Large-scale healthcare projects, from new projects to renovations, face a challenging future. After the tedious process of securing permits and getting approved plans and even issuing press releases, many of these ambitious projects stall due to financial pressures. Increasingly, healthcare systems may hit the pause button as they take a closer look at cost-benefits, with emphases on expanding market share and reducing cost of care. In today's post, we will look at how a healthcare project can help achieve both goals by focusing on proven infection prevention infrastructure.
In today's healthcare marketplace, it is growing commonplace to consider patients as customers - and the shoe fits, so to speak. Patients do have choices when it comes to medical care, and now have plenty of ratings and data points to consider when selecting a physician, an outpatient center, a hospital or a long-term care facility. One of those data points is patient experience, which encompasses the many interactions with medical staff, facilities, and representatives. In today's post, we will consider the measurable aspects of the patient experience, including infection control and prevention.
One of the most tracked and reported metrics in today's healthcare facilities is infection rates. Anyone working in a hospital is aware of the importance of keeping these rates as low as possible, as they impact not only patient outcomes, but reimbursement rates and facility reputation as well. It may be an assumption by the general public that these rates are an objective metric with little grey area. However, a recent study investigated what infection prevention experts think about these metrics, and the results may surprise you!
In our previous posts about the Case-Mix Index (CMI), we explored what it conveys and how it is calculated. Today we will discuss who looks at that the CMI and how they use it, including both clinical and financial entities.
Last week, we looked at Diagnosis-Related Groups and how they receive codes based on cost and complexity. These numbers play a key role in the Case-Mix Index, and today we will look at how those MS-DRGs form the basis of the CMI.
The Case-Mix Index (CMI) has been defined in many ways. One definition might read "a relative value assigned to a diagnostic-related group." Another may be "a rough estimate of how sick a hospital's patients are." Yet another could be "an indicator of how much reimbursement is expected by the hospital." All these definitions point to one fact: The CMI is a measure used by a variety of healthcare personnel in a variety of ways. This week we will begin our exploration of this multi-faceted number.
The Centers for Medicare and Medicaid Services (CMS) uses a Prospective Payment System (PPS) to provide incentives for healthcare providers to be effective and efficient. Much like health maintenance organizations (HMOs), the PPS provides a flat fee for each service, encouraging providers to stay within efficient financial limits. (In contrast, the older fee-for-service model incentivized over-utilization of services.) Each year, CMS releases changes to the PPS, in their efforts to remain flexible to changing medical needs and feedback from patients and providers. Earlier this month, CMS released the final inpatient rule (all 2,087 pages), including a few important changes.