MS-DRG Case Study
MS-DRG Case Study
Medicare severity diagnosis-related group or MS-DRG is Medicare refinement to the diagnosis-related group (DRG) classification system, which allows for payment to be more closely aligned with resource. The Medicare Severity-DRG (MS-DRG) is the most commonly used DRG system, because it governs the ever growing ranks of Medicare patients (Bushnell, 2013).
MS-DRG has a payment rate called a weight (Casto, 2013). Higher weights are associated with groups in which patients require more resources for care and treatment. Higher resource consumption is related to higher intensity of services due to the severity of illness or the type of services needed for the care and treatment, such as expensive equipment or medications. Higher weights translate into higher payment (Casto, 2013).
MS-DRG was specifically designed for the purpose of Medicare hospital inpatient services payment. Diagnosis Related Group (DRG) is to help put patients into categories based on similar clinical conditions on similar levels for the hospital to know the required treatment. Each DRG is assigned a relative weight that is appropriate for the amount of hospital resources used to treat the patient. MS-DRG is just one of the categories used for DRG. MS-DRG range from 001-999 with many of them unused numbers which leaves more for MS-DRG expansion.
Medicare Severity-Diagnosis Related Group or MS-DRG helps to provide great reimbursements for the hospitals that have more sever patients. The MS-DRG is mainly for Medicare inpatient services to help determine the correct reimbursement for the hospital.
Bushnell, B. (2013, December). The Evolution of DRGs. AAOS Now. Retrieved from
Casto, A. (2013). Principles of Healthcare Reimbursement 4th Edition.
Vital Source Bookshelf
University/College: University of Chicago
Type of paper: Thesis/Dissertation Chapter
Date: 20 September 2016
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