement Action: One reason for excessive staff pay rates may be a staffing mix that is heavily weighted toward higher paying positions. For example, you may have a higher ratio of RN to Medical Assistance staff than your industry peers. A first step to address this problem is to adopt a principle of having each employee work in activities that represent the top of their certification or skill set. You can implement this principle by utilizing the lean work-flow tool to gain a deep understanding of the skills required throughout the process of care and then apply that understanding in your assignment of positions to each activity. The activity-based management tool can then be used to quantify the actual FTE needs by position level.
A second cause for excessive staff rates per hour is above market pay rates. To avoid this problem the organization must establish and adhere to a market-based pay range for each position. Maintaining an appropriate pay range will require recurring assessments of market-based pay for each position to make sure the organization is competitive. Consistent adherence to the pay range will require a staff pay policy which outlines the method of determining pay and establishes strict criteria, as well as high-level leadership approval for making exceptions. Engaging physician leadership in the establishment and application of this policy will significantly enhance your success in managing staff pay.
A highly effective approach toward achieving optimal pay levels and aligning the organization is to institute a robust bonus system that rewards employees for the organization’s success and their contribution to that success. This system requires both an actionable Key Performance Indicator (KPI) System that effectively measures organizational success as well as Individual Performance Factors (IPFs) for each position that causally links to the KPIs. When the bonus system becomes the mechanism for rewarding performance all hourly pay rates can be set at the market regardless of employee performance. Meanwhile, the increased employee alignment caused by the bonus system will accelerate organizational improvements.
9. Providers’ pay per wRVU:
a. Assessment: Provider pay per paid wRVU is a metric that evaluates provider pay in comparison to expected revenue. The following three sets of values should be considered to establish target values and quantify this opportunity:
1. The organization’s current specialty specific pay per wRVU for both physicians and APCs.
2. Specialty specific regional benchmarks for pay per wRVU for physicians and APCs. You may also want to consider the cost-of-living index in your location compared to the cost of living in the region to provide a more precise comparison.
3. The organization’s specialty specific net revenues per wRVU for physicians and APCs.
Setting a target for provider pay per wRVU will require balancing the need to be competitive in attracting and retaining providers while maintaining a strong financial position. Several factors will have an impact on this decision, including geographic location and the organization’s reputation. Pursuing each financial opportunity identified in these financial optimization blogs will serve to optimize your financial performance and reduce the burden of this balancing act.
The financial opportunity is calculated by multiplying the difference between actual and targeted provider pay per wRVU by the wRVU generated by each provider.
b. Improvement Action: One major reason for the high pay per wRVU is low provider production combined with fixed compensation arrangements. Steps toward increasing production levels were outlined in the revenue improvement section. A compensation arrangement which sets base pay at a below market level then links additional pay to wRVU is a standard approach to putting an incentive on production. When implementing this system, the organization must have internal controls in place to assure the wRVUs attributed to each provider are for charges that are allowed and accepted by the applicable payers.
A major flaw in the payment per wRVU compensation system is its failure to recognize aspects of provider performance other than production. Organizations wishing to optimize their performance must institute a system that aligns provider compensation with desired results. When considering desired results there must be a distinction made between specialties. The desired results for primary care physicians and others who primarily manage chronic conditions is to maintain or improve patient health.
The continuous monitoring and management of each patient’s health condition is required to achieve these results. The pay per wRVU system for this group places the focus on incremental volume rather than health condition monitoring and management. A payment system based on a per member per month rate adjusted for the attributed population’s health and provider performance would align compensation with desired results for this group of providers. The following link offers a plan for primary care compensation.
– https://www.hfma.org/Compensating Primary Care Physicians for Their True Value
Meanwhile, the desired results for providers who perform episodic interventions is the effective and efficient restoration of each patient’s health and functioning. While productivity is one desired result for this group the optimal compensation system should also consider results around service, quality, costs, and citizenship. A pay per wRVU approach using an adjusted rate based on these other performance factors would align compensation with desired results for this group of providers. The following link offers a compensation plan for interventional physicians.
– https://www.hfma.org/Provider Compensation – The Value Equation for Interventional Care
10. Service costs-to-revenue:
a. Assessment: There are a broad scope of service requirements for a physician enterprise. At the top of the list, in terms of costs, are software services for electronic medical records, practice management, revenue cycle management, accounting, and reporting, purchasing and inventory management. Other service requirements may include: housekeeping, linen and laundry, alarm monitoring, security, landscaping, telecommunications—wired and wireless, telephone phone answering and nurse triage services, language translations, telehealth, copying and printing, hazardous & other waste disposal, patient satisfaction surveys, medical gases (oxygen, liquid nitrogen), shredding, sign language, equipment tagging and inventory management.
