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Understanding Hospital KPIs: The Role of Technology in Improving Performance

By AGS Health

August 25, 2022

Providing excellent patient service is the primary goal of any healthcare organization. To this end, key performance indicators (KPIs) measure well-defined, quantifiable goals that healthcare providers can strive for. According to the Institute for Healthcare Improvement, vital KPIs measure the Triple Aim:

  • Improving the overall patient experience of care – with a focus on quality and patient satisfaction
  • Improving the health of populations
  • Reducing healthcare costs per capita

Key Performance Indicators

There are a variety of metrics that can be used to assess the performance of healthcare organizations. Clearly defined KPIs help organizations more quickly improve performance because they allow for better focus. Some primary KPIs that organizations should focus on to improve revenue cycle performance include:

  • Case Mix Index (CMI) - CMI is the average value assigned to a group of people with the same diagnosis based on their personal details and treatment. This enables healthcare organizations to allocate specific resources to patient care based on these considerations.
  • Average Length of Stay (LOS) - The average LOS calculation quantifies the time patients spend in healthcare facilities after admission, as well as establishes optimal timing management for specific procedures and groups.
  • Claim Denial Rate - Insurance companies reject claims they deem not payable due to billing errors, missing information, or patient coverage policies. Healthcare organizations can gain insight into the effectiveness of their revenue cycle by keeping track of claim denial rates.
  • Patient Satisfaction & Safety - Another significant healthcare KPI is holistic patient satisfaction and safety, which all healthcare providers should prioritize. This includes tracking incidents, minimizing risk exposure, and gathering patient feedback.
  • Medical Costs by Payer - Organizations estimate revenue brackets for their facilities by determining what kind of health insurance policies (or lack thereof) patients have.
  • Treatment Costs - To establish proper financial management, healthcare organizations calculate treatment costs based on different categories over a period of time.
  • Patient to Staff Ratio - The number of staff per patient to determine whether a facility is understaffed or overstaffed.
  • Patient Wait Time - The time it takes for a patient to arrive at the facility and be seen by a doctor, which helps organizations understand and plan for busy times and adjust resources accordingly.
  • Clinical Documentation Improvement (CDI)- Improve the quality of healthcare records to deliver better care and stronger reimbursement for services. Organizations can establish benchmarks for where their documentation stands now, how much time it takes to code patient data, and identify gaps to be filled productivity.

Improving Organizational Performance

With technology playing such an essential and growing role in modern medicine, a unified platform to help healthcare executives and providers better understand and monitor KPIs is critical.

Using AGS’s robust analytic tools, organizations gain a clearer picture of real-time performance and metrics.

Advanced analytics further help executives achieve their efficiency, quality, and financial goals by highlighting trends and providing actionable insights.

AGS’s robust reporting functionality is customizable, helping healthcare executives conduct in-depth analyses of their KPIs, focusing on primary metrics directly related to their main growth areas.

Through the use of actionable insights, this data-first approach helps improve the quality of patient care and financial management.

To learn more about how AGS can help you monitor your organization’s KPIs, request a meeting or book a short demo.

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AGS Health is more than a revenue cycle management company—we’re a strategic partner for growth. Our distinctive methodology blends award-winning services with intelligent automation and high-touch customer support to deliver peak end-to-end revenue cycle performance and an empowering patient financial experience.

We employ a team of 12,000 highly trained and college-educated RCM experts who directly support more than 150 customers spanning a variety of care settings and specialties, including nearly 50% of the 20 most prominent U.S. hospitals and 40% of the nation’s 10 largest health systems. Our thoughtfully crafted RCM solutions deliver measurable revenue growth and retention, enabling customers to achieve the revenue to realize their vision.

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