How Does Your Practice Measure Up? Insights from Benchmarking Medicare Payments

Area of Science:

• Healthcare Management
• Health Economics
• Medical Practice Administration

Background:

• Physician practices face challenges in benchmarking services due to limited payment information transfer.
• The evolving healthcare environment necessitates a clear understanding of revenue streams for financial viability.

Purpose of the Study:

• To outline a method for physician practices to benchmark a specific revenue stream.
• To provide a practical example using publicly available data for local market comparison.

Main Methods:

• Utilized standard analysis tools, such as Microsoft Excel.
• Employed data from the Centers for Medicare & Medicaid Services (CMS) for the years 2012-2014.
• Focused on patients serviced under original Medicare.

Main Results:

• Demonstrated a feasible approach for benchmarking a single revenue stream.
• Provided a detailed case example applicable to physician practices.
• Highlighted the importance of data analysis for financial performance evaluation.

Conclusions:

• Benchmarking revenue streams is achievable for physician practices with available data and tools.
• Understanding revenue streams is crucial for navigating changes in healthcare payment models.
• This methodology supports improved financial health and strategic decision-making for practices.