Monday Special: Interview with Frank Cohen, Host of “Lean Six Sigma for the Medical Practice”

Frank Cohen

I was intrigued to interview the man behind the upcoming free webinar “Lean Six Sigma for the Medical Practice.”  Frank Cohen, former Physician Assistant, Hospital CEO, and Consultant of 20 years is the Senior Analyst of MIT Solutions, Inc., and the host for this and other webinars that I think many healthcare managers will be interested in.

Cohen specializes in data mining and statistical modeling for medical practices.  His website describes their services this way:

MIT Solutions, Inc. has been leading the health care industry in the development of decision support and business intelligence tools for medical practices since 1992. Our sole purpose is to help the practice staff work faster, smarter, make more money and improve compliance. At MIT Solutions, we develop products and services that transform the way you do business.

Cohen is a significant player in the healthcare improvement world for several reasons.  He worked with the AMA in 2008 to introduce the first Payer Report Cards, which focused on how quickly and accurately payers reimburse physicians for medical services.

The report card compared Medicare and seven national commercial health insurers on the timeliness and accuracy of claims processing and was based on a random sample drawn from 3 million claims.  According to the AMA report, UHC ranked lowest in contract compliance with a rate of 62% of claims correctly paid per contract.  Aetna ranked higher with 71% correctly paid and 98% of Medicare claims were correctly paid.  You can review the payer report card here.  Knowing how hard it can be to ensure that claims are paid correctly in the typical medical practice makes the feat of collating and analyzing the data on this scale impressive.

Cohen also developed CMPA, or Comprehensive Medical Practice Analysis, which includes analyses of Procedure Code Compliance, Provider Productivity, Modifier Analysis, E & M Code Utilization Review, Correct Code Initiative (CCI) Compliance, Fee Analysis, EOB-Based Reimbursement Analysis, Procedural Cost-Accounting/Break-Even Analysis, Managed Care Contract Analysis, Relative Value Scale Studies, and Statistical Modeling by Location by Physician.

Cohen’s website hosts an array of valuable downloads available for managers to use.  Here are some examples:

  • Comparison of GPCI values by Location – CY2009 vs. CY 2008
  • Comparison of RVU values by procedure code – CY 2009 vs. CY 2008
  • Physician Compensation Model Using Work RVUs
  • RBRVS Calculation Template – 4th Quarter, 2009

Like most of us, Cohen has an interest in how medical practices can continue to meet the burden of increasing costs and shrinking reimbursements.  He looked to the dual programs of Six Sigma and Lean to reveal ways for practices to eliminate wasted time, energy and resources and promote efficiencies in the practice.  Cohen writes:

    …I obtained my Six Sigma Black Belt certification and more recently, certification as a Lean Six Sigma (LSS) instructor. Over the past few years, I have struggled with developing a process improvement model that is specific to medical practices only, vetting a host of different tools to eliminate those that have little or no application in our vertical market and customize others to work specifically within a physician’s office. I started applying these to some projects in the past couple of years and am very excited about this model and encouraged that this is one of the best ways to optimize profitability for physicians.

Cohen is providing an introduction to his Lean Six Sigma for medical practices through a free webinar on Tuesday, February 24, 2009 from 11:00 a.m. to 12:00 p.m. Eastern.  Webinars are a wonderful way to spend a little time and no money to learn something.  You need a phone for the audio and a computer for the video and chat functions.  I’ve signed up and I hope to “see” you there.

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