Are you making informed business decisions using real-time data?

Ian Goldberger: ©Kaufman Rossin

Many primary care physicians rely on a simple but limited benchmark to assess their practice’s performance: whether there’s more cash at the end of the month than at the beginning. While this method might indicate short-term solvency, it does little to inform long-term strategy, highlight inefficiencies, or guide sustainable growth. At a time when value-based care, staffing challenges, and increasing payer complexity are reshaping practice economics, knowing your numbers and understanding what they mean has never been more critical.

Today’s primary care practices generate more data than ever before, thanks to electronic health records (EHRs), patient scheduling platforms, billing systems and even patient satisfaction surveys. Practices are sitting on a wealth of data, yet most of that information remains untapped. Business intelligence (BI) offers a way to transform raw data into actionable insights, enabling physicians to make faster, smarter, and more profitable decisions. Whether you’re operating independently or managing a network of providers, BI has the potential to elevate both patient outcomes and business performance.

Lilia Restrepo: ©Kaufman Rossin

What is business intelligence? And why should physicians care?

Business intelligence is the process of collecting, cleaning, analyzing, and visualizing your practice’s data to support decision-making. Think of it as a way to check the vital signs of your practice’s business health in real time, allowing you to monitor performance and diagnose issues.

It’s important to know that BI is a strategic tool, and not just a tech solution limited to complex dashboards or IT departments. This strategic resource can empower both physicians and administrators to track key metrics, predict trends, and identify inefficiencies. With today’s tools, even non-technical users can automate many aspects of data analysis. For primary care practices juggling dozens of responsibilities, this means BI can surface the insights you need without necessarily adding hours to your week.

Solving persistent pain points with BI

One of the most immediate benefits of BI is its ability to bring clarity to the revenue cycle. Issues like inconsistent collections, high denial rates, and underbilling are common across primary care settings. BI helps recognize these patterns, identify their causes, and guide solutions, whether that means refining coding practices, renegotiating payer contracts, or improving claims follow-up.

Operational challenges are another area where BI can shine. Practices often struggle with mismatched staffing levels, unpredictable patient flow, or inefficient front-desk workflows. By analyzing patient volume trends and productivity data across different departments and roles, BI can help optimize resource allocation and scheduling. It also allows practices to look beyond intuition or anecdotal feedback and make evidence-based adjustments.

Fragmented data presents another hurdle for many practices, especially those using separate systems for scheduling, billing, and EHR. Business intelligence can integrate these data sources into a single, cohesive platform. Not only does this improve visibility, but it also allows for deeper analysis, such as correlating clinical quality with revenue trends or identifying operational patterns that affect patient satisfaction.

Keep in mind, data is only useful if it’s accurate. Clean, consistent, and well-structured data is essential for generating reliable insights. Practices don’t need to overhaul their entire system at once. Starting with a few key metrics and gradually improving data hygiene is often the most effective approach. Think of data cleaning not as a one-time project, but as a foundational process that enables long-term success.

KPIs that illuminate business health

Knowing which key performance indicators (KPIs) to track is just as important as having the data. While each practice will have its own priorities, several core metrics offer a valuable snapshot of financial and operational health:

• No-show and cancellation rates provide insight into patient engagement and scheduling efficiency.
• Trends in CPT code usage can highlight changes in service mix or point to underutilized billing opportunities.
• Revenue by payer can help reveal contractual strengths and weaknesses, while denial rates may indicate documentation process or coding issues that need attention.
• Analyzing the timing and volume of claims submitted versus collections received can help identify payment delays or shortfalls that contribute to cash flow gaps.
• Other valuable metrics include room utilization rates, patient volume trends, and staff productivity benchmarks.

Together, these KPIs can paint a clear picture of how your practice is functioning, and where improvements can be made.

More than a pre-sale tool

While BI can undoubtedly be useful when preparing a practice for sale, its benefits extend well beyond exit planning. Growth strategy, succession planning, payer negotiation, and patient satisfaction initiatives all stand to gain from timely, accurate insights.

For example, a practice evaluating the addition of a new physician can use BI to model how that hire might impact revenue, appointment capacity, and staffing needs. If your goal is to expand services or open a new location, BI can help forecast demand and assess financial feasibility. For practices working to improve access and satisfaction, BI can connect patient experience data with operational inputs, revealing the factors that truly move the needle.

The guiding principle is simple: you can’t improve what you can’t measure. BI can empower physician groups to move from reactive management to proactive leadership.

Essential for value-based care

As the health care industry continues its shift toward value-based care, BI becomes even more indispensable. For practices participating in risk-based arrangements, the ability to track quality metrics, cost-of-care data, and patient outcomes in real time is crucial.

These insights support member and population specific metrics and help attribute to practices delivering high-quality, cost-efficient care. BI enables continuous monitoring and rapid course correction, which is crucial in contracts where financial incentives are directly tied to performance. For physicians navigating these arrangements, BI isn’t just helpful, it’s foundational.

How to get started

With BI, it’s good to start by identifying the systems where your data lives, such as medical records, billing, scheduling, accounting, and selecting a handful of KPIs that align with your goals. Begin standardizing and cleaning your data, even if manually, and consider tools or consultants that specialize in healthcare BI. With even basic dashboards or reports, you can start uncovering insights that improve operations and outcomes.

Get your practice administrator or office manager involved early in the process. Their on-the-ground perspective is critical for shaping useful reports and adopting changes. And remember, your first attempt doesn’t need to be perfect.

Guarding privacy and compliance

Keep in mind, business intelligence must never compromise patient privacy or HIPAA compliance. Aggregated or anonymized data should be used wherever possible, and any tool or vendor you work with must meet strict privacy standards. Make sure your BI approach aligns with compliance expectations from day one.

A long-term investment in practice health

As business intelligence is about more than technology, practices can transform how they think and lead. With accurate data and meaningful insights, physician groups make better decisions, build more resilient operations, and adapt with greater confidence to a changing healthcare landscape.

In a time where every dollar, staff hour, and patient interaction counts, BI is more than a nice-to-have; it’s a strategic investment in the future of your practice.

Ian Goldberger, CPA, is a Principal in Kaufman Rossin’s Business Consulting Services and helps lead the Transaction Advisory practice, advising companies on M&A, capital raises, and post-deal integration.

Lilian Restrepo is the director of business intelligence at Kaufman Rossin.