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Current diagnosis-related group-based bundling for upper-extremity arthroplasty: a case of insufficient risk adjustment and misaligned incentives myDRG Stellenmarkt Gesundheitswesen

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Current diagnosis-related group-based bundling for upper-extremity arthroplasty: a case of insufficient risk adjustment and misaligned incentives

Current diagnosis-related group-based bundling for upper-extremity arthroplasty: a case of insufficient risk adjustment and misaligned incentives (Elsevier).

The current Centers for Medicare & Medicaid Services diagnosis-related group (DRG) bundled-payment model for upper-extremity arthroplasty does not differentiate between the type of arthroplasty (anatomic total shoulder arthroplasty [ATSA] vs....

[...] Under the DRG-based model piloted by the Centers for Medicare & Medicaid
Services, providers and hospitals would be reimbursed the same amount
regardless of the type of surgery (ATSA vs. hemiarthroplasty vs. TEA), patient
comorbidity burden, and diagnosis and indication for surgery (fracture vs.
degenerative pathology), despite each of these factors having different
resource utilization and associated reimbursements. Lack of risk adjustment for
fracture indications leads to strong financial disincentives within this
model.

Quelle: Elsevier, 30.03.2020

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erschienen am Montag, 30.03.2020
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