Crunch the Numbers
HME and DME providers are under tremendous pressure to participate in competitive bidding and better manage audits from a myriad of government programs.
Competitive bidding is a difficult fact of life for providers. The American Association for Homecare is currently soliciting feedback on the often-painful bidding process as it urges government leaders to review and even rescind competitive bidding.
HME/DME providers are also under intense pressure to comply with numerous government audits, including Health Care Fraud Prevention and Enforcement Action Team (HEAT)/Medicare Fraud Strike Force investigations, Zone Program Integrity Contractor (ZPIC)/Program Safeguard Contractor (PSC) and Medicaid Integrity Contractor (MIC).
Comparative analytics is one way HME/DME providers can prepare for, and cope with, competitive bidding and audits. This technology offers real-time data on utilization, productivity and reimbursement.
The Promise of Comparative Analytics
Comparative analytics offers HME/DME providers a strategy for addressing the burden of competitive bidding and softens the blow of the tidal wave of government audits.
The ideal analytics solution functions in real time. It allows HME/DME providers to instantly examine and compare their performance on reimbursement, utilization and productivity against competitors. For example, a Philadelphia provider can measure and compare its performance to competitors both on the state and national levels.
HME/DME providers can easily determine whether they are outliers for RAC audits. They can discover if their competitors have higher or lower denial rates, along with faster or slower payments. They can compare their coding usage to state averages and understand how well their staff performs against peers and competitors.
While some providers may believe that such data is available from government agencies in print form, the data within these publications is sometimes at least two years old. HME/DME providers will find real-time data more beneficial. It is fast and easy to view, understand, use and share.