Clinical Analytics Benchmarking and Severity/Risk Adjustment Methodology
Frequently Asked Questions
You can download this PDF here. Measure-specific information can be found in the Benchmark Calculations section.
What is benchmarking?
Benchmarks are a standard reference or measure for comparison that can help evaluate performance and identify opportunities. Clinical Analytics benchmarks are derived from All Payer and MedPAR encounter data sources. Clinical Analytics purchases, maintains, and utilizes a proprietary database that houses a vast amount of patient encounter records across the United States. For internal benchmarking, your facility provides internal data fields to Clinical Analytics for data processing and mining within the tool.
Which data sources are used for benchmarks?
Clinical Analytics purchases, maintains, and utilizes a proprietary database of millions of patient encounter records. Benchmarking can be done based on external encounter data or internal encounter data.
- External benchmarking utilizes All Payer state data and CMS MedPAR data, aggregated into peer groups, for comparison. Clinical Analytics has a library of over 1200 standard peer groups for external benchmarking, in addition to the ability to create custom peer groups made up of a client selected group of facilities.
- Internal benchmarking refers to a comparison to one’s own data. Within Clinical Analytics, users can compare within their own organization to identify care variation across physicians, nursing units, service lines, facilities, and much more.
Who are we being compared to in Clinical Analytics?
Clinical Analytics provides users with the ability to select the comparison benchmark and toggle between peer groups. Flexible functionality allows for a comparison of either internal or external benchmarking. For questions on what is included within the peer group for comparison, contact Support.
Can I customize the peer group I am being compared to?
Peer groups are absolutely customizable. If Clinical Analytics doesn’t have the desired peer group, contact Support for assistance in creating the desired custom peer group(s).
Can I benchmark within my own organization?
Yes, you can create internal benchmarks to compare measures and performance across your own organization. One example might be looking at one facility within the health system compared to another facility within the same health system. Furthermore, you can continue to narrow the internal benchmark comparison and look at one physician in comparison to his/her service line or physician group as a whole.
How is the severity/risk adjustment calculated?
The methodologies utilized for severity/risk adjustment for inpatients are 3M APR-DRG and MS-DRG. 3M methodology provides a severity and risk adjustment methodology, whereas MS-DRG provides a CC/MCC methodology with a focus on resource utilization only. As a user, you can select the methodology to use throughout Clinical Analytics.
How are inpatient and outpatient benchmarking different?
Inpatient and outpatient benchmarking differ in the data being compared and the severity/risk adjustment methodology.
- Inpatient benchmarking is comparing to inpatient encounters and utilizes APR-DRGs and/or MS-DRGs to severity and risk adjust.
- Outpatient benchmarking utilizes hospital-based outpatient data for comparison and utilizes a variety of risk adjustment methods depending upon the patients being analyzed. These methods include Principal APC, Principal CPT, Principal Diagnosis, and ED Level of Care. For more information on Outpatient analytics, contact Support.
How often are external benchmarks updated?
Clinical Analytics updates benchmark data on an ongoing basis. The benchmark release schedule follows closely with our software quarterly updates, and the content of the releases varies depending on which states released updated data and when the MedPAR annual release falls. The Clinical Analytics Data Operations team sends out detailed email notifications to all clients when new benchmark data are released.
How old are the benchmark data sources?
Clinical Analytics benchmark data varies in age. Whether you are using an All Payer based peer group or a Medicare based peer group, the benchmark data can have a lag time of around 12 - 18 months.
Questions?
Contact Clinical Analytics Support: peaksupport@syntellis.com or (847) 441-0022
