> -----Original Message-----
> There was a famous program that maximised DRG claims for
> hospital care in the USA. I think it's central tactic was to
> work out which of multiple problems was the primary diagnosis
> which would give the highest DRG for reimbursement.
Johathan:
I am not sure, but you may be referring to a program I saw many years ago,
that was used by utilization and practice managers to assess the
cost/reimbursement profile for healthcare facilities. As I recall, it was a
bubble plot, with selected DRGs represented by the bubbles, the size of
which was proportional to the number of patients in the represented
category. The x and y axes were cost and prospective payment. Dividing the
plot into quadrants and measuring the sum of the areas of circles in each
quadrant produced a quantitative measure of cost/reimbursement profile of
the institution.
Bubble plots can be generated in Excel or PowerPoint, but the real value of
this type of analysis was in comparing profiles of peer institutions. It
also reveals visually which DRGs have the greatest impact on your balance
sheet.
Best regards,
Roger
Roger L. Bertholf, Ph.D.
Associate Professor of Pathology
Director of Clinical Chemistry & Toxicology
University of Florida Health Science Center/Jacksonville
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