This is a Rate Comparison between the Client Hospital and two or more area facilities based on the most current data available. This information is confidential and should only be utilized for comparative purposes. It will include a complete listing of facility charges by line item, as long as these charges are utilized by the facility on a regular basis and utilize a CPT/HCPCS code. The data will be as current and inclusive as possible based on all available data.
An Area Rate Comparison is based on HCPCS/CPT codes and descriptions from the client facility CDM and charge information from the two or more facilities designated by the client. The Hospital will be provided listings, by HCPCS/CPT codes, delineating current charges for the facility and two or more additional facilities utilized in the study. The comparison would include a complete listing of facility charges by line item, as long as these charges are utilized by the facility on a regular basis and that contain a CPT/HCPCS code. The data will be as current and inclusive as possible based on all available National data.
The Area Rate Comparison will be incorporated into the CDM Strategic Pricing program. The facility can designate limits for price changes based on area rates, for example
95%, 98%, 105% of the highest area charges or they can be utilized for comparative purposes at the end of the analysis.
This information is confidential and should only be utilized for comparative purposes. When an Area Rate Comparison is performed in conjunction with a CDM Strategic Pricing Initiative, the results of the optimization often improve dramatically.
The Area Rate Comparison will provide the following:
- Compares data between facilities by CPT code, insuring a reasonable level of accuracy.
- Allows for a true evaluation of facility charges in comparison to competitors.
- Can result in defining problem areas (departments and/or specific services) where charges are excessive for the market.
- Can result in a defining of charge line item shortfalls (departments and/or specific services) where charges are low in comparison to the market.
- When utilized in conjunction with Strategic Pricing, the service can realign the entire Chargemaster, evaluating each line item by payor class and market standing.
- Provides the Hospital with ammunition to illustrate its current standing in the market. Some facilities use the information to satisfy physician and/or Governing Board pricing concerns.