Measure:

Net Days in Accounts Receivable

Purpose:
Trending indicator of overall A/R performance

Value:
Indicates revenue cycle efficiency

Equation:
N: Net A/R
D: Average daily net patient service revenue


Measure:

Aged A/R as a Percentage of Billed A/R

Purpose:
Trending indicator of receivable collectability

Value:
Indicates revenue cycle’s ability to liquidate A/R

Equation:
N: 0-30, >30, >60, >90, >120 days
D: Total billed A/R


Measure:

Cash Collection as a Percentage of Adjusted Net Patient Service Revenue

Purpose:
Trending indicator of revenue cycle to convert net patient services revenue to cash

Value:
Indicates fiscal integrity/financial health of the organization

Equation:
N: Total cash collected
D: Average monthly net revenue


Measure:

Bad Debt

Purpose:
Trending indicator of the effectiveness of self-pay collection efforts and financial counseling

Value:
Indicates organization’s ability to collect self-pay accounts and identify payer sources for those who can’t meet financial obligations

Equation:
N: Bad debt
D: Gross patient service revenue


Measure:

Charity Care

Purpose:
Trending indicator of local ability to pay

Value:
Indicates services provided to patients deemed unable to pay

Equation:
N: Charity care
D: Gross patient service revenue


Measure:

Charity as a Percent of Uncompensated Care

Purpose:
Trending indicator that monitors charity care versus bad debt

Value:
Reflection of charity care (provided to the community)

Equation:
N: Charity care
D: Total uncompensated care (bad debt + charity care)


Measure:

Uninsured Discount (New MAP Key, June 2014)

Purpose:
Trending indicator of amounts not expected to be paid by uninsured patients

Value:
Indicates the portion of the self pay gross revenue not included in cash, charity or bad debt metrics

Equation:
N: Uninsured discounts
D: Gross patient service revenue


Measure:

Total Uncompensated Care (New MAP Key, June 2014)

Purpose:
Trending indicator of total amounts not collected from patients related to self pay discounts, charity and bad debt combined

Value:
Indicates the total amount of self pay gross revenue that is not collectable or expected to be collected

Equation:
N: Uninsured and uncompensated care (bad debt + charity care + uninsured care discount)
D: Gross patient service revenue


Measure:

Cost to Collect

Purpose:
Trending indicator of operational performance

Value:
Indicates the efficiency and productivity of revenue cycle (RC) process

Equation:
N: Total Revenue Cycle (RC) Cost
D: Total cash collected


Measure:

Cost to Collect by Functional Area

Purpose:
Trending indicator of operational performance by functional area as reported in Cost to Collect

Value:
Indicates the efficiency and productivity of revenue cycle process by functional area

Equation:
N: Total x (x = the cost of each functional area) cost*
D: Total cash collected

*Sum total of all x’s (i.e. sum of the cost of each functional area) should equal total cost of Cost to Collect


Measure:

Case Mix Index

Purpose:
Trending indicator of patient acuity, clinical documentation, and coding

Value:
Supports appropriate reimbursement for services performed and accurate clinical reporting

Equation:
N: CMI (average RW/Patient) = sum of relative weights for all inpatients*
D: Number of inpatients in the month*

*Excludes normal newborns and Medicare-exempt units