Looking at the analytics dashboard

QUESTION 1

compare the "target" (expected) with the "current" (actual) value for the LOS (length of stay) index.

Comparing these figures, what conclusion can you make regarding the length of stay?

QUESTION 2

What action might the organization take in regard to case management/utilization review processes to address the length of stay index?

QUESTION 3

Compare the target and current values for the Unplanned/Related Readmit Rate....what conclusion can you make when comparing these figures?

QUESTION 4

What might the organization look at with respect to case management/utilization review processes as a result of the readmission data?

QUESTION 5

Compare the data for target and current inpatient denials, not medically necessary. What conclusions can you come to by comparing this data?

QUESTION 6

What might the organization doo as a result of the inpatient denial data?

* NI n/ 4 o 4 3 3 Cumulative Year Current SPC Status Indicator Value Target (Fiscal) Updated Alert Value Start Case Management > LOS Report Card LOS Index 1.02 0.95 Oct 2015 0.98 Jul 2015 LOS (Obs) 7.58 n/a Od 2015 7.14 Jul 2015 LOS (Exp) 7.41 n/a Oct 2015 7.30 Jul 2015 Opportunity Days 200 -1 Oct 2015 -705 Jul 2015 Case Management > Readmission > Readmits by Index Service % Unplanned/Related Readmit Rate 15.6% 13,3% Od 2015 16.0% Jul 2015 % Medicare Readmit Rate 15.9% 13.3% Od 2015 16.4% Jul 2015 % Medicaid Readmit Rate 19.3% 13.3% Od 2015 17.4% Jul 2015 Case Management > Revenue Cycle # Medicare IPs Without Cert Notes Nov 2015 32 Jul 2015 Inpatient Denials 0 Nov 2015 30 Jul 2015 AS IP Denials Medicare A to B -$1,650 $0 Nov 2015 -$21,450 Jul 2015 IP Denials Not Medically Necessary-51,798 $0 Nov 2015 -$78,526 Jul 2015 AS IP Denials UM 1215 -S17,816 Nov 2015 $214,220 Jul 2015 IP Denials UR Incomplete $0 Nov 2015 so Jul 2015 Case Management > UM Reviews Code 44's Nov 2015 9 Jul 2015 # Type 121's 0 Nov 2015 1 Jul 2015 Case Management > Volume Metrics Inpatient Discharges 1131 Oct 2015 4540 Jul 2015 Observations 115 n/a Od 2015 400 Jul 2015 Observation Rate 17% 17% Oct 2015 17% Jul 2015 Obs Conversion Rate 43% n/a Od 2015 51% Jul 2015 Outpatients in a Bed 198 n/a Oct 2015 696 Jul 2015 Obs/OPs in a Bed > Day LOS 0 Oct 2015 45 Jul 2015 + $0 $0 : : 2 0 ON + n/a 10