Medicare Hospital Home Care Discharges by DRG Report Tutorial A

Filed under Report Tutorials & FAQs

HOW TO USE OUR DATA

Outlined in the chart below are analytical observations derived from reviewing the sample Medicare Hospital Home Care Report and the implication and/or actions to take on the next sales call with your hospital prospect. Click on Exhibit 1, Exhibit 2, Exhibit 3 to view the highlighted report. The Exhibits will open in a new window so you can view them together with the chart below.

Download a sample report now and decide which key account could benefit most from this information.

Statistical support for the observations can be found below the chart.

Exhibit/Observation Implication/Actions
Exhibit 1 – Hospital refers less to home care than region and state averages(A) Opportunity to “grow the pie”, instead of “fighting for share”. Discuss with prospect reasons for suboptimal performance
Exhibit 1 – Hospital has length of stay problem and could benefit from earlier discharge to home care(B) Discuss with prospect reasons for length of stay problems and focus on key DRG’s or disease types. Ask if identifying patients earlier for home care would help
Exhibit 2 – Discharge planner who covers respiratory and cardiac units is responsible for 41% of discharges to home care(C) Calculate referral share of your agency with this key individual and focus sales efforts on these types of patients with possibly, a specialty program
Exhibit 2 – Referrals to home care could grow by 42%, when compared to best practices(D) Target key DRG’s with greatest potential to grow. Work with prospect to understand current discharge preferences
Exhibit 3 – Hospital is 45% more likely to refer to facility(rehab, SNF, etc) upon discharge than region average and less likely to community(self-care).(E) Appears to be doing a good job of minimizing risk of re-admission by discharging fewer patients to self-care. May have bias towards in-house sub-acute unit.
Exhibit 3 – Hospital has higher percentage of frail elderly, which should require more referrals to home care than other hospitals in the region. (F) Patient mix does not account for underperformance in home care referral rate, as noted on Exhibit 1. Probe on rationale for preference towards skilled nursing facilities as discharge setting.

STATISTICAL SUPPORT FOR OBSERVATIONS
A. TOTAL Discharge Rate to Home Care for “Chosen Hospital” – 15.8%
TOTAL Discharge Rate to Home Care for “Region” – 17.7%
TOTAL Discharge Rate to Home Care for “State” – 18.1%

B. TOTAL Actual Length of Stay(LOS) for “Chosen Hospital” – 8.5 days
TOTAL Expected Length of Stay(LOS) for “Chosen Hospital” – 5.7 days
(Expected length of stay is based on Medicare national statistics)

C. # of Discharges of Patients with Respiratory Diseases – 129
# of Discharges of Patients with Respiratory Diseases – +187
41% of TOTAL Discharges to Home Care of 766 : 129+187= 306

D. TOTAL Discharge Rate to Home Care for “Chosen Hospital” – 15.8%
TOTAL Discharge Rate to Home Care for “Top Performers” – 26.5%
(Top Performers rate is median discharge rate of top 10% hospitals nationally)

E. TOTAL Discharge Rate to Community for “Chosen Hospital” – 32.0%
TOTAL Discharge Rate to Community for “Region” – 45.1%
TOTAL Discharge Rate to Facility for “Chosen Hospital” – 38.0%
TOTAL Discharge Rate to Facility for “Region” – 25.9%

F. TOTAL Percentage of Frail/Elderly for “Chosen Hospital” – 28.4%
TOTAL Percentage of Frail/Elderly for “Region” – 25.2%
(National data show Frail/Elderly use home care more frequently)