Preview

Related Studies of Hospital System

Good Essays
Open Document
Open Document
871 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Related Studies of Hospital System
Related Studies
Foreign
An article from the internet (http://www.irpsys.com/articles/tw_rura.htm) on "Rural Local Community Hospitals Utilizes an Affordable Method to Generate Accurate Medicare Reimbursements" is also significant to the study because it gives an example on Local Community Hospitals system, whereby is East Adams Rural Local Community Hospitals is a 20 bed Local Community Hospitals in a town with a population of less than 2000. The elderly constitute a very high proportion of the population of our service area which means patients tend to be quite ill and stay for a long time. The current system of Medicare reimbursements, on the other hand, bases its payments strictly on the diagnosis related group (DRG) to which the patient's stay is grouped or assigned. Most large third party payers have also adopted the DRG system in the state of Washington. As a result, reimbursements frequently do not cover the cost of patient care. Further difficulties are generated by the fact that the terminal patients are frequently transferred to larger Local Community Hospitals in Spokane. This normally means the Spokane Local Community Hospitals gets the major portion of the reimbursement because their DRG assignment is based on the procedures performed and the larger Local Community Hospitals naturally is able to perform more procedures. Before this Local Community Hospitals had difficulties in the turnover of records, as well as manual billing system whose efficiency left much to be desired. In many cases, some charges were lost in transit because of poor paper handling and hence the Local Community Hospitals was receiving much less than the meager reimbursement it is entitled and that there was not enough time in the day to make manual system work so the need for computerized alternatives
Another article from the internet (http://www.besoftware.co.uk/products-services/Local Community Hospitals-informations.html) "Local Community Hospitals Information Systems -

You May Also Find These Documents Helpful

  • Good Essays

    Given the lower reimbursements provided by medicare/Medicaid combined with the growing number of uninsured, and the longer A/R process in medical practices it is a daunting process for a medical provider to reach this level of patient revenue from services.…

    • 391 Words
    • 2 Pages
    Good Essays
  • Good Essays

    The financial impact of the MS-DRGs for Medicare inpatients services is that the hospital can…

    • 593 Words
    • 3 Pages
    Good Essays
  • Good Essays

    4. Offer a $1,000 signing bonus to anyone who joins the organization and stays for at least 180 days.…

    • 617 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    What Is Ms-Drg

    • 260 Words
    • 2 Pages

    Originally the Centers for Medicare and Medicaid Services used a DRG system created in 1980 by Robert Barclay Fetter and John D. Thompson at Yale University to show severity and deliver payments to physicians and hospitals. (diagnosis-related groups, 2010) Effective October 1, 2007 changed to the MS-DRG system. The idea was to code based on the severity of the case. The change increased the codes from 538 to 745, this added new codes for complications. Payments are now cost based. Documentation needs to be enhanced to deal with the codes for chronic and acute situations. There was an increase as well as a decrease in the rates for some services. There are ongoing changes being implemented yearly. (instacode institute, 1998-2011)…

    • 260 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Hammond General Hospital is a 334 bed general hospital located in a Mid-western town of 45000 and serves a countrywide population of approximately 140,000. Recently the board of directors at Hammond awarder the management contract of the Food Service Department to an outside company, Master Host Company. Master Host appointed Dave Smith as director of food service. It must be noted that this is the first time in the hospitals history that someone outside the hospital has been appointed as director of a department.…

    • 2321 Words
    • 10 Pages
    Good Essays
  • Powerful Essays

    Currently, hospitals are paid a flat fee per hospital case by the federal Medicare program, using the Inpatient Prospective Payment System (IPPS). The prospective payment price, also referred to as the DRG (Diagnosis Related Groups) payment, covers all hospital costs for treating the patient during a specific inpatient stay, including the costs of all devices that are used. CMS adjusts DRG payments annually to reflect changes in hospital costs and changes in technology. This fee is paid to the hospital based on the patient’s symptoms, age, sex, discharge status, and the presence of complications, but does not account for length of stay or how many hospital services are actually used. (Ellis, 2011) Over time, the attempt has been to keep these rates close to the average cost of providing the services per case, although many hospitals claim that often the case payments they receive are below their own full costs. (Reinhardt, 2009)…

