How is severity of illness tied to reimbursement' The federal government, through the Health Care Financing Administration, (HCFA) has chosen to use the diagnosis-related group
These last authors proposed the use of pediatric modified diagnosis-related groups
(PMDRGs) for all children.
Table 5 Ability (R-squared x 100) to predict hospitalization charges for models based on diagnosis-related groups
(DRG), purpose of admission (POA), and complexity indicators: Lung, colon, and breast cancer Model Lung Colon Breast DRG only 22.
(DRGs)--The patient classification system used by Medicare to place patients into 477 mutually exclusive and exhaustive patient groups based on information from the discharge record such as the principal diagnosis, surgical procedure, age, sex, discharge status, and the presence or absence of an additional diagnosis.
Under the APR DRG system, the ability to accurately capture the resources used by each patient will be essential to providers' viability," continued Waldo, referring to the all-patient refined diagnosis-related groups
classification system proposed by the Centers for Medicare and Medicaid Services for 2007.
Under the contract, CSC will provide the CDAC with medical record abstraction, data entry, sampling, coding and validation of diagnosis-related groups
to support the CMS.
Because an objective of the new funding methodology was to recognize differences in patient severity, the decision was made to use refined diagnosis-related groups
(RDRG) as a transitional severity-of-illness system until a more clinically valid system could be implemented.
Potential for inpatient-outpatient substitution with diagnosis-related groups
Healthcare institutions are reimbursed for the entire diagnosis-related groups
(DRG) procedures rather than being compensated merely for the implants used in the hip and knee replacement procedures.
(DRGs) tend to have a greater effect currently on hospitals, but, as they are implemented in outpatient settings, they will also affect physicians.
MPRO has identified 192 diagnosis-related groups
(DRGs) which produced a minimum 2-1 benefit-cost ratio for the Medicare program during this time period.
Among the latest challenges facing University Clinic Erlangen are the establishment and expansion of the electronic patient folder, the implementation of Diagnosis-Related Groups
The prospective payment system, based on diagnosis-related groups
(DRGs), taught two lessons.
In a unprecedented move, CMS assigned two new diagnosis-related groups
, or DRGs, for drug-eluting stents even before this new device has gained FDA approval (expected in early April of 2003).
government's long-standing, industrywide investigation of alleged improper billing under certain Medicare diagnosis-related groups