Missing benchmark values
Occasionally, in the course of your analysis, you may come across a measure missing a benchmark value; this missing benchmark value is likely due to one of the following conditions.
NOTE: Internal data sources typically do not miss any benchmark values because the following stipulations do not apply. Internal benchmark values are missing only when there are no patients found for that particular grouping (APR-DRG/SOI, APR-DRG/ROM, or MS-DRG).
Readmissions
There are no external readmission benchmark values for Same-Day, Same-Hospital, One-Year, and Backward-looking readmission rates because of the intent and limitations of the National Readmission Database (NRD).
With the NRD, there are external readmission benchmarks for these forward Readmission measures:
- 7-Day
- 10-Day
- 14-Day
- 30-Day
- 90-Day
- 180-Day
In general, external readmission rates are difficult to obtain because external data sources are de-identified to protect PHI and the identity of individual patients. This means that, with our other benchmark sources (except NRD), we cannot link two separate encounters, even if they are the same patient, which we need in order to detect readmissions. If you would like to see benchmark values for readmission measures besides those listed above, you must select one of your Internal profiles as your Benchmark Profile.
External data source limitations
There are certain measures that rely on data fields not available in our external data sources. For example, National Drug Codes (NDCs) are not provided in MedPAR nor All Payer sources, so there are no external benchmarks available for pharmacy utilization measures. Another example of this relates to the MedPAR cost categories. Because MedPAR costs are aggregated by bucket instead of revenue code, Clinical Analytics cannot calculate Medicare benchmarks for cost measures defined outside of the provided MedPAR cost categories. Contact Support for more details or with questions about specific measures and benchmark availability.
Encounter Rule of 11 and Facility rule
Clinical Analytics Software has high internal standards for the data and benchmarks we make available to our clients. The Encounter Rule of 11 and Facility Rule protect private information while keeping benchmarks and statistics relevant.
When you request an external benchmark from the system, it runs the data through both rules to make sure the data is statistically relevant and anonymous before displaying the benchmark on the screen. If you do not see a benchmark value, it may have violated one of the following rules. In this case, if you would like to see benchmark values, you must select an internal benchmark profile, or a larger external benchmark profile. You may also be able to project benchmark values for the peer group profile but setting Project Benchmarks to Yes in the Profile Editor.
The Encounter Rule of 11
The Encounter Rule of 11 applies to all encounter-level benchmark data. Whenever you request external benchmarks from the system, it first checks to make sure there are at least 11 encounters in the relevant data set. If there are fewer than 11 cases in the peer group for the analysis level (APR-DRG/SOI, APR-DRG/ROM, or MS-DRG), Clinical Analytics does not produce a benchmark. This ensures results are statistically significant and reduces the effect of outliers on benchmarks. It also helps protect patient privacy, as no single patient is identifiable in a larger group.
Facility rule
The Facility rule is similar to the Encounter Rule of 11, but it applies to facilities rather than encounters. When Clinical Analytics aggregates benchmark data, it checks to make sure enough facilities are included.
Each state has its own rules for the number of facilities required to make up a peer group. Some states require at least two hospitals, while the others, including well as Washington DC and Puerto Rico, only require one. Clinical Analytics Support can provide a list of state requirements upon request.
The Facility Rule is designed to protect facility data; in a group, no single facility is distinguishable from the rest. The rule is applied after the Encounter Rule of 11, and after Clinical Analytics creates measures at the facility level. This means that if a peer group has fewer than the required number of hospitals with Encounter Rule of 11-qualified benchmarks, no benchmark value displays.
