AHA Launches Hospital Revenue and Claims Comparison Tool

The American Hospital Association (AHA) recently launched the AHA Vitality Index, a data benchmarking tool that provides hospitals with a dashboard to track claims and reimbursements, as well as compare hospital revenue with peers, according to a recent announcement.

Hospitals can anonymously compare their operational and financial performance with that of other hospitals. The tool will also help hospitals determine whether payers are treating all hospital systems equally in terms of reimbursements. Users can break down reimbursements by payer, specialty, and patient type, among other criteria.

“By providing AHA members visibility into metrics related to denials, reimbursement and claims processing, we are helping them identify where to focus their improvement strategies,” said Gloria Kupferman, Chief Data Strategy Officer at AHA, in a press release. “AHA Vitality Index is a solution that is central to our mission of helping our members improve performance in order to enhance care delivery.”

The AHA Vitality Index will ensure reimbursement equity by allowing hospitals to easily crosscheck their data with peers. They can pinpoint whether their claims processing is faster or slower than their peers, and if denials and reimbursements are better or worse compared to other hospital systems.

Hospitals may submit raw claims data voluntarily, and the tool will output analyses split into four quadrants: velocity, variety, volatility, and value.

Velocity refers to how fast claims are paid compared to peers, while variety assesses what type of reimbursements can be expected. Volatility evaluates the potential risks that could have an impact on reimbursement speed and amounts, and value refers to the fairness and equity of a hospital’s reimbursements. 

The tool is the latest addition to AHA’s data solution portfolio. Others include the AHA Annual Survey Database, AHA DataQuery, AHA MarketCapture, and AHA MetricVu. All these tools rely on using a hospital’s financial data to make educated assessments intended to drive better results.

Objective and reliable data is crucial for healthcare revenue cycle management. Tracking the life cycle of each claim has been a constant challenge for hospitals, as data input issues and the sheer volume of claims cause roadblocks, leading to negative impacts on reimbursement amounts.

Health IT and EHR systems have allowed for more organization and efficiency when it comes to tracking claims. But a recent survey found that approximately one-third of hospitals do not use revenue cycle automation. The survey found that organizations with net patient revenues of $1 billion to $10 billion reported the most frequent use of revenue cycle automation.

Meanwhile, the mid-revenue cycle management and clinical documentation improvement market is projected to be worth $4.55 billion by 2027, according to a recent report. The market encompasses various services and solutions that are meant to improve revenue outcomes.

The COVID-19 pandemic put a temporary strain on hospital revenue, volumes and margins; but hospital operating margin climbed in April 2021 both year-to-date and year-over-year, according to a recent Kaufman Hall report. Some hospitals are disproportionately feeling the effects of COVID-19, particularly ones that treat uninsured and underinsured individuals. As demand increases, safety-net hospitals have seen a significant dip in profitability, even though they serve some of the most vulnerable populations.

Despite recent revenue increases, hospitals struggled significantly in the early months of the pandemic and have a long way to go in terms of recovery.