Metrics Matter: Primary Diagnoses That Provide the Greatest Revenue Potential
Which primary diagnostic groups offer the greatest revenue potential on a per-patient basis? That’s what we look at in this month’s metric, along with the various key financial indicators for patients with various primary diagnoses.
In this chart, we present the key financial indicators for patients with various primary diagnoses based on 2007 Medicare home health claims data. The recert rate (episodes per discharge), the percentage of Low Utilization Payment Adjustment (LUPA) episodes, and the average case weight index are all drivers of revenue for home health agencies.
This Key Indicators by Primary Diagnosis chart demonstrates:
- Conventional industry wisdom tells us that diagnoses requiring physical therapy are the most financially attractive patient group. This is supported with the highest average revenue per episode in the nervous category (which includes patients with stroke), as well as the injury/fracture diagnostic group.
- The least financially desirable patient group is the blood category; for example, patients who require B12 shots. This diagnostic group generates the highest percentage of LUPA episodes, as well as the lowest average revenue per episode.
- Diabetes patients – represented in the endocrine/nutrition/metabolic category – appear to generate a huge number of visits per episode. Unfortunately, this data may be skewed by the outlier behavior in southern Florida discussed in Healthcare Market Resources Identifies Outliers As a Major Source of Abuse in the Healthcare System.
Click here or call 215-657-7373 to learn more about this metric and how Healthcare Market Resources’ data can help you find new ways to optimize your revenue.