Estimate Clinic visits that were not a "top-of-the-license" use of the specialist/expert.

[jonc101]

Ideas with Kevin Schulman on how to develop concept

• Could be simple Excel model to show potential productivity model
	○ On potential difference of top-of-the-license percentage
• Simple profile provider practices just in department of medicine

	○ Top license mix, may not be 100%, but can at least specify a more consistent rate
• Look at how often proceduralist visits don't lead to procedures
	○ Maybe E&M for counseling

Okay for specialist E&M is valuable, just not generating a bunch of "toys" and technical fees. Get access to the intelligence, without the technology.

	○ Calculate the mix of services across specialty disciplines
		§ Tells you what top-of-the-license is in the group, so how to meet demand
		§ Take that to markets on how to design and allocate hiring (otherwise just hiring based on more RVU > cost of individual)
		§ What's minimal volume of services for high quality service
			□ Try comparing state by state at organizational level
			□ Score at top of license
	○ Could just interview some specialists, how many visits could have been done by PCP

	○ Relative Index "Top of License" 
		§ Then compare across practitioners and then across providers