Important Charge Capture Metrics for Hospitalists

As a hospitalist, you are responsible for the care of your patients during their stay in the hospital. This includes managing their symptoms, ordering and interpreting diagnostic tests, and consulting with specialists as needed. In addition to providing direct patient care, you also play an important role in the hospital’s financial health. One of the most important ways you can contribute is by ensuring that all your charges are captured accurately.

Charge capture involves recording all the services you provide to a patient so they can be billed correctly. This may seem like a simple task, but it can be quite complex. You need to be aware of many different charge capture metrics, and it is important to understand which ones are most important for you.

Important Charge Capture Metrics for Hospitalists

1. Length of Stay (LOS)

The length of stay is one of the most important charge capture metrics for hospitalists. This is a key metric ¹not only for billing analytics measured by charge capture software but also from the hospital and facility perspective as it measures how long a patient stays in the hospital from admission to discharge. A shorter length of stay generally results in lower overall costs, so you need to ensure your patients are discharged in a timely manner.

Many factors can influence a patient’s length of stay, such as their overall health status, comorbidities², and social support system. As a hospitalist, you should work with your team to develop strategies for reducing the length of stay for your patients. This means ensuring:

• Patients are getting the care they need in a timely manner
• There is a smooth transition of care from the hospital to home or another facility
• There is adequate discharge planning in place

2. Readmission Rate

The readmission rate is another important metric for hospitalists. This metric measures the percentage of patients who are readmitted to the hospital within 30 days of their discharge. A high readmission rate can indicate that patients are not receiving adequate follow-up care after they leave the hospital. It can also lead to increased costs for the hospital if patients require additional care during their readmission.

There are many strategies that you can use to reduce readmissions, such as:

• Improving communication with patients and their caregivers
• Ensuring that patients understand their discharge instructions
• Making sure that patients have a follow-up appointment scheduled before they leave the hospital
• Coordinating care with other providers involved in the patient’s care
• Ensuring proper medication management and aftercare
• The proper transition of patient care programs after discharge

3. Infection Rate

The infection rate is a metric that measures the number of infections that occur in the hospital. This includes nosocomial infections³ (infections that occur in hospitals) and healthcare-associated infections (infections that occur in patients recently discharged from the hospital). A high infection rate can lead to increased length of stay, readmissions, and costs for the hospital.

There are many strategies that you can use to reduce the infection rate, such as:

• Improving hand hygiene
• Using personal protective equipment (PPE)
• Improving environmental cleanliness
• Screening patients for infections prior to admission

4. Mortality Rate

The mortality rate is a measure of how many patients die while under your care. While this may seem like an abstract concept, it is actually a very important charge capture metric. A higher mortality rate can indicate that there are problems with the quality of care being provided. It can also lead to increased scrutiny from accrediting bodies and regulators. As a result, it is important to do everything you can to ensure that your mortality rate is as low as possible.

There are many factors that can influence a patient’s risk of mortality, such as their age, comorbidities, and severity of illness. As a hospitalist, you should work with your team to develop strategies for reducing mortality for your patients. These include:

• Developing protocols for the early identification and treatment of sepsis⁴
• Creating order sets or care bundles for common conditions such as pneumonia or heart failure
• Implementing handoff procedures to ensure that all team members are aware of a patient’s condition
• Conducting regular rounds to check on patients’ progress

5. Patient Satisfaction Scores

Patient satisfaction scores are another important metric for hospitalists. These scores are typically collected through surveys that are sent to patients after they have been discharged. The scores can be used to identify areas where care needs to improve and give patients’ perspectives on hospital care. Patient satisfaction scores can impact a hospital’s bottom line.

In many cases, insurers will use these scores to determine how much they reimburse a hospital. A hospital with low satisfaction scores may receive lower payments from insurers. Therefore, it is important to ensure that your patients are satisfied with their care. There are many ways to improve patient satisfaction, such as:

• Making sure that patients understand their discharge instructions
• Providing patients with information about follow-up care
• Answering any questions that patients have about their care
• Making sure that patients are comfortable and have all of their needs met

6. Documentation Accuracy

Documentation accuracy is another important metric for hospitalists. This metric refers to how well a hospitalist documents a patient’s care. Documentation is important for many reasons. It’s used to bill for the services that a hospitalist provides, track a patient’s progress to create a record of their care and identify areas where care needs to improve.

There are many ways to improve documentation accuracy, such as:

• Using templates or checklists to make sure that all pertinent information is included in the record
• Reviewing records regularly to identify errors or omissions
• Working with a medical scribe to help document patient encounters
• Using voice recognition software to dictate notes

Other Metrics That Also Matter

• Number of Patients Seen per Day – The number of patients seen per day also matters. Not only does this metric give you an idea of how productive you are, but it also provides insight into how well you’re able to manage your time. If you’re seeing fewer patients than you’d like, it may be time to reevaluate your workflow.
• Percentage of Charges Billed on Time – The percentage of charges billed on time is also vital. This metric can give you an idea of how efficient your charge capture process 
• is. It’s important to note, however, that there will always be some charges that are delayed for one reason or another. A good goal to aim for is a 95% on-time billing rate.
• Average Cost per Patient Encounter – The average cost per patient encounter is also critical. This metric can be helpful in two ways. First, it can give you an idea of how much each patient encounter is costing your facility. Second, it can help you identify potential cost-saving opportunities. For example, if you notice that certain diagnostic ⁵tests are costing more than they should, you may be able to work with your laboratory to negotiate a better price. 

Conclusion 

Charge capture metrics are important for hospitalists to track to gauge their productivity and identify potential areas for improvement. By tracking the number of patients seen per day, the percentage of charges billed on time, the average length of stay, the average cost per patient encounter, and other metrics, hospitalists can get a well-rounded view of their performance and make changes accordingly.

1. Chávez, Edgar, et al. “Searching in metric spaces.” ACM computing surveys (CSUR) 33.3 (2001): 273-321. ↩︎
2. Cavaillès, Arnaud, et al. “Comorbidities of COPD.” European Respiratory Review 22.130 (2013): 454-475. ↩︎
3. Kollef, Marin H., et al. “Nosocomial infection.” Critical care medicine 49.2 (2021): 169-187. ↩︎
4. Hotchkiss, Richard S., and Irene E. Karl. “The pathophysiology and treatment of sepsis.” New England journal of medicine 348.2 (2003): 138-150. ↩︎
5. Wolffsohn, James S., et al. “TFOS DEWS II diagnostic methodology report.” The ocular surface 15.3 (2017): 539-574. ↩︎

Last Updated on July 26, 2024 by Sathi Chakraborty, MSc Biology