Actionable Analytics For Improved Financial Outcomes in Healthcare

Hospital leaders face substantial challenges when it comes to aggregating and comparing vast datasets to identify and correct problems. The sheer magnitude of data is prompting these healthcare organizations to recognize this deficit in their existing systems. As they learn about the value and benefits of actionable analytics to address and solve problems in virtually every aspect of operations, they are adopting new technology that is now available. A key benefit is that these new platforms overlay current transactional systems to deliver a cleaner, smarter and cost-effective solution.

The consolidation of data required to perform actionable analytics, allows astute hospital leaders to efficiently retrieve, compare, reconcile and analyze all data through multiple platforms. Because there is no large upfront investment and no need to discard existing systems, this puts organization management in control of aggregating data, and detecting/resolving issues that impact revenue integrity, as well as clinical and operational performance.

Radiology Case Study For Actionable Analytics
Let's say a patient presented a script for a CT scan of the abdomen without contrast. The patient underwent the first test, but upon review the radiologist decided a CT with contrast was needed and updated the order. The problem was that the initial registration and authorization were for CT without contrast, and the new test and fee were completed without the proper authorization.

As a result, the bill contained several errors related to insurance authorization and an unexpectedly higher bill, leading to lower than expected revenue in the department, re-work and delays in the receivable, a late bill and the potential for an insurance denial.

With actionable analytics, the story would see significantly better results: Sophisticated actionable analytics systems would have allowed the hospital to use any data from any transactional system to set up sophisticated alarms, and the issue would have been detected immediately.

Source: Health IT Outcomes (View full article)

Posted by Dan Corcoran on November 21, 2017 06:49 AM

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