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21-MK-DM-027-Blog Post

10 Value-Based Healthcare KPIs you Should be Tracking

October 20, 2021
October 20, 2021

Key Performance Indicators (KPIs) help us measure value in healthcare. These are important metrics in the current healthcare business environment as we continue to evolve away from a volume-based system and towards a value-based model for reimbursement and public reporting purposes.  

Choosing the Right KPIs

Building a great dashboard, optimizing analytics and reporting for your team and choosing the right KPIs are the keys to managing the vast amounts of data that are generated by every healthcare organization. All of these are essential elements towards building a more sustainable, safe, efficient and reliable organization. While there are literally hundreds of KPIs from which you might choose, the following should definitely be on your radar screen. 

1.  Average length of stay - Length of stay is typically part of every dashboard. Be sure to include the ability to report this data by various categories including procedure, unit and other patient demographic categories for a more accurate and actionable picture of this indicator. 

2.  Readmission rates – Too many unscheduled readmissions within 30 days of discharge can result in penalties for hospitals making this another critical KPI which means that it should have a place on every hospital’s dashboard. Using electronic health records (EHR) to identify at-risk patients, appropriate coordination of care, clear discharge instructions, and evidence-based medicine can help hospitals avoid these penalties.

3.  Bed Availability – The pandemic has put the spotlight on this measure for patients, consumers and healthcare leaders. This KPI helps leaders identify the percentage of beds available during a specific period of time. This indicator can help to reduce pressure on people, the facility and may also help in infection control. 

4.  Bed/Room Turnover – This measure should be reported with bed availability and indicates how efficiently patients are being discharged from and admitted to the facility. Changes should also be tracked against unscheduled readmission rates to insure that pressures to discharge patients promptly are not driving any increases in readmission rates. 

5.  Patient Perceptions of Care – This KPI is likely already on the dashboard of every hospital regardless of size or orientation. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) has been in use since 2006 to measure patient perceptions of their experiences. Performance on these measures drives a percentage of reimbursement making it essential to any organization’s dashboard. 

6.  Patient Safety Measures – Quality and safety indicators help healthcare leaders, insurers and regulators measure how safely and effectively care is being delivered. Value-based KPIs such as post-operative infections, medication errors, sepsis, urinary tract infections and antibiotic-associated diarrhea are key indicators of how safely and effectively care is being delivered. 

7.  Medical Equipment Utilization – This KPI can be overlooked, but it should be reported as well as it has implications for patients and finance. The results can help prioritize the purchase of new, advanced, high-cost equipment. It can also be an early warning system for over-used equipment that is in danger of needing maintenance potentially leading to diagnostic and treatment delays. 

Do not overlook the operational and revenue cycle measures. Consider including these KPIs. 

8.  Accounts Receivable Turnover – Accounts receivable (AR) is an indicator of how efficiently the organization is collecting receivables. Even small improvements in the revenue cycle can contribute to the overall financial health of the organization.

9.  Claims Denial Rate – The majority of healthcare costs are paid by health insurers so it is important to understand the rate of denials as well as the causes of those denials. 

10.  Claims Processing Time – Every organization can be dealing with literally dozens of payors. This KPI can vary significantly by payor but it is an important financial metric that helps predict cash flow and manage AR. 

Managing your KPIs

Whether you are reporting ten KPIs or hundreds, be sure that the way in which they are reported truly delivers the kinds of insights that support decision-making in the C-suite and at the unit/department level. Use dashboards and reporting tools that help keep leaders focused on the right KPIs and help users customize their view from an organization-wide look to a unit or department level. Be sure to provide education that will help users build the reports that will help them the most.