    • 3618 Words
    • 15 Pages
    Powerful Essays
  • Powerful Essays

    Health Insurance Matrix

    • 3146 Words
    • 9 Pages

    Health maintenance organizations use a prospective payment system in which providers within a specific network are paid a flat rate per member on a predetermined scale regardless of if services are not utilized or over utilized. According to (“Patient Advocate Foundation” 2012), “care can be provided in a larger geographic service area than would be possible with only one physician group. This network model offers the patient choice of physicians and managed…

    • 3146 Words
    • 9 Pages
    Powerful Essays
  • Good Essays

    With MS-DRG implementation, hospitals experienced increases or decreases in payment. Medicare no longer has a fee-for-service reimbursement policy. Nowadays, Medicare pays for the care under IPPS. Each case is assigned a MS-DRG and that MS-DRG assignment determines how much the hospital will be reimbursed. This payment reflects the average length of time that group received care as an inpatient. If a patient is discharged before the average, the hospital will see a profit; however, on the opposite hand, if a patient stays longer than average, the hospital loses profit.…

    • 542 Words
    • 3 Pages
    Good Essays
  • Best Essays

    Healthcare Payment Types

    • 3254 Words
    • 14 Pages

    Initially healthcare reimbursement was a term used in dealing with hospitals, but it has grown to be much bigger than that. Financing methods and organizational patterns have shifted over time and created medical groups, surgery centers, home health firms, large healthcare organizations, and many others in both the private and public sectors. Even though healthcare organizations are businesses just the same as any other business, they have one area that completely sets them apart from any other; that is the way they receive payments. There is not a single industry that has as unique and complex of a revenue system as the healthcare industry. In fact, in 1999 complexity was listed as “one of the five trends threatening the very future of medicine (Washburn 1999, 34). This paper will examine the history of reimbursement in the U.S. health system, the types of healthcare reimbursement methodologies, and also the best option of healthcare reimbursement models.…

    • 3254 Words
    • 14 Pages
    Best Essays
  • Better Essays

    Healthcare System

    • 976 Words
    • 4 Pages

    Employment based, Government funded, and Private Pay Health Insurance is the most common type of coverage. Workman’s Compensation is Government funded with a portion of the funds coming from employers. Also, separately funded, is the Military Medical Care system, caring for active, discharged, retired, and families of military men and women.…

    • 976 Words
    • 4 Pages
    Better Essays
  • Powerful Essays

    Critical Access Hospitals

    • 3119 Words
    • 13 Pages

    Medicare Rural Hospital Flexibility Program and Critical Access Hospitals Rand Health. (2006). Effects of Medicare’s Prospective Payment System on the Quality of Hospital Care. Retrieved from http://www.rand.org/content/dam/rand/pubs/research_briefs/2006/RAND_RB4519-1.pdf Rural Assistance Center. (2012). CAH Frequently Asked Questions. Retrieved from http://www.raconline.org/topics/hospitals/cahfaq.php#flex Rural Assistance Center, (2012). Health Care Workforce. Retrieved from http://www.raconline.org/topics/hc_providers/ Rural Assistance Center. (2012). Hospitals. Retrieved from http://www.raconline.org/topics/hospitals/ Rural Wisconsin Health Cooperative. (2002). Eye on Health. Retrieved from http://www.rwhc.com/eoh02/September.pdf Schoenman J, and Sutton J. (2008). Impact of CAH Conversion on Hospital Finances and Mix of Inpatient Services. NORC Walsh Center for Rural Health Analysis. Retrieved from http://www.norc.org/PDFs/Walsh%20Center/Main%20Page/ImpactofCAHConversion_F inalReport_NORC.pdf Southwest Rural Health Research Center. (2003). Rural Healthy People 2010 Project. Retrieved from http://www.srph.tamhsc.edu/centers/rhp2010/publications.htm Stensland J, Davidson G, and Moscovice I. (2004). The Financial Benefits of Critical Access Hospital Conversion for FY 1999 and FY 2000 Converters. University of Minnesota Rural Health Research Center Working Paper, 51. Retrieved from http://rhrc.umn.edu/wp-content/files_mf/wpaper051.pdf Stensland J, Davidson G, and Moscovice I. (2003).The Financial Effects of Critical Access Hospital Conversion. University of Minnesota Rural Health Research Center Working Paper, 44. Retrieved from http://rhrc.umn.edu/wp-content/files_mf/workingpaper044.pdf The National Rural Health Association. (2013). Benchmark Performance for Critical Access Hospitals; The Top 100 CAH Report of Findings. Retrieved from http://www.ivantagehealth.com/wp-content/uploads/2013/03/TOP-100-CAH-Report-ofFindings.pdf Virginia Department of Health. (2012). Medicare Rural Hospital Flexibility Program (Flex). Retrieved from http://www.vdh.state.va.us/healthpolicy/primarycare/ruralhealth/flex.htm…

