Dermatology Practice Analytics: Biopsy Tracking, Procedure Mix, and Prior Auth Burden

Dermatology practice analytics span a uniquely wide range: skin cancer detection and biopsy management, Mohs micrographic surgery operational efficiency, chronic disease management with high-cost biologic therapies, and elective cosmetic procedures — all under one practice roof. Each of these revenue streams has different analytics needs, different quality metrics, and different payer dynamics. A practice running all four without cross-referencing data is making scheduling, staffing, and financial decisions on incomplete information.

Biopsy management analytics are among the highest-stakes tracking needs in outpatient medicine. A pathology result that is not followed up — a melanoma or squamous cell carcinoma that falls through the workflow — creates serious patient safety risk and malpractice liability. Tracking biopsy volume by provider, pathology turnaround time (target under 7 business days), and the follow-up completion rate for malignant results is the foundational quality metric in dermatology. Most practices track this in paper logbooks or in a spreadsheet that the MA maintains.

Biologic prior authorization analytics are increasingly critical as dermatology has become one of the highest biologic prescribing specialties. Dupilumab for moderate-to-severe atopic dermatitis, IL-17 and IL-23 inhibitors for plaque psoriasis (secukinumab, ixekizumab, risankizumab, guselkumab), and anti-IgE therapy — each requires prior authorization from commercial and Medicare Part D payers with different step therapy and documentation requirements. A practice that knows which payers approve which medications on first submission vs. which require appeals can optimize the prescribing and documentation workflow to reduce the administrative burden on both staff and patients.

MIPS quality measures for dermatology include melanoma appropriate management (biopsy reporting), psoriasis treatment plan documentation, and DLQI documentation for biologic therapy candidates. The American Academy of Dermatology (AAD) maintains the DataDerm registry — a qualified clinical data registry for MIPS reporting that includes dermatology-specific quality measures including skin cancer screening counseling, follow-up for biopsied skin lesions, and psoriasis activity assessment (DLQI and PASI scoring).

The Prior Authorization Reform Act and state-level PA legislation increasingly require payers to provide real-time decisions for urgent PA requests. Dermatology practices that track payer PA performance data are better positioned to advocate for formulary changes with payer medical directors and to document the administrative burden of PA requirements for advocacy with state insurance commissioners.