CHARLOTTE, NC – The Premier healthcare alliance has boosted its ClinicalAdvisor quality benchmarking and regulatory reporting technology to include capabilities focused on Medicare's Recovery Audit Contractor (RAC) program.
ClinicalAdvisor (CA) offers analysis, benchmarking, consulting, knowledge-sharing and other customized services and is designed to help hospitals and health systems close performance gaps. Officials say it helps identify the gaps through the use of risk-adjusted outcomes and comparative data, along with cost and clinical resource use information.
Enhancements to CA will allow users to access Revenue Audit Contracting reports to identify potential inpatient overpayments prior to RAC audits, allowing for proactive intervention on patient records in case corrections are needed, Premier officials said CA will also offer a new Practitioner Profile, providing the ability for online collaboration and dialogue with practitioners while supporting The Joint Commission's professional practice evaluations.
In June, San Diego-based Premier acquired Phase2 Consulting (P2C), which offers expertise and consulting capabilities around RAC readiness and charge capture, revenue cycle services, strategic planning and service line analysis.
"These enhancements to ClinicalAdvisor will help hospitals properly prepare for RAC audits to receive appropriate reimbursement while minimizing payment recoveries, both past and present," said Susan DeVore, Premier's president and CEO. "Hospitals will also meet The Joint Commission's professional practice evaluation requirements by promoting open dialogue and collaboration with clinicians during their reviews."
CA provides critical performance and outcomes measurements against comparative benchmarks through the Premier Perspective database, a repository of clinical, financial and outcomes information containing more than 100 million patient records, according to Premier.
"Overall, ClinicalAdvisor provides hospitals with more flexibility and time to leverage detailed comparative clinical outcome measures and transaction-level cost data, enabling them to make data-driven decisions to help improve their quality of care while reducing associated costs," DeVore said.
Along with the added RAC and practitioner measurement capabilities, CA is designed to help hospitals:
* Prioritize quality improvement efforts and set measurable goals;
* Improve financial performance through service line analyses of outcomes and resource use;
* Achieve regulatory compliance with a single solution for submitting quality measures including Core Measures, Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators and Centers for Medicare and Medicaid Services Hospital Acquired Conditions;
* Identify resource use variance down to the transaction level; and
* Promote confidence in measures and analyses through employment of nationally recognized 3M APR-DRG severity and CareScience Analytics risk adjustment methodologies.
More than 2,200 U.S. hospitals and 63,000 other healthcare sites make up the Premier healthcare alliance.
