Reasons for Fluctuations in Your Case Acceptance Rate

A common trend I see when reviewing practice case acceptance rates is a wide fluctuation in these numbers from one month to another, with no logical pattern or trend. In fact, it is not unusual when looking over a year’s worth of month-to-month data to see a difference in excess of 50% between the high and low months for a practice. At first glance, this can appear to be a disturbing set of data. However, there are several factors that come into play here that can significantly skew your numbers, and should therefore be taken into consideration.

Before reviewing those factors, know that it is highly unlikely that your TCs are responsible for such large fluctuations in your case acceptance rate. In fact, if your TCs follow the same effective and consistent methodology with each new patient consultation, we can rule their skill-set out of the equation.

Some factors that can influence your monthly numbers:

• Non-qualified visitors. By ‘non-qualified’ I refer to individuals who could not start treatment now, irrespective of their desire to do so. The most common example would be observation cases; however this would also include patients requiring surgery or other prerequisites before starting treatment, and the occasional case that cannot make financial arrangements, either through themselves or a third-party, to pay for your services. Nothing that your practice does is going to change the fact that these are, for now at least, non-starts in your case acceptance numbers. They therefore do not reflect on the consultation skill-set of your practice.

• Time of the year. To cite one example, it is common in the late fall of the year for patients to put off beginning treatment for purposes of using pre-tax savings dollars or insurance activation in the next calendar year. This can negatively affect your numbers in October through December, with an expected up-tick in the first quarter of the following year.

• Transience. In several practices that I have worked with, a significant portion of patient families are military personnel, and an anticipated deployment announcement can cause a wait-and-see delay in decisions to start treatment. If you draw patients locally from large, publicly held corporations, you are likely to run into this issue as well.

There are other factors. The point is this: If you want to get an accurate idea of how your practice (and your TC)  is doing with regard to case acceptance, remove, each month, the non-qualified (can’t-start-now) visitors from your total number of consultations, and focus on the remaining cases. This leaves those patients that could start treatment now if they wanted to, and is therefore the group with which your practice has influence. This can be done informally each month, but it is useful data to know.

Regarding pending cases: With a few exceptions, such as a patient who says they are going to start, but has a specific, valid reason for a long delay in doing so, my opinion for pending cases is that after 60 days, any influence that you, your TC and the practice had in the decision for treatment has largely evaporated. I therefore suggest that you treat these as non-starts at that point, and not include them in your measurement of practice performance if they do start later. In other words, if they do start after 60 days, look at them for what they are – a gift.