Health Care Reform Will Renew Interest in Benchmarking
Blog posted by Nancy Rehkamp (retired)As bi-partisan discussions heat up and health care reform becomes a hot topic again, we are hearing lots of buzz about what this might mean for providers. One common element is many expect continued pressure to reduce health care costs.
Reducing costs, particularly at significant levels (5 percent or greater as might be required under some of the anticipated payment reform alternatives) will be challenging without some major changes. Although benchmarking is not new, it might reveal ideas if applied more broadly. If we approach the variations in health care, such as reported in the Dartmouth Atlas, as an opportunity to benchmark with providers outside our region or state (or even outside the health care field), we might find there are new possibilities for cost reductions and improving care.
Some of the toughest and least sophisticated areas to benchmark are services provided in skilled nursing facilities, homecare, and home and community based services. Part of this is because there is no automated data collection and the significant portion of private pay services that are not reported publicly. There are some good data sources that offer assistance such as the LarsonAllen Annual Skilled Nursing Cost Comparison Report which is organized by region and performance quartiles. Customized reports can also be developed by LarsonAllen and other consulting firms using Medicare Cost Reports (MCR), OSCAR (Online Survey, Certification, and Reporting systems) and other proprietary data bases.
Long-term and acute care providers have much to gain by going across state lines for comparative data. Some areas of the country have had significantly lower reimbursement rates from Medicare and Medicaid and have adapted. Because reimbursement rates are so varied, there are many organizations doing great things that they do not recognize as innovative. Identifying these organizations and examining their processes of care and operations might be just help address some tough issues.