Q&A: The role of case management in data collection

Q. How can case management assist in data collection and benchmarking?

A. Case management does not have to collect all the impor­tant data points, but it does need to determine what is necessary to tell the story and where to get the data. Some lessons learned about data sources and collection:

• If case management does collect the data, either by hand or input into software, such as avoidable day data, consider collecting it periodically (as a sample)—for example, the first week of every month. Or consider having an outside agency audit avoidable days for more objective data.
• Use proxy numbers if you can’t get actual numbers; for example, if there was an all-out campaign on LOS, compare census month to month between last year and this year to show the case manager’s influence on increased volume (increased volume made possible by freed-up beds). Of course, this is meaningful only in hospitals that have folks waiting in the ED for beds. That issue brings to mind another proxy: ED-to-bed time. Follow through on the idea for finding proxies: “If we do this, then what results will we see upstream and downstream?”
• Consider the Program for Evaluating Payment Patterns Electronic Report (PEPPER) as Medicare’s data dashboard. Take highlights from it to put on your data dashboard, including statewide benchmarks. 

For more information, see Case Management Models: Best Practices for Health Systems and ACOs, Second Edition.

Need expert advice? Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.