Improve Hospital Case Mix Index with Azure solutions-based Advanced Analytics: 2-Week Proof of Concept

RSM in partnership with ClinIntell will utilize Azure solutions-based predictive analytics to identify potential gaps in hospital severity reporting, resulting in decreased net revenue realization. RSM will advise clients on defining opportunities for improved severity reporting at the provider and clinical condition level. The two-week proof of concept will analyze the hospital’s unique patient population utilizing the organization’s inpatient claims and clinical data.

What is the RSM ClinIntell solution?

• Severity reporting is assessed under the inpatient Medicare Severity Diagnoses Related Grouping (MS-DRG) system at all levels of the organization (provider, specialty group, clinical condition)
• Algorithms are based on a predictive model that provides insight into full severity reporting of an individual hospital’s unique patient population via the analysis of inpatient claims data
• ClinIntell is an Azure solutions-based data analytics firm that has pioneered patient population severity reporting assessments, turning hospital data into actionable insights
• Based on 150M+ claims data, the solution’s algorithms have been refined, calibrated, and validated for over a decade

How is the RSM ClinIntell Solution Different?

• It is the only tool in the market that provides documentation improvement opportunities specific to each hospital’s unique patient mix
• It is population focused versus the traditional chart focused CDI (Clinical Documentation Improvement) approach
• Because the solution utilizes each client’s unique patient population, it removes the reliance on benchmarking as an approach to assess performance and identify opportunities
• No software to install, data to results within 48 hours for Proof of Concept (POC)

Other benefits of the RSM ClinIntell solution’s analytics:

• The analytics support not only margin improvement initiatives through severity Case Mix Index (CMI) capture, but can also drive operational and other quality improvement initiatives, including:
• Quality-related conditions gaps (Elixhauser Readmission and Mortality, HCCs)
• Operational – Length of Stay severity gaps
• Through the two-week POC, RSM will utilize the ClinIntell analytics results to highlight areas of opportunity

RSM US LLP’s Partnership with ClinIntell, Inc.

• RSM’s Healthcare Consulting practice partners with ClinIntell, to turn your data into actionable insights.
• During the two-week proof of concept review, we will prepare and guide clients through data onboarding and review of the analytics insights, providing recommendations on how your organization can optimize their investments to drive margin
• RSM will work with the hospital organization to develop a customized approach, providing insights for severity capture down to the individual provider level

Proven Results

• On average, clients report an ROI of 28:1
• References - All clients are 100% referenceable

**Duration – Data available immediately if utilizing traditional Medicare only claims data. Post receipt of hospital’s All-Payer inpatient claims data, turnaround time approximately 1 week.

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