Articles Tagged With: DRGs
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Hospital-at-Home Programs Can Work — Even When the Home Is a Car
A case management-style hospital-at-home program produced $6 million in savings and cut hospitalizations by 53% in one year.
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The Importance of the Physician Advisor
The physician advisor role has been evolving over the last couple of decades. Case managers are discovering their relationships with these clinicians can be incredibly valuable when made a priority.
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CMS May Suppress Data on Complications in Hospitals
CMS is planning to suppress data on many dangerous medical and surgical complications in hospitals because data from the COVID-19 era may be unreliable. The plan would suppress data on sepsis, kidney harm, deep bedsores, lung collapse, and many other measures. -
The Basic Elements of Healthcare Reimbursement, Part 3
In this month’s issue, the conversation on healthcare reimbursement turns to the additional prospective payment systems found across the continuum of care. Prospective payment remains a way in which the Centers for Medicare & Medicaid Services can determine the rates for care based on predetermined amounts rather than on billing. The processes are similar to the use of the diagnosis-related groups in the acute care setting, with some differences.
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The Basic Elements of Healthcare Reimbursement, Part 2
This month will continue the discussion of healthcare reimbursement by third-party payers. We began last month with a review of the diagnosis-related groups (DRGs) and associated terminology. We will continue by reviewing how medical records are coded followed by the new MS-DRGs implemented in 2007.