PEER GROUP FACTORS RELATED TO THE FINANCIAL PERFORMANCE OF CRITICAL ACCESS HOSPITALS

Abstract

Context: The Flex Monitoring Team created the Critical Access Hospital (CAH) peer grouping methodology ten years ago. The methodology has proven successful over time, but the operating environment has changed.

 Purpose: To assess whether the factors used in the current CAH peer grouping methodology continue to be associated with hospital performance, and evaluate whether new factors such as geographic or community characteristics should be considered when developing peer groups.

 Methods: This was a retrospective cross-sectional study to determine whether there was evidence suggesting that geographic factors, community factors, or hospital factors may need to be added to the current CAH peer grouping methodology and whether the current factors are still associated with CAH performance. Using data from fiscal years 2011-2014, multivariate regression analysis was utilized to determine which factors were most relevant for CAH peer groups.

 Findings: As a group, hospital factors were the most influential on hospital performance. All four of the current factors used in creating CAH peer groups were still relevant. Geographic factors, especially region, demonstrated relevancy in CAH peer grouping. The most rural CAHs stood out in this study, and rurality influenced all five revenue indicators. The top two peer group factors, based on statistical significance at p < .05, were net patient revenue and region.

 Conclusions: The hospital factors used in the current CAH peer grouping methodology are still associated with hospital performance and should be used for establishing CAH peer groups. Geographic characteristics should be considered when formulating peer groups, especially region.