Empanelment Resource 5:

Approach to Adding New Patients to Panels

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This resource is part of the Empanelment Implementation Guide, offering steps and activities to help your practice select and implement a methodology to create patient panels and develop continuity reports. It is the second in the “Building the Foundation” series of implementation guides.

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Practices should determine panel size and fullness using an approach that accounts for attrition.

Suggested Attrition Formula

New visits per session = (visits per session ÷ 2) x ((max size panel as percentage, e.g., 105% x clinical FTE) – projected needs as % + (1 – estimated or calculated attrition rate for PCP as %)) [note attrition rate is 1 – retention rate]

 

Example 1: One FTE, 10 patients per half-day session, 360 sessions per year (45 weeks x eight sessions per week at this CHC), 95% full by weighting/projected needs, attrition 15% per year. New per session = (10 ÷ 2) x ((105% x 1.0) – 95% + 15%) = 1.25 NEW patients to be seen per session.

This provider would be given one new patient per session and an additional new patient for every four sessions (about 10 per week total). In one year, the provider should have lost nearly 200 patients through attrition and gained 450 multiplied by the new patient show rate (health center should try to increase the show rate). If the show rate for new patients is 60%, then the provider would have 70 more patients by the end of a year and would be at 100% instead of 95% (if the panel size was 1,400).

 

Example 2: 0.5 FTEs, 12 patients per session, projected needs 53% (currently empaneled will need 0.53 FTE of PCP time), 30% attrition per year. New per session = (12 ÷ 2) x ((105% x 0.5) – 53% + 30%) = 2.07 new patients per session.

This provider is likely to lose over 200 patients in a year (30%). The provider will be scheduled with 360 new patients per year (180 sessions X two new patients). Depending on show rate, the provider will stay about even. To have less new patients, the care team members (and the CHC leadership) need to work on reducing attrition.

 

Example 3: 0.8 FTEs, 14 patients per session, projected needs 87% of PCP FTE, 5% attrition per year. New per session = (14 ÷ 2) x ((105% x 0.8) – 87% + 5%) = 0.28 new patients per session. In practice, this provider would have a closed panel (<0.5 calculated per session).

This provider is likely to lose around 50 to 75 patients in a year and will likely start to get new patients halfway through the year when monthly calculation goes above 0.5 per session.