Title: Healthcare Key Performance Indicator Consulting
1Healthcare Key Performance Indicator Consulting
2Enhance 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
3Case 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.
4Coder/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
5Denials
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
6Miscellaneous
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
7Contact us
Visit Our Website- https//www.ezdi.com/ Address
- 12806 Townepark Way, Louisville, Kentucky 40243