DRG benchmarks out there?

careed

Does anyone know of benchmarks for individual DRGs for Medicare patients? I know the PEPPER has MCC/CC capture, etc. I don't have access to all the cool reports that are available but thought some of you might know.

Thanks!

Christine Reed, BSN, RN, CCDS
Clinical Documentation Specialist Team Leader
careed@beaconhealthsystem.org
600 East Blvd., Suite 141, Elkhart, IN 46514
Phone: 574-389-5665
Pager: 888-301-9402

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don.cdi.rn@gmail.com

Table 7 from the IPPS final rule every year gives the volumes of medicare
patients for EACH drg. Easy enough to run any number of calculations.
For example:
% of CHF with MCC
% of all admits for COPD (add the 3 DRG volumes, divided by total # of DRGs)
Comparison of COPD and Resp Failure volumes
Comparison Sepsis vs common infections DRGs (cellulitis, pna, uti, etc.)
....

Don

evanspx@sutterhealth.org

Don:

As always, thank for your great insight regarding data and statistical analysis. Do you know if I can find any of the metrics below in the public domain? I am trying to find a comparative data base I can use for my metrics. One limitation is that without MedPar or other national comparator benchmarks, we can’t assess our performance against other like-institutions, but can only track our own performance over time. I have not found a practical way to obtain MedPar data??

We bring coding data into a Statit report that reports trended financial data displaying control bars to help define what is statistical “noise” versus possible true signal and Opportunity for Improvement. We calculate the following metrics:

1) Hospital CMI, 2) Hospital Adjusted CMI (excludes trach and transplant encounters which are not affected by the CDI program), 3) Hospital Medical CMI, 4) Hospital Surgical CMI, 5) Hospital Adjusted Surgical CMI (excludes trach and transplant encounters), 6) Medical / Surgical Mix, 7) Hospital CC/MCC Capture Rate, 8) Hospital Medical CC/MCC Capture Rate, and 9) Hospital Surgical CC/MCC Capture rate. (See one Example below)
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Paul Evans, RHIA, CCS, CCS-P, CCDS

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421

evanspx@sutterhealth.org

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careed

Thanks Don this is very helpful

Christine Reed, BSN, RN, CCDS
Clinical Documentation Specialist Team Leader
careed@beaconhealthsystem.org
600 East Blvd., Suite 141, Elkhart, IN 46514
Phone: 574-389-5665
Pager: 888-301-9402

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