MS-DRGs:
HISTORY:
In 1980s, Health Care Financing Administration (HCFA) which is now known as Centers for Medicare and Medicaid Services (CMS) developed a methodology Diagnosis Related Groups (DRGs) under the Inpatient Prospective Payment System (IPPS) to describe all kinds of patient services provided in an acute care hospital. Later, in 1987 3M developed an all patient DRG (AP-DRG) system based on a New York’s hospital reimbursement program for non-Medicare discharges. In 1989, Yale University came up with Refined DRG (RDRG) system to identify the severity of illness incurred to Medicare candidates. Again there was a reform in the system by HCFA which is present CMS in 1990, which includes complications and comorbidities in Medicare DRGs under the category known as …show more content…
In late 1990s, 3M later developed all patient refined DRG system which addresses the severity of illness and mortality of all patient population and this system became popular as it includes the methods for rate settings. APR-DRG system has a four scale method comprising of minor, moderate, major and extreme level of severity of illness and the risk of mortality and many hospitals can be used for internal quality improvement as well as public reporting. The need for the measurement tool is to evaluate the differences of hospital mortality rate and develop quality supporting critical pathway that identify and classify patient services provided by the hospitals with involving several factor in the case mix such as severity of illness, risk of mortality, prognosis, treatment difficulty, need for intervention and resource intensity. A new DRG system was proposed in 2007, Medicare Severity DRGs (MS-DRGs) which was used within the Medicare’s inpatient prospective payment system to have a better account of severity of illness and resource utilization for the
HISTORY:
In 1980s, Health Care Financing Administration (HCFA) which is now known as Centers for Medicare and Medicaid Services (CMS) developed a methodology Diagnosis Related Groups (DRGs) under the Inpatient Prospective Payment System (IPPS) to describe all kinds of patient services provided in an acute care hospital. Later, in 1987 3M developed an all patient DRG (AP-DRG) system based on a New York’s hospital reimbursement program for non-Medicare discharges. In 1989, Yale University came up with Refined DRG (RDRG) system to identify the severity of illness incurred to Medicare candidates. Again there was a reform in the system by HCFA which is present CMS in 1990, which includes complications and comorbidities in Medicare DRGs under the category known as …show more content…
In late 1990s, 3M later developed all patient refined DRG system which addresses the severity of illness and mortality of all patient population and this system became popular as it includes the methods for rate settings. APR-DRG system has a four scale method comprising of minor, moderate, major and extreme level of severity of illness and the risk of mortality and many hospitals can be used for internal quality improvement as well as public reporting. The need for the measurement tool is to evaluate the differences of hospital mortality rate and develop quality supporting critical pathway that identify and classify patient services provided by the hospitals with involving several factor in the case mix such as severity of illness, risk of mortality, prognosis, treatment difficulty, need for intervention and resource intensity. A new DRG system was proposed in 2007, Medicare Severity DRGs (MS-DRGs) which was used within the Medicare’s inpatient prospective payment system to have a better account of severity of illness and resource utilization for the