BENCHMARKING

Over many years of successful client engagements, Healthcare Management Partners has developed a number of sophisticated tools that enable us to rapidly assist clients and corporate partners to achieve their unique business objectives.  Our professionals employ these tools to quickly evaluate our healthcare clients’ market placements, productivity, financial conditions, and short-term debt capacities to meet pressing working capital needs.

We have also developed a tool to accurately evaluate the payment patterns and practices of third party payors to assist providers in maximizing their collection efforts.

Finally, HMP has developed a unique set of tools that enable us to minimize the cost of managing the administrative burdens of a healthcare client in bankruptcy.

Peer Group Benchmarking for Healthcare Providers

HMP MetricsTM uses a custom electronic database that includes Healthcare Cost Report Information System (HCRIS) data from more than 200,000 Medicare Cost Reports filed by hospitals, nursing homes, home health agencies, and other providers since 1994. Additionally, for hospitals only, the HMP MetricsTM database also includes selected data elements from the Medicare Provider Analysis and Review (MEDPAR) database and data sets licensed by HMP from credit rating agencies and healthcare industry trade associations.

Using proprietary filters, the data contained in the HMP MetricsTM database have been “scrubbed” to exclude incorrect, partial period, and statistically aberrant data elements for individual hospitals or health systems. This data validation process enables HMP MetricsTM to produce highly accurate and defensible peer group comparisons for dozens of standard industry metrics. HMP MetricsTM will also provide the number of records (cost reports) that were excluded from the computation of that particular metric.

HMP can easily create customized reports that mix or create new peer groups and then compare them to state or national benchmarks. Examples of peer groups that a user might wish to examine include:

  • Hospital members of a single multihospital system
  • Hospitals with a specific long-term debt rating (BBB, A-, AA, etc.)
  • Hospital members of specific hospital trade association (CHA, NCHRI, AAMC, etc.)
  • Hospitals by ownership, size, geographic region, or teaching status
  • Hospitals with outstanding bonds issued by a specific bond authority

The diversity of peer groups and metrics that can be measured is nearly limitless. Additionally, for each peer group comparison and metric, HMP MetricsTM also produces the peer group mean and median values and associated record counts for each quartile within the peer group.

Our HMP MetricsTM benchmark reports very quickly identify problem areas within an organization that can then be investigated further to properly understand its causes and work towards timely resolution.

Patient Migration Studies (Market Share Analysis)

HMP licenses and has expertise in the analysis of data contained in the Medicare Provider Analysis and Review (MEDPAR) database. MEDPAR, which is updated annually, contains over 100 data elements for all Medicare inpatient and outpatient claims. HMP has built models to enable us to use MEDPAR as well as state level Medicaid and patient billing databases, if available, to determine hospital market share by major diagnostic category (MDC), conduct patient migration studies, and prepare analyses related to allegations of fraud, abuse, or other corporate compliance issues.

Hospital Financial Forecast Model

The Hospital Financial Model is a modular, yet integrated, financial model that enables the user to quickly and accurately build operating budgets, test the financial sensitivity of alternate operating scenarios, and evaluate business risk. Using a control board that contains variable values for all key forecast assumptions, the user can quickly assess the financial impact of alternate assumptions or business risk profiles.

  • Historical Inpatient and Outpatient Origin
  • Definition of Historical Inpatient and Outpatient Geographic Service Areas
  • Medical Staff Profile and Historical Utilization
  • Competitor Profile
  • Historical and Projected Inpatient Demand
  • Historical and Projected Outpatient Demand
  • Historical and Projected Units of Service (UOS)
  • Historical and Projected Revenues and Expenses by Cost Center
  • Historical and Projected Financial Statements
  • Historical and Projected Key Financial Ratios
  • Projected Debt Capacity

When this tool is combined with our customized data mining and analysis capabilities and used in concert with HMP MetricsTM, we can rapidly diagnose operating problems and opportunities and, perhaps of equal or greater merit, communicate those findings to key constituencies in a clear, actionable manner.

Patient Accounts Receivable Financing Borrowing Base Calculator (BBC)

HMP has developed a process and companion financial model that allows for rapidly computing a hospital’s borrowing base availability, for which active patient accounts receivable (or the revenue thereof) is used as collateral for the underlying credit facility. The model enables the hospital to compute its borrowing base on a daily or weekly basis and produce a valid “Officer’s Certificate” to enable it to draw on an available credit facility.

This tool, which was created to mirror the strict documentation standards of a leading lender to the healthcare industry, was specifically designed to be used in conjunction with credit facilities drawn on a local bank or perhaps a non-financial lender (DIP lender or potential buyer of the facility) that is not regularly engaged in patient accounts receivable financing.  Once installed, HMP will monitor the process on behalf of the lender on an ongoing basis.

Third Party Payor Payment Patter Analysis

Because the database we have designed for the Patient Accounts Receivable Financing Borrowing Base Calculation, or BBC Database, contains virtually 100% of all patient accounting activity (billing, collections, adjustments, etc.), it is a relatively simple matter to reorganize the data to prepare a comparative analysis of the historical payment patterns of all third party payors.  In turn, this information can be used to either identify weaknesses in the hospital’s revenue cycle management or, with the advice of legal counsel, enable the hospital to demand “specific performance” on the part of individual payors to address non-compliance with contract payment terms.

Bankruptcy Administration

In an effort to create efficiency and reduce professional fees charged to estates of healthcare providers in bankruptcy, HMP has developed the following automated tools:

  • 13 and 26 Week Cash Flow Model
  • Monthly Operating Report (MOR)
  • Court Supervised Professional Fee Application
Customized Data Mining and Analysis

As most business transactions are now completely electronic, a strong reliance on databases and automated workflows has led to an increased demand for the collection and analysis of electronic information. Our professionals offer a hands-on approach to collecting and analyzing information found in large databases, and we leverage our findings to create comprehensive reports used in investigations and litigation.

Our experts have worked with database formats such as Oracle, SQL Server, and Informix, among others, as well as most major hospital information systems. We focus on helping clients uncover essential electronic information to help solve complex problems.

In addition, we license and are experts in the analysis of data contained in the Healthcare Cost Report Information System (HCRIS), Medicare Provider Analysis and Review (MEDPAR) federal databases, and state Medicaid and patient billing databases; we use these analyses to determine competitive cost structures and market share and to prepare reports related to allegations of fraud, abuse, or other corporate compliance issues.

Our Data Mining and Data Analysis services include:

  • Identification of Key Financial Systems
  • Preservation and Extraction of Financial Databases
  • Damages Calculations
  • Analysis of Financial Databases
  • Presentation through Reports and Graphs
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