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Related Experiment Videos

Forecasting hospital reimbursement.

B C Becker, A Sapienza

    Hospital & Health Services Administration
    |October 7, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Hospital administrators can forecast reimbursement potential by analyzing physician admissions. This method links physician office practice admissions to hospital revenue, improving financial planning.

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    Area of Science:

    • Healthcare Administration
    • Health Economics
    • Medical Informatics

    Background:

    • Third-party payer reimbursement changes necessitate accurate hospital financial forecasting.
    • Existing models predict census, demand, and revenue but neglect physician impact on reimbursement.
    • Physician office practice admissions are a key, yet unmodeled, factor in hospital reimbursement potential.

    Purpose of the Study:

    • To analyze the relationship between admitting physicians, their patients' third-party payers, and hospital reimbursement.
    • To develop a method for forecasting hospital admissions and reimbursement potential based on physician referral patterns.
    • To provide hospital administrators with a tool to better predict revenue influenced by physician practice behavior.

    Main Methods:

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  • Retrospective analysis of admitting physician patient data.
  • Categorization of patients by third-party payer.
  • Development of a forecasting model utilizing historical physician admission data.

    • Main Results:

    • Demonstrated a direct correlation between physician admissions and hospital reimbursement potential.
    • Quantified the impact of physician referral patterns on hospital revenue streams.
    • Validated a method for predicting future hospital admissions and revenue based on physician activity.

    Conclusions:

    • Physician office practice admissions significantly influence hospital reimbursement potential.
    • The proposed method offers a novel approach to hospital financial forecasting by incorporating physician-specific data.
    • Accurate forecasting of hospital admissions and reimbursement requires understanding the physician's role in patient referrals.