How is your agency doing in relation to your peers? Are you still using the national model as your benchmark, or do you have more current data? If you’re not using some sort of benchmarking, you’re behind the times. Many agencies have learned from, and adapted to, PPS and its nuances. Compare your agency to others and be able to reconcile the variances.

For example, agencies have found ways to provide care more efficiently than CMS envisioned. The national model on which payments were built, forecasted a total of 31 visits per episode on average. For the first three quarters of the fiscal year 2003, the average visits per episode were anywhere from 15 to 17. This information comes from Outcome Concept Systems (OCS) in Seattle, Washington.

OCS information also shows a disparity in what type of visits are performed, as well as their frequency. While the national model expected 14 skilled nursing visits per episode, OCS data reflected skilled visits of only seven to eight per episode. Home health aide visits appear nowhere near their expected levels; the national model called for 13 visits per episode, while OCS data showed an average of only two or three visits.

Therapies reverse the trend as they seemed to exceed the national model formula which expected less than four visits per episode. Therapies in the OCS study appeared to run from six to seven per episode.

OCS data shows the average length of stay ranging from 35 to 39 days. This should bode well for the industry since payment is based on a 60-day cycle.

OCS data includes more than 150,000 episodes at about 350 agencies between the fourth quarter of 2002 and the second quarter of 2003.

Other benchmarking firms you may want to consider are Fazzi and Associates, and Patient Care Technologies.

Benchmarking should be an integral part of managing your agency. It can highlight, sometimes in great detail, what you’re doing well, and what areas need improvement.