Healthcare Key Performance Indicator Consulting - PowerPoint PPT Presentation

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Healthcare Key Performance Indicator Consulting

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ezDI analysts and consultants perform in-depth analysis of a hospital’s KPIs, including, Coder and CDI Productivity, Denials and a host of other metrics to enhance reimbursement and quality. If you are looking for Healthcare Key Performance Indicator Consulting. Visit Us:- – PowerPoint PPT presentation

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Title: Healthcare Key Performance Indicator Consulting


1
Healthcare Key Performance Indicator Consulting
2
Enhance reimbursement and quality through data
driven, actionable insights. ezDITM analysts and
consultants perform in-depth analysis of a
hospitals KPIs, including Case Mix Index (CMI),
Coder and CDI Productivity, Denials and a host of
other metrics. Contact Us
3
Case Mix Index
Case Mix Index (CMI) is the average of DRG
weights of all inpatients.
  • CMI Consulting
  • Improve CMI by analysing high-impact MS-DRG
    pairs
  • Identifying reasons for any increase or
    decrease in CMI
  • Comparison of a Hospitals CMI against
    National, State and
  • Regional Peer group.
  • Identification of the top 10 MS-DRGs within a
    fiscal year.
  • Comparison of the Geometric Mean Length of Stay
  • (GMLOS) to the Actual Length of Stay (ALOS)
    for the top 10
  • MS-DRGs, with impact and opportunity
    assessment.
  • Tracking of trends in patient mix (total cases,
  • medical/surgical cases).

Did You Know? 14-site hospital system
lost 3M in reimbursement in a year from an
unspecified code (F32.9), where more specific
code (F32.3) could have been assigned.
4
Coder/CDIS Productivity
Coder Productivity is defined as the time
required to code a patient record.
Did You Know? 271-bed hospital identified 25
increase in coder productivity level, and thus
savings of 276K with analytics driven case
allocation. This was in addition to 47 increase
with CAC adoption.
  • Coder/CDIS Productivity Consulting
  • Benchmark productivity levels to determine the
  • gaps
  • Productivity level analysis by individual
  • Coder/CDIS
  • AI-based optimization modeling on past data
  • designed to
  • enhance current Coder/CDIS productivity and
  • accuracy l levels
  • Coder Productivity by service lines, LOS, DRGs

5
Denials
Denial is the refusal by payor to honor a request
of a provider to pay for healthcare services.
Did You Know? Approximately 9 (262 billion) of
hospital charges in 2016 were initially claim
denials. However, roughly 165B of denied claims
were recoverable.
  • Denials Consulting
  • Manage denials by knowing potential at risk
    MS-DRGs in
  • advance
  • Uncover and eliminate root causes for Denials
  • List of denied claims that are likely to be
    appealed based
  • on higher rate of approval
  • Denials analysis by service line/MDCs, CDS,
    coder,
  • physician, top 10 DRGs

6
Miscellaneous
Did You Know? A 271 beds hospital enhanced its
cashflow by 2.3M by decreasing its DNFC from 7.6
days to 4.7 days (38 drop)
  • Detailed analysis will be conducted on following
    KPIs and shared with the provider in order to
    achieve efficiencies and prevent any revenue
    leakage in the existing processes
  • DNFC days
  • LOS Variance
  • 30- day Readmission cases

7
Contact us
Visit Our Website- https//www.ezdi.com/ Address
- 12806 Townepark Way, Louisville, Kentucky 40243
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