Healthcare organizations are often challenged to pinpoint the areas where they should focus their efforts to maximize performance, especially given the increasing demands being placed on their enterprises. To overcome these challenges, forward-thinking organizations are turning to advanced business intelligence (BI) solutions featuring comparative analytics to identify the areas of their businesses where improvements can make the biggest impact.
As organizations begin evaluating solutions, they may wonder how BI and comparative analytics solutions differ.
BI solutions use technology that enables organizations to collect, maintain and organize specific knowledge about themselves, such as key performance indicators (KPIs). Common uses of BI solutions include measuring accounts receivable (A/R) days, assessing internal performance metrics, measuring payer payment turnaround rates, evaluating cost measures, reviewing patient prescription adherence, as well as monitoring clinical pathway compliance.
In contrast, emerging comparative analytics solutions build upon the concepts of BI, but add a contextual component by comparing that data against peers and other benchmarks. In addition to enhancing the KPIs presented by traditional BI solutions, common uses of comparative analytics solutions include salary and compensation statistics, measuring reimbursement rates against benchmarked data (although that data is typically months or years old), and comparing actual clinical treatments against published pathways.
Next-generation comparative analytics capabilities include the use of real-time data to benchmark against peer indicators, such as claim denial rates, denial reasons, deviations in coding and claim types, staff productivity, payer performance compliance, utilization and more. More timely data enables more accurate comparisons that reflect what is happening now so that it can be corrected or modified immediately, before any negative financial impact is realized.
With declining reimbursements, increasing costs, the ever-changing landscape of reform, and increasing regulations, every organization needs transparency now more than ever to be successful. Add to this the dynamic growth in patient volumes expected under the Affordable Care Act, coupled with a decline in the physician population, the need for technically proficient and timely BI tools that include comparative analytics capabilities becomes self-evident. The future of healthcare organizations will depend on being able to measure, compare/interpret, and act for the benefit of the patient and the organization.
“We’ve always done it that way” won’t cut it anymore.
Brian Fugere serves as chief operating officer for RemitDATA. He is responsible for all channel sales, marketing, product management, support, training, consulting and strategy activities for the company. Since arriving at RemitDATA, Fugere has led the shift from direct to channel marketing, and has developed and implemented a new product management methodology. He is currently re-imagining the company’s value delivery processes for all of its customers and partners.
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