A nice summary on Medicare’s valuation approach to compiling a “price” it pays to a hospital for a stay. If you recall, there are 746 DRG’s CMS tweaks to an infinitely granular level to arrive at a reimbursement total.
As Reinhardt relays, CMS pays for costs, as close as it can approximate, not value.
If you are a hospitalist and have even a hint of skin in the game, i.e., you take care of patients, play with data, or are one of those advanced types who sit behind a desk and tell the rest of us what to do, this one is worth your time.
Take a look!
Also note, as reform advances, DSH payments will be clipped, labor costs will be contested and defended (“the unions are killing us,” “you are missing hidden costs in our city,” and non EBM-based political meddling), and GME dollars will be ratcheted up or down based on residency program performance. The wealth pie is shrinking and institutions will surely fight for every nickel.
Algorithm for a Hospital Episode Price
“We Need Creative Solutions” When I read or hear the sentence above, I think of one thing and one thing only. The solution is long in coming, involves input from multiple parties, has no obvious fix, is costly–in either money or time, and we undergird it by a whopper of a collective action problem. How […]
It’s that time of (every other) year! Once again, your hospital medicine group (HMG) has a unique opportunity to contribute to our collective understanding of the current state of hospital medicine in the United States. SHM’s State of Hospital Medicine Survey kicked off this week and will be open until February 16th. I strongly urge […]
For several decades, providers working within hospitals have had incentives to reduce stay durations and keep patient flow tip-top. DRG-based and capitated payments expedited that shift. Accompanying the change, physicians became more aware of the potential repercussions of sicker and quicker discharges. They began to monitor their care and as best as possible, use what measures […]