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INPATIENT SERVICES

Providing Data and Unique Insights About Your Medical Practice

Physician Analytics is a new compliance report offered by HMS Associates to provide you with your own data and a penetrating analysis of your inpatient practice patterns, and your significance to your hospitals, communities and payers. Using authoritative data from licensed facilities, HMS extracts information relevant to your practice, and provides unique and useful insights specific to you. Physician Analytics provides data on admissions, procedures, physicians, and other indicators for your individual practice and offers a comparison with other physicians at your hospital, in your region, and across the state. Demand analyses provide data and norms for assessing the potential for growth and identifying underutilized services.

Physicians Analytics Compliance Reports utilize inpatient data on attending and operating physicians covering all payers and all licensed facilities in selected states. The Compliance Report is an improvement over many existing systems that provide data and analyses only on a particular hospital, payer or practitioner. Compliance benchmarks are based upon a more extensive and comprehensive set of data, over 2 million records per year in selected states, and hence less subject to bias and standard error. The Compliance Report can be used to demonstrate your practice's:

1. Importance to your hospital or health system both as an admitter and revenue generator

2. Efficiency relative to your use of resources as measured by length of stay and charges by DRG

3. Importance to your community as a source of medical care

4. Principal geographic market, market share, and competitors or colleagues

5. Emerging and potentially saturated geographic markets

6. Quality of care as measured by volume thresholds

7. Importance of payers and their relative importance to your practice

8. Data in statewide databases.

Predictably, physicians' own records are often at variance with the data in the state database. Yet, many of the analyses have relevance by providing benchmarks from which you can review your own performance. For example, "norms" on ALOS, operating room time and number of secondary procedures, and charges by DRG or procedure by hospital, county and region, unmet demand by procedure and market share provide insights on your practice and may help you negotiate better with hospitals, payers, better manage your practice and better plan for expansion of services.

In addition, the source data set is becoming more accessible to the general public. In these days of health related data explosion, we strongly believe that physicians need their own capacity to verify or refute what's being said about them.

 

Physician Analytics Includes:

Profile 1 - Hospital Significance

This profile will help you see and understand both the absolute and relative magnitude of your inpatient practice in terms of patient discharges and total hospital charges. For example, the chart below shows that Dr. Merchant's patients were billed in excess of $1.5 million, more than all but five other attending physicians at his hospital. As such, he is a key generator of revenue for the hospital. This is a strong negotiating factor for him in matters pertaining to his relationship with the hospital.

Profile 2 - Inpatient Efficiency

This profile examines inpatient efficiency through a comparison of your DRG-related data with average length of stay "norms" for other physicians in your hospital, physicians in the county in which your hospital is located, and for physicians throughout the region of state. This report can be used to document your efficiency or point to areas where improvements in efficiencies may be warranted. It will be useful in discussions with hospitals and payers.

 

Profile 3 - Community Significance

This profile identifies your service area and your corresponding market share through a compilation of patient ZIP codes. You will see maps of your market share for high frequency DRGs by ZIP code in both actual numbers and percentages. A listing of other physicians treating those DRGs in the communities you serve is also provided.

This report will be useful in discussions with providers and payers to demonstrate the significance of your practice to communities they may treat or seek to enroll.

 

Profile 4 - Unmet Demand

This profile compares age / sex adjusted utilization levels in your principal market area with other market areas. It identifies degrees of potential "overservice" or "underservice" and thereby helps you to identify the potential for growth of your practice and assess claims of overutilization by payers.

 

Profile 5 - Payer Significance

This profile will help you understand the payer mix of your inpatient population. It provides data for all of your discharges by payer compared with payer mix data for other physicians in the hospital where you practice, and in your county. This report can show if you either over-serve or under-serve patients in particular payer groups and may suggest areas in which you may wish to expand or reduce emphasis.

 

Profile 6 - Actual Data Set

This profile lists data from selected fields on each patient for whom you were the attending physician. It provides the basis for your own audit of data available on public records about your practice.

Sample Fields for Each Inpatient Record:

 1. Discharge Number

2. Hospital

3. Admit Weekday

4. Discharge Year

5. Discharge Month

6. Discharge Weekday

7. Patient County

8. Patient ZIP Code

9. Patient Sex

10. Patient Race

11. Type of Admission

12. Admit Diag. Code & Desc.

13. Prin. Diag. Code & Desc.

 14. Other Diag. Code & Desc.

15. Prin. Proc. Code & Desc.

16. Other Proc. 1 Code & Desc.

17. Other Proc. 2 Code & Desc.

18. Fed. DRG Code & Desc.

19. Fed. MDC Code & Desc.

20. Patient Status /Disposition

21. Length of Stay

22. Reimbursement Source

23. Total Inpatient Charge

24. Attending Phy'n. License

25. Operating Phy'n. License

26. Other Phy'n License

Actual listings vary by state.

 

Trend Analyses

Physician Analytics will give you a year to year comparison across all the indicators tracked. Use this data to access your changing market position, spot trends in utilization or reimbursement, or evaluate the impact in changes in your practice such as new office locations or affiliations. Reports for 1997, 1998 and 1999 will be available with subsequent years to follow. Each new year's report gives you a clearer perspective on key trends. More current quarterly reports also will be available. Profile content and availability may vary by state

 

Cost

Physician Analytics fees range from $549.95 for an annual Compliance Report which includes all 6 profiles, to $1,149.95 for two consecutive annual Compliance Reports and Trend Analyses. Reports are available for individual physicians and groups of physicians. Discounted rates are available for group purchases. Individual profiles are also available.

Physician Analytics saves you time and money. A rapid scan provides relevant information at a fraction of the cost of acquiring and analyzing the data yourself.

 

HMS Associates

HMS Associates, a Buffalo New York-based health care consulting firm was established in 1990. HMS Associates has conducted numerous analytical studies for health care institutions, practitioners, academia, and branches of local, state and federal government. Gregory Bonk, founder of HMS Associates, has been a clinical instructor at the State University of New York at Buffalo, School of Medicine and Biomedical Sciences since 1989 and has authored a variety of publications.

Information sources for Physician Analytics are hospital reports in state databases. Although not warranted or guaranteed by HMS Associates, this data set is among the most authoritative information available on hospital inpatient utilization. Physician Analytics Compliance Reports on ambulatory surgery are also available.

 

Physician Analytics

Physician Analytics is a ready reference on your practice patterns which will give you:

  1. An annual summary of key statistics on your inpatient practice patterns.
  2. Comparative data which describe your relative efficiency of inpatient utilization as well as your market position in the hospitals where you are attending, in the communities you serve, and with the payers you bill.
  3. A succinct interpretation of comparative data which can be used when negotiating contracts with hospitals, provider groups or payers.
  4. An authoritative and independent basis for evaluating statements made by hospitals, provider networks, or payers regarding your utilization of inpatient resources.
  5. Measurements of unmet demand for services in your community to assist in business planning.
  6. A patient origin geocoded map of your service area.
  7. Actual data in hard copy or electronic format so you can review directly and in detail information about your practice.

Physician Analytics also comes with a money- back guarantee. If you are not satisfied with the report, return it within 30 days of receipt and receive a full refund.

Order Form



HMS AssociatesSuite B, Box 3742280 Millersport HighwayGetzville, NY 14068
Tel. (716) 688 - 8448Fax (716) 688 - 0395Toll Free (877) 889-6519

E-mail: Consulthms@aol.com



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