    • 3119 Words
    • 13 Pages
    Powerful Essays
  • Good Essays

    For example, if a patient is admitted to the hospital, under this system, the hospital will only be reimbursed a set amount for this visit. Whether the patient is admitted for one day or 100 days, the reimbursement is the same. This can incentivize hospitals to increase the quality and efficiency of their care, but does carry some risk that they could also move patients out before they are ready, which leads to poor patient outcomes as well unnecessary readmissions. To help prevent this, many payers are also implementing pay for performance systems, which may pay an additional amount to the provider if they can demonstrate desired quality outcomes (Gapenski, 2012). Some payers, such as CMS, are also withholding a percentage of reimbursement if a provider demonstrates poor quality outcomes.…

    • 433 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    Medicare Overview

    • 1393 Words
    • 6 Pages

    This paper is an overview of the Medicare system and how it works. The document is intended…

    • 1393 Words
    • 6 Pages
    Powerful Essays
  • Good Essays

    The traditional fee-for-service and the usual, customary and reasonable methods by the hospitals and physicians to the diagnostic related groups and resource based relative value scale. The establishment of accountable care organizations and advanced primary care practice and payment methods like bundle and global payments are briefly explained. The Patient Protection and Affordable Care Act (ACA) which was passed in 2010 has also provided with multiple provisions in the development of new methodologies. ACA resulted in the formation of Center for Medicare and Medicaid Innovation (CMMI) under the Center for Medicare and Medicaid Services (CMS) to put forth some innovative models with an idea of tying the Medicare payments with a value based model. The aim is to formulate some potential prospects of reducing the healthcare cost while increasing the efficiency of the system and improving the overall care of the Medicare beneficiaries. The review also provides some alternative methods to the current Medicare system in comparison to other countries around the…

    • 1747 Words
    • 7 Pages
    Good Essays
  • Better Essays

    Health Care System

    • 1727 Words
    • 7 Pages

    Growth is an organizational necessity. It is required to keep up with changing customer needs and want. Growth marshals the organization’s energy. Profits from growth help fund nonrevenue producing activities and provide startup capital for further growth. As the population of Georgia and Cobb County continues to grow, the need for health-care services is in greater demand, particularly as the population of those 65 and older is expected to surge in coming years. In response to this need, Marietta-based WellStar Health System Inc. is under- going major expansion upgrading facilities, developing new construction projects and expanding its reach through acquisitions. “Large health systems, like Wellstar, are increasingly an option for metro-Atlanta area residents seeking health care,” Wellstar has multiple projects in Cobb County under way.” Part of WellStar’s expansion includes the $11.5 million acquisition of 25 acres in South Cobb, near Vinings and Smyrna. The site is in close proximity to interstates 75 and 285, making it convenient for metro-Atlanta area residents seeking health care.…

    • 1727 Words
    • 7 Pages
    Better Essays