Due to the increasing competition to remain viable, health care service providers are finding it necessary to undergo annual price reviews in order to optimize net revenues. There are two more reasons why hospitals are opting to analyze hospital data for benchmarking analyses – the transformation into consumer driven health care environment and the changes happening in government legislation.
HPS (Hospital Pricing Specialists) from the year 1993 has been providing comprehensive hospital pricing reports and consequently helping the health care service providers by providing the custom hospital data on the basis of which the clients can choose specific hospitals for pricing comparison at the HCPCS or MS-DRG levels.
The hospital data, consisting of outpatient data, inpatient data, department level pricing, inpatient service line pricing, hospital room rates and hospital financial data is mission critical information for a hospital executive to monitor. HPS can provide these types of crucial data after deriving them from CMS claims data and Medicare cost reports within the time frame of just 48 hours.
The researchers at HPS consult the MEDPAR file for analyzing the inpatient record of any Medicare patient who gets admitted in the hospital for the treatment of any ICD diagnosis.
MEDPAR is short for Medicare provider analysis and review. MEDPAR helps in analyzing the patterns and outcomes of a particular hospital’s inpatient care by the length of stay of patients, their complications and prices. The MEDPAR records also contain the final action claims data in which all adjustments have been resolved.
In order to choose the right medical service provider the consumers should be able to do accurate hospital price comparisons and HPS provides the detailed report for this. The reports provided by HPS also help the medical service provider whether it is a hospital or a nursing home to have the information such as inpatient pricing and outpatient pricing.
The health care medical system becomes more cost effective and efficient based on the hospital price comparisons with hospital benchmarking. On the other hand consumers are also able to make accurate price comparisons with the help of strong medical data.
The short name for Outpatient Prospective Payment System is OPPS. OPPS is a database made by CMS for reimbursement of hospitals that provide outpatient services.
This database has proved to be very useful for patients along with Centers for Medicare and Medicaid service providers. It has been made mandatory for every CMS hospital to have a Hospital Outpatient Prospective Payment System (OPPS). Implemented on August 1, 2000, OPPS has helped in reducing the beneficiary co-payments to a large extent.