Did you know?
- Inpatient services are the highest cost services and therefore reflect the highest level of payment from the Medicare Trust Fund.
- Utilization data will always play a critical role in structuring the healthcare delivery system to ensure that patients receive the right care in the right place at the right time and for the right cost.
- As a general rule, patients should meet certain standards for intensity of services and severity of illness to be admitted.
Why should I care?
- Utilization changes are early detectors of your hospital’s market share risk.
- In actionable terms, utilization data can help reveal your hospital’s strengths and its vulnerabilities, including:
- How effectively are you reducing unnecessary readmissions?
- How much disparity exists within your affiliated physician groups?
- To what extent are you transferring care to outpatient settings?
What should I do?
- Review the most current utilization data internally, for your hospital, and externally, for your immediate service area, to understand the utilization shifts in “real time.”
- Compare your services internally and against your competition to learn which variations exist and why.
- Identify which services are being treated in an alternative setting to determine if you are successfully transferring care within your own system, or losing to a competitor.