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Benchmarking in Revenue Cycle Management

By Scott Everitt, Vice President of Analytic Solutions

One of the most common questions I am asked by new clients or prospective clients is, “Do you have benchmarks?” As a company specializing in healthcare business intelligence, it is not surprising that this request is so common. Typically, PDS is bringing hundreds of new performance metrics to our clients, along with business logic, rules and various dimensions or perspectives for managing these metrics. As such, it is only natural to want to compare the newly accessible KPIs to similar organizations to see how performance stacks up... and possibly where there may be the greatest opportunities for improvement.

Incorporating benchmarks can be an incredibly useful tool in managing the performance of a physician practice. KPI dashboards and reports are important, but adding benchmarks can provide managers and key stakeholders with better context and meaning behind the numbers. Comparing your practice’s performance against similar organizations in key revenue cycle areas such as provider productivity, patient access, collection efficiency, AR management, denials, etc. can be an invaluable tool in driving goal-setting and overall strategy for the group. Additionally, benchmarking can highlight variances, identify outliers, and provide practice managers with laser-focused opportunities to achieve performance improvement.

However, there are challenges to benchmarking which can make the process discouraging or ineffective if not addressed early on in developing your practice’s benchmarking strategy. The strategic processes behind a benchmarking initiative can often be time consuming and costly. 

Management teams often struggle to define what to measure or which KPIs are relevant for benchmarking. There can be uncertainty as to whether the benchmark is calculated the same way as your practice’s key metrics. For example, is the benchmark using gross or net AR, and are they calculating aging from date of service or date the AR was transferred to the current payer, etc.

The greatest risk to benchmarking is in the communication and presentation of the comparison reports. If not managed effectively, benchmarking efforts can lead to questions of validity of the data and/or applicability of the benchmarks.  As a result, there can be internal resistance to the whole initiative. Over the years, there have been a countless number of times I have heard providers say, “You can’t compare what I do to some ambiguous average. I’m different. My patients are sicker. The diseases I manage are more complex…”

The fact is, benchmarking has great value in the management of a practice, but there are a number of pitfalls which need to be avoided in taking on the effort. In the coming weeks I will discuss more about best practices on how to incorporate a benchmarking strategy into your practice. I will also share some additional strategies in which benchmarks have been effective in helping drive change within organizations.  

Tags: Benchmarking

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