You probably hear this all the time: regularly checking your data is important. You’d better keep an eye on your metrics! In-depth analytics are crucial to keeping your agency going! Business, numbers, etc.
The truth is, you’ve been hearing right. Running a home health agency without data insight is like driving a car with no gauges on the dashboard. It’s difficult to see what’s going on, and you don’t know when something may go wrong. But, what data should you check, and how does it help?
Obviously, an agency can’t stay open without revenue coming through the door. Regularly checking your claim data gives you valuable insight about the efficiency of your billing practices and agency’s cash flow.
Some good metrics to frequently check are the status of your claims in the billing process, which claims came back Return to Provider (RTP) or rejected, and the reason codes for those claims. This allows you to identify certain trends in your claims submission process. Is one reason code producing frequent RTPs? Maybe it’s time to examine why.
If you’re still unsure about taking necessary action based on your claim data, comparing your data to your peers will add clarity. A comparative analytics solution offers insight into critical metrics like claim processing time, denials, and amount paid on claims. Comparing data with your peers lets you pinpoint exactly where you need to improve so you’re not wasting time.
If billing Medicare claims weren’t hard enough, home health agencies also deal with additional rules, deadlines and possible penalties with Request for Anticipated Payments (RAPs). Thankfully, you can monitor specific information to reduce the risk of takebacks. RAPs that are close to the cancellation deadline, cancelled RAPs, and paid RAPs are just a few numbers to track for a better handle on your deadlines and takebacks. You should also assess your risk for Z-RAPs – when RAPs pay at 0% instead of 60% of the final payment.
It’s no secret that the lifeblood of home health agencies is referrals from hospitals, and a great way to foster those referrals is to keep your hospital re-admission rates low. Regularly monitoring and benchmarking your re-hospitalization rates against CMS best practice standards will put you in a better position to catch and fix any problems before re-admissions get too high.
Patient Care and Your Five-Star Rating
If you want to improve and maintain your five-star rating, the key is in your CASPER data. Checking your agency’s quality measures monthly gives you insights into trends that affect your rating and the care your patients receive. Once you understand these trends, you can determine if you should take action.
Unfortunately, retrieving your CASPER reports is a slow process, so many providers only check them quarterly. Manually checking this data ties up staff resources, locks up computers and kills productivity. Many agencies even have a dedicated staff member pulling these reports.
In this case, automation is important for your data to be valuable. Having a system that delivers CASPER reports directly to your inbox on your schedule lets you focus more of your resources on patient care and gives you more timely data.
Staying on top of your home health KPIs, CASPER reports and claim data gives your agency the power to excel in multiple areas while providing better quality care to your patients. At the end of the day, looking at data is good, but knowing exactly where the problems lie and how to fix them is what sets your agency apart.