St. Clair Ingenix Financial Analysis Reports
Under a marketing arrangement with Ingenix (St. Anthony/Medicode/CHIPS), St. Clair is selling its financial analysis reports.
Outpatient Financial & Statistical Data
Ingenix outpatient financial reports assist the Client Hospital to stay competitive with its rates and charge capture by comparing its outpatient pricing and services to user-defined peer facilities and the Metropolitan Statistical Area. They include the below-described Outpatient Price and Cost Profile report and Outpatient Charge Capture report, as well as the Outpatient Pricing Profile and the Outpatient Rate Builder.
Outpatient Price and Cost Profile. For each of the top 100 HCPCS/CPT services based upon the Client Hospital’s total charges, a 1-page Adobe analysis report is prepared comparing the charge/unit and cost/unit of the Client Hospital with four user-defined peer facilities over the most recent available three years. An Excel spreadsheet report compares the Client Hospital’s charge, volume and cost for all HCPCS/CPT services, with eight user-defined peer facilities. The three years of data allows the Client Hospital to see how it is trending toward the future. The data source for these comparisons is a combination of the MEDPAR file and the Medicare Outpatient Standard Analysis file.
Outpatient Charge Capture
. This report identifies the Client Hospital’s potentially missed outpatient services. For each primary CPT, a 1-page Adobe report presents the most recent available volume and the payment data for each of the secondary CPT codes, which are most commonly billed with the primary CPT for the selected Metropolitan Statistical Area (MSA). Based upon the average utilization of the secondary CPT codes for the MSA, the report projects "payment rate" impacts for the Client Hospital if it had the average utilization rate. An Excel spreadsheet report provides, for each primary CPT, the volume, utilization and the payment data for the Client Hospital and the MSA by "billing related" secondary CPT code. The data source for these comparisons is a combination of the MEDPAR file and the Medicare Outpatient Standard Analysis file.Inpatient Financial & Statistical Data
Ingenix inpatient financial reports assist the Client Hospital to benchmark its inpatient clinical services against its competition and take steps to correct identified financial weaknesses. They include the below-described Inpatient Price and Cost Profile, as well as Inpatient Pricing Profile, Inpatient Room Rates, Inpatient Department Price and Cost Profile, and DRG Pairings Profile
Inpatient Price and Cost Profile
. For each of the top 100 DRGs based upon the Client Hospital’s total payments, a 1-page Adobe analysis report is prepared comparing the charge/unit and cost/unit of the client Hospital with four user-defined peer facilities over the most recent available three years. An Excel spreadsheet report compares, by DRG, the Client Hospital’s charge per admit, allowed (payment) per admit, cost per admit, ALOS, discharge volume, and case mix index with eight user-defined peer facilities. The three years of data allows the Client Hospital to see how it is trending toward the future. The data source for these comparisons is the MEDPAR file.