HSFTW
IntroductionToDRGs.pdf

Html help table of contents and index is a mouse

Info icon This preview shows pages 13–16. Sign up to view the full content.

"HTML Help" - Table of contents and Index is a mouse click away; head2right "Context Sensitive Help" - point to any field and right mouse click; head2right "Attestation report" - automated and printed for doctor signature; head2right "Pre-coding for re-admissions" - saves time by pre-coding for the new admission, the results of a prior admission; head2right "Quality Assurance" - clinical indicator reporting with accreditation ratios calculated, re-admissions report; head2right Direct export to government and/or insurers; head2right "Ad Hoc" reporting - Hospitals can design their own analysis reports.
Image of page 13

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

An Introduction to DRG's TC Health Administration © 14 Hospital Casemix Management The term "Casemix" refers to the process of managing the application of DRG financing but also describes the range of DRG's that any one Hospital is experiencing. A Midwifery hospital will have a small range of DRG types whereas a Teaching Hospital will have a broad range. That comparison of hospitals represents the difference in the mix of cases between Hospitals - the Casemix. Outcomes – Improving Quality of care The mandated application of DRG financing relies on the ability of each hospital to: head2right Capture data and detect clinical indicators and other related measures; head2right Formalise patient quality assurance processes such that doctors are leading the supervision of quality patient care; head2right Define outcomes, assess results and modify practice where indicated; head2right Change behaviour and the organisational model. Managing Finance As mentioned above, assigning the DRG on admission and involvement of clinical staff in inter active software entry of patient diagnosis can ensure that billing occurs as the patient is discharged. Cash flow is optimised. The TC Health "Casemix Grouper" supports Finance and DRG analysis. There are pre-constructed reports for: head2right Highest volume DRG's with comparison to volume budget; head2right Actual expense compared to DRG income; head2right LOS actual to DRG LOS; head2right Cost weight budget compared to actual volumes. Clinical Costing Hospitals have an interest in knowing if their cost of treatment exceeds the rate of payment reimbursement. The experience in Australia is that maintaining continuous clinical costing is time consuming and therefore expensive. It is not a process that clinical staff easily identify with and is therefore difficult to maintain. Expensive software solutions can be applied where data is obtained from normal hospital practice e.g. issuing pharmacy, medical and surgical supplies, payroll or automatic extraction from general ledger accounts etc. In practice, most Australian hospitals do not apply continuous clinical costing. They choose to monitor actual expense against DRG income entitlements and heir cost weight budget on a monthly basis.
Image of page 14
An Introduction to DRG's TC Health Administration © 15 The TC Health "Casemix Grouper" provides the following support: head2right
Image of page 15

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

Image of page 16
This is the end of the preview. Sign up to access the rest of the document.
  • Fall '18
  • Diagnosis-related group, DRG

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern