Comparative analytics: Measure yourself against peers

A. HME providers must align critical financial and operational business components to deliver cost-effective solutions for customers and maintain healthy financial performance. Businesses need to measure, monitor and manage these components. 

Leading organizations are employing advanced business intelligence solutions that feature comparative analytics to give them an edge in identifying where improvements can make the most significant impact.

Business intelligence solutions use technology that enables organizations to collect, maintain and organize specific knowledge, such as key performance indicators. Examples include: assessing staff and payer performance metrics; measuring accounts receivable data; evaluating cost measures; and monitoring clinical pathway compliance.

Comparative analytics solutions, however, leverage the concepts of business intelligence but contextually compare that data against peers—a key differentiator.

For example, comparative analytics solutions would enable HME businesses to garner insight into core metrics to be successful at competitive bidding; procedure utilization comparisons to reduce audit risk; and reimbursement rate benchmarking data to pinpoint problem areas and improve cash flow.

Next-generation comparative analytics capabilities provide even more transparency and value, including real-time data to benchmark against peer indicators, such as claim denial rates, denial reasons, payer performance compliance, cash flow and more, to identify and manage any areas of concern.

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. Providers can use comparatives to analyze their gross reimbursement and collection ratios against peers, as well as view payment velocity rates to determine if peers are getting paid faster by the same payers. By drilling deeper into the data, businesses can evaluate peers' denial rates by payer, as well as code and modifier utilization. Providers are also able to see if peers are earning more reimbursement on similar procedure and demographic mixes.

Brian Fugere is COO of RemitData. Reach him at bfugere@remitdata.com.