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PubMedDate not supplied

Cluster approach allows budgeting, planning with DRGs.

Measuring costs and revenues on a diagnosis related group (DRG) basis allows health care managers to define product lines, identify market shares, and examine the effects of case mix and physician behavior on profitability. It also enables public agencies to predict bed needs and evaluate certificate-of-need applications. The large number of DRGs, however, and other managerial considerations may discourage the use of DRG-based budgeting and planning. To save time and enhance data usefulness, financial officers may consolidate the DRGs into fewer groups. Revenue, for example, can be estimated by grouping the DRGs into 23 major diagnostic categories or by clustering them according to cost weight or into one group. Comparisons of payment rates and costs will identify the DRGs that lose money and will determine whether departmental costs are excessive. Strategic planning units formed from the 468 DRGs will help health care managers analyze and project performance. Product lines for this purpose may be clustered according to major diagnostic category, physician specialty, or clinical department. Since a potentially enormous amount of DRG-based clinical and financial information could be generated, hospitals should create data committees to ensure that managers receive only the information they need.

Budgets↗
PubMed1986

Comparison of alternative relative weights for diagnosis-related groups.

During this study, we investigated the extent to which diagnosis-related group (DRG) relative weights based exclusively on charge data differ from DRG weights constructed according to the methodology used in deriving the original relative weights for the Medicare prospective payment system (PPS). The PPS operating cost weights were based on a combination of cost and adjusted charge information (Pettengill and Vertrees, 1982). The results of this study reveal only minor differences between the two sets of weights. Interhospital differences in cost-to-charge ratios do not produce large, arbitrary differences between charge-based and operating cost weights. Whether the data are standardized for differences in capital and medical education costs also appears to make little difference.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1987

Determining true nursing costs improves financial planning.

The traditional method of apportioning nursing care costs ona per diem basis does not consider nursing intensity or patients' special needs and often includes nonnursing duties. Many hospitals now favor a fee-for-service concept and are determining direct patient care costs to identify the true nursing cost. A patient classification system correlated with the diagnosis-related group (DRG) classification improves nursing cost analyses. For each patient, nurse managers need systems to determine quantified nursing tasks and patient acuity levels for each day. This information can be used to adjust staffing and to establish variable billing procedures. Then they can institute variable billing methods that are based on direct care costs as well as indirect costs of administration, education, and supplies. Variable billing identifies revenue cost centers, allows systematic monitoring of nursing services, and improves budget planning. The entire nursing staff must become involved in the financial system so the hospital can obtain an accurate data base for rate setting and third-party reimbursement.

Accounting↗
PubMed1987

Anglicising DRGs.

Explore the source record for details and available documents.

Cost Allocation↗
PubMed1988

The high price of technology: factors affecting hip implant costs.

As the cost of new technology for hip implants escalates, financial managers are finding an increasing amount of the DRG payment is spent on the technology itself and not nursing care, maintenance, or overhead. Four factors affect the cost and quality of hip implant prosthetics--the materials, design, fixation, and instrumentation--and must be considered in the cost and quality issues associated with selecting a prosthetic device. Financial managers must be sensitive to quality issues associated with new technological advances in hip implants, and they must be able to communicate the financial impact of this new technology to the physicians who use it and the third-party payers who pay for it.

Ancillary Services, Hospital↗
PubMed1988

Marketing in the HMO industry: an analysis of spending patterns and enrollment growth results.

The purpose of this paper is to assess the level of marketing spending in the HMO industry and the enrollment growth HMOs have achieved in return for their marketing dollars. This study identifies industry norms that are designed to assist HMOs in the evaluation of their marketing performance. The study is based on data from 1985 to 1986 covering approximately half the HMOs in the country and comprising a substantial proportion of industry-wide enrollment (Table 1). The analyses are designed to allow operational HMOs to compare their marketing efforts, enrollment growth, and marketing costs per new member with industry norms within similar age, model type, enrollment level, and geographic categories. The marketing expenses provided by each HMO are an aggregate figure including sales staff salaries, benefits and commissions, advertising, costs for the production and printing of marketing materials, and all other expenses directly related to the marketing effort. Components of the aggregate marketing expenses, such as the amount spent on advertising versus sales staff compensation, were not available.

Cost Allocation↗
PubMed1988

DRG production costs: one more dimension in management information for South Australia hospitals.

This paper summarises and discusses a report of a recent study undertaken by the South Australian Health Commission (SAHC) aimed at the measurement of the production costs of diagnosis related groups. Data were generated on an experimental basis for the seven major public hospitals in the State. The methodology was judged to be feasible, and data outputs of great potential value. It has therefore been decided that the costing process should become a routine component of the hospital management information system. Work is proceeding to extend the process to other sites. It is anticipated that production costs data of these types will make significant contributions to clinical program management, facilities planning, and hospital budgeting decisions in the future.

Accounting↗
PubMed1983

Medicare cost reporting: how to put a hospital's cost report on a micro-computer.

The major advantage of the micro-computer, in addition to its cost and speed, is that a particular analysis or work sheet can be done with relatively ease by the accountant. Without waiting for a programmer to program the particular application, debug it, and then change it several times after determination that it doesn't provide all of the information needed, the financial manager can do this right at his desk.

Computers↗