Premier’s ClinicalAdvisor offers customized benchmarking and regulatory reporting solution for hospitals and health systems

To help hospitals achieve maximum revenue retention as a part of Medicare's Recovery Audit Contractor (RAC) program, the Premier healthcare alliance has enhanced its quality benchmarking and regulatory reporting solution to include RAC capabilities.

Premier’s ClinicalAdvisor^® (CA) offers analysis, benchmarking, consulting, knowledge-sharing and other customized services to help hospitals and health systems close performance gaps. It helps identify these gaps through the use of risk-adjusted outcomes and comparative data, along with cost and clinical resource utilization 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. CA will also offer a new Practitioner Profile, providing the ability for online collaboration and dialogue with practitioners while supporting The Joint Commission's Ongoing Professional Practice Evaluations.

In June, Premier acquired Phase 2 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 president and CEO. “Hospitals will also meet The Joint Commission Ongoing Professional Practice Evaluation Requirements by promoting open dialogue and collaboration with clinicians during their reviews.”

CA quickly provides critical performance and outcomes measurements against comparative benchmarks through the Premier Perspective™ database, the nation’s most comprehensive repository of clinical, financial and outcomes information, containing more than 100 million patient records.

Continued DeVore: “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.”

Along with the added RAC and Practitioner Measurement capabilities, using CA hospitals can:

• Prioritize quality improvement efforts and set measurable goals;
• Improve financial performance through service line analyses of outcomes and resource utilization;
• 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 & Medicaid Services Hospital Acquired Conditions;
• Identify resource utilization 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.