Recouping Inpatient Revenue

As hospitals see more and more service lines shift to the outpatient space, it is crucial to understand your data and associated revenue opportunities. For example, with the Final Hospital Outpatient Prospective Payment System Rule removing total knee arthroplasties from the inpatient only list, this could result in a shift of thousands of procedures from inpatient to outpatient – and millions of dollars.

How can you recoup some of the lost inpatient revenue? Look at your data. In the following example, a single hospital within a mid-sized system is below average as compared to its peers, potentially resulting in missed revenue opportunity.

Using the most recent MedPAR data available, our clinical team can conduct data analysis at the Service line and DRG level to assess potential revenue and compliance opportunities as compared to peer hospitals in your state, region, or nationally. Our proprietary analysis can help pinpoint potential areas of opportunity for very specific interventions.

Using the most recent data for your organization, our team can apply our Revenue Integrity Audit methodology in the identified areas to review a sample of records to confirm the data, identify opportunities, and educate your team. Interested in viewing your data? Contact us at

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