The value of the opportunity for savings on services is calculated by identifying your current cost to revenue for services and comparing it to a benchmark or target for this metric. Setting a target will typically involve identifying your total cost-to-revenue benchmark and then determining the portion of this benchmark that can be attributed to service costs.
b. Improvement Action: Service costs tend to creep up over time so organizations should plan to review these costs on a recurring basis. Prioritize your service cost evaluation project starting with the services that have the highest costs. A first step in the evaluation is to review or develop a statement of work (SOW). The SOW should identify the purpose or objective for the service and then provide details on the work to be done. The details should list the deliverables for the service with quantitative quality, frequency and timeliness standards established for each deliverable.
Next details on payment expectations should be established covering the basis for payments, unit pricing, and the timing of payments. The SOW should provide an understanding of the connection between the standards and the service costs.
To optimize service costs, the standards should be established to meet but not exceed the needs of the organization. The next step in evaluating service costs is to complete a market assessment to compare your costs to what others are paying or what other vendors are offering.
If, after completing this assessment you find there is an opportunity for improvement you should prepare a formal request for proposal (RFP) from other vendors sufficiently prior to the contract termination date to allow for a smooth transition. The SOW should serve as the basis for your RFP. Due diligence in vendor evaluations includes reference checks and gaining a full understanding of all aspects of the proposed contract.
Service effectiveness must be a priority before any efficiencies is made through improved pricing. If your organization does not have resources or expertise to complete the service evaluation and negotiation process, there are vendors that provide this support.
11. Supply & Drug Costs:
a. Assessment: The level of supply and drug costs will vary by specialty so the assessment must be conducted at the specialty level. In addition, the supplies and drugs may be broken into two categories, consumables and goods sold. The method of assessing the opportunity in these two categories will vary.
For consumable supplies the value of the opportunity for savings is calculated by identifying your current cost to revenue for consumables and comparing it to a benchmark or target for this metric. As discussed in the Service brief, setting a target will typically involve identifying your total cost-to-revenue benchmark and then determining the portion of this benchmark that can be attributed to consumable supply costs.
For goods that are sold the direct revenues and costs for the goods should be carved out from other supplies. The opportunity is determined by setting a target for the margin between direct revenue and direct costs. Setting this target will require research to identify industry benchmarks. Optimizing the margins on goods sold requires a recurring review as both revenue and cost changes may occur that will result in a loss on these items.
Improvement Actions: Improvements on both consumables and goods sold are achieved by making sure you are paying the lowest purchase price available for each item. To effectively achieve this objective, you must first identify the minimum quality needs for each item.
Next you must evaluate pricing on a recurring basis. Improvements in both categories are also achieved through flawless inventory management. Elements of a flawless inventory management system include eliminating losses through shrinkage and product expiration as well as optimizing the balance between out-of-stock instances and minimizing holding costs. A third improvement opportunity is available for goods sold through increased revenue. The contract rates and revenue cycle management actions explained in the revenue section should be deployed on goods sold to realize this opportunity.
12. Administrative (Overhead) Costs:
a. Assessment: In addition to prudently managing the clinical operating costs, every medical group should be actively managing the costs generated by administrative/support functions. These functions include organizational leadership and support services, revenue cycle management, information technology, accounting and reporting, marketing, materials management, and facilities management.
Each organization should set a cap or target for overhead expenses as a percentage of total revenue and then segment the percentage into functions. Function leaders must be expected to manage their resources to stay below the target. The value of the opportunity for savings on overhead functions is calculated by identifying your current cost to revenue for these functions and comparing it to the established targets.
Improvement Actions: Several of the services listed above fall within these administrative functions and it should be the role of the function leader to actively manage those services. In addition, the function leaders should be deploying the staffing and supply management improvement actions listed above within their areas of responsibility to make sure the costs for these resources are effectively managed.
While these overhead services are frequently considered indirect costs, their magnitude can often be linked to the volume of the line services they support using SIPOC, process maps, and activity-based costing tools. Smaller organizations will have more difficulty meeting aggressive targets due to their minimum operating needs unrelated to volumes. However, there is an opportunity to reduce costs in nearly all organizations through the application of competitive pricing and lean tools.
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Final Thoughts – Execution/Take Action
As a final thought, we suggest reviewing each of the 12-part series and making sure you take action where you
see opportunity. An assessment of the six revenue and six expense improvement opportunities covered in the last twelve briefs will provide you with the total value of the financial opportunity in your physician enterprise and serve as the basis for your financial improvement plan. A root cause analysis for each area with a shortfall should be conducted to establish effective corrective actions.
Successful execution of improvements will be achieved by adopting an agile continuous improvement approach. This approach involves a comparison of actual performance to the standards each month with an expectation that below standard performance is addressed with a corrective action plan. Manager mentoring and an evaluation of improvement performance must be completed each month by following up on planned actions, evaluating results, and agreeing on next steps if the problem has not been solved.
This continuous learning and improvement approach will result in more effective corrective action plans each month as the managers continually gain a better understanding of the factors driving performance.
John Rezen
