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The Hospital Efficiency Index (HEI) is an invaluable consulting resource for strategic decision makers in the health care industry. These include decision makers at provider, managed care and privately insured organizations.
The HEI represents statistical/actuarial methodologies for analyzing hospital inpatient admissions, length of stay and days, as compared to benchmark most efficient practice, in order to estimate potentially avoidable admissions and days. The primary objective of the HEI is to compare any set of given hospital inpatient experience to the equivalent case-mix/severity adjusted most efficient practice found anywhere in the US. The results are all indexed to this common benchmark. (most efficient practice) to determine potentially avoidable days and admissions and to readily allow direct comparisons on a consistent basis.
The Hospital Efficiency Index is available in two formats: 1) the Analysis Browser or 2) Hard Copy Reports. In addition customized data analysis can be performed on any carrier or facility data.
Separate Hospital Efficiency models are developed for Medicare inpatient care (Medpar data based on UB-92 information) and Commercial (HMO, PPO, indemnity) and Medicaid admissions using public data from 20 states.
Applications of the Hospital Efficiency Index
For providers, the Hospital Efficiency Index can be applied in the following areas:
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Risk or capitation evaluation
• Cost cutting/reengineering focus
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Long-term strategic planning
• Profitability of Medicare DRGs
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Acquisition/Integration/Consolidation
• Identification of most efficient practice facilities
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Determination of reasons why days are potentially avoidable
For risk takers and carriers the Hospital Efficiency Index can be used for:
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Selection/evaluation/integration of networks
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Determination of hospital efficiency adjusted charge or reimbursement levels
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Development of new reimbursement structures
• UR focus
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Negotiation of provider contracts
• Avoiding medical malpractice risk
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Determination of reasons why days are potentially avoidable
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Identification of benchmarks by DRG or specialty
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Identification of most efficient practice facilities
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