OASIS Alert
Visit Data Provide Opportunities For Benchmarking
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If you can't explain why your utilization data is remarkably different from other agencies in your state, you could be asking for an investigation. Two regional home health intermediaries have reported benchmarks for home health claims from October to December 2002 for 30 states (see charts), but haven't separated it out per episode. "The calculation of the average spans all episodes any one beneficiary might have" within the quarter, explains a Palmetto GBA spokesperson. "The average visits per beneficiary for this report is calculated by dividing the total number of claim lines by the total number of beneficiaries within state and discipline for a given time frame." United Government Services' data includes claims for all home health patients during the time period, a UGS official tells Eli.
OASIS Alert
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