In this age of increasing regulation governing areas such as electronic medical records, coding and Medicare reimbursements, optimizing performance at today’s healthcare organizations is not easy. It requires aligning the critical financial and operational business components that are necessary to deliver cost-effective care to produce optimal patient outcomes. Organizations need to measure, monitor and manage these components.
Measurement can be a complicated process, though. Considering the many variables within an organization, it becomes challenging to pinpoint those areas in which efforts need to be focused in order to maximize performance. To overcome these challenges, leading organizations are utilizing advanced business intelligence solutions that feature comparative analytics to give them an edge in identifying those components of their business for which improvements can make the most significant impact.
Traditional use of comparative analytics within an enterprise has included measuring and monitoring isolated areas, such as:
- The American Heart Association’s tracking of heart disease and treatment patterns to develop clinical pathways.
- Non-clinical performance measures, such as clinician salaries, and the cost of medical supplies per patient and per procedure.
- The Medical Group Management Association’s ongoing compensation and utilization surveys.
In addition to these traditional uses, comparative analytics is increasingly being used in new ways across the industry as more and more organizations understand the added value of employing comparative analytics solutions over simple business intelligence.
So what’s the difference?
Business intelligence solutions use technology that enables organizations to collect, maintain and organize specific knowledge such as key performance indicators. Examples include: measuring accounts receivable data; assessing internal performance metrics; measuring payer payment turnaround rates; evaluating cost measures; receiving patient prescription adherence; and monitoring clinical pathway compliance.
The common denominator of all these activities is that they focus on analyzing internal data and, generally, do not benchmark comparisons against peers.
In contrast, comparative analytics solutions leverage the concepts of business intelligence but contextually compare that data against peers and other benchmarks – a key differentiator.
For example, comparative analytics solutions enable organizations to access salary and compensation statistics, measure reimbursement rates against benchmarked data and compare actual clinical treatments against published pathways.
Next-generation comparative analytics capabilities provide even more transparency and value, including the use of real-time data to benchmark against peer indicators such as claim denial rates, denial reasons, durations in coding and claim types, staff productivity, payer performance compliance, utilization and more.
In addition, more timely data provides more accurate comparisons that reflect what is happening now so that it can be connected or modified immediately, before the financial impact is realized.
Brian Fugere serves as chief operating officer for RemitDATA. He is responsible for all 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 reinvigorating the company’s support and training programs as well as building and launching a new hybrid big data-consulting offering.