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The Outpatient Charge Analysis (OCA) provides the valuable insights needed to help providers make smart pricing decisions that are financially sound and regulatory compliant.

Analyze Pricing on a Code-by-Code Basis

Utilizing procedure-based charges, this report allows users to compare hospital-specific outpatient pricing practices and address critical revenue issues. By understanding how a hospital's outpatient pricing structure compares with that of the local market, decision-makers can quickly determine the strategies needed to remain compliant while preventing revenue loss.

The OCA allows a client to choose up to ten "comparator" hospitals, which may include local area providers or composite benchmarks such as teaching facilities.

The OCA gauges whether a hospital's pricing policies are overly aggressive by comparing charges on a code-by-code basis. Charges-per-visit for each hospital are determined as well as the average charge-per-visit for the same code, allowing the user to analyze charges on a "line item" basis against peers. HDI then identifies pricing concerns or the revenue potential that could be realized if the charge-per-visit was equivalent to that of the peer group.

HDI summarizes this information and aggregates the informatics at the department-level to help identify departments with issues or opportunities.

Flexible, Accurate Analysis at Multiple Levels of Detail

The Outpatient Charge Analysis supplies both bundled and unbundled procedure code-based charges, allowing users to "drill down" to compare departmental performance for surgical procedures and analyze departmental charges at the cost level.

This analysis package provides the flexibility to review outpatient pricing performance on multiple levels of detail including overall hospital-level, ancillary department-level, top procedures by procedure code, and at the charge code-level by department, allowing facilities to avoid costly management mistakes.

About the Data

The data contained in the Outpatient Charge Analysis comes from the Center for Medicare and Medicaid Services' 100% Standard Analytical File-Outpatient. This file contains hospital-based Medicare outpatient claims totaling over 103 million patient records. The report period captures a full calendar year of data (January-December). We make every effort to ensure the validity, integrity, and quality of the data contained in the OCA.

The Outpatient Charge Analysis—powerful, insightful analytical intelligence from the leaders in strategic healthcare solutions.