Understanding Patient Panels: What They Are and Why They Matter in Value-Based Care

As the healthcare industry gradually shifts from volume-based to value-based care models, traditional metrics like Work Relative Value Units (wRVUs), gross charges, and patient encounters are beginning to lose their footing as the sole indicators of physician productivity. This transition is prompting many healthcare organizations to reassess how they measure and reward provider performance, especially in primary care and other specialties responsible for ongoing patient management.

One metric gaining renewed attention is patient panel size—a concept that, while not new, is being applied in fresh ways to reflect value-based goals. Here’s a practical overview of what patient panels are, how they’re measured, and why they matter more than ever.

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What Is a Patient Panel?

In simple terms, a patient panel refers to the group of unique patients a physician is responsible for managing over a defined period of time. Because patient interactions vary in frequency, panels are usually determined by counting the number of distinct patients seen within a retrospective window—commonly 18 months. That time frame can be modified to better reflect the services provided by unique specialties, especially those that see patients less frequently but are still responsible for their care.

The goal is to look beyond episodic volume to obtain a realistic understanding of a provider’s ongoing patient responsibilities.

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How Is a Patient Panel Measured?

Patient panel data is typically extracted from an organization’s Electronic Health Record (EHR) system. Unique patients are attributed to providers using rules that might include:

• Most recent visit
• Primary care provider designation in the EHR
• Evenly splitting patients among multiple providers seen

Alternatively, payer data may be used to define panels, particularly in capitated models. However, payer-based panels often cover only a subset of patients and aren’t yet widely adopted.

No matter the method, the key is consistency: choose a clear methodology, document it, and apply it uniformly.

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Should You Adjust Raw Panel Data?

Raw panel counts treat all patients equally, but in reality, patient complexity varies widely. Just as not all encounters generate the same number of wRVUs, not all patients require the same level of provider effort.

Adjusting panel data is critical for creating meaningful insights. There are two common approaches:

• Age/Sex Adjustments – A simple method that accounts for expected resource use based on demographic characteristics.
• Risk Adjustments – More sophisticated models—like the Hierarchical Condition Category (HCC) —that better reflect patient acuity and care needs, assuming the necessary data is available.

Adjusted panels allow fairer comparisons across providers and more accurate workload assessments.

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What Can You Do with Patient Panel Data?

Once calculated and (ideally) adjusted, patient panel data becomes a powerful tool across several domains:

1. Compensation Design
   More organizations are weaving patient panel size into provider compensation models, either as a bonus metric or as a primary driver in value-based arrangements. While it’s premature to base full compensation on panel size in fee-for-service environments, integrating it gradually in panel-managed specialties is a smart move.
2. Performance and Operational Insights
   Panel data offers visibility into:
   
   • Access challenges and patient wait times
   • Panel management decisions (e.g., when to open/close panels)
   • Workforce planning, including needs for additional providers
   • Workload balancing across care teams
   • Readiness for value-based care through better patient population insights

Final Thoughts

Patient panel size is not yet the definitive measure of provider productivity, but its relevance is growing. Even if your organization isn’t ready to tie compensation directly to panel data, capturing and analyzing it now can lay the groundwork for more sustainable, value-driven operations. In many cases, the mere act of exploring panel data can spark impactful conversations and smarter decision-making.

As healthcare continues its pivot toward value, understanding and leveraging patient panel metrics will become a vital part of leading effective, efficient care delivery.