Financial management and DRGs

Area of Science:

• Healthcare Management
• Health Economics
• Financial Risk Assessment

Background:

• The federal government's refinement of the Diagnosis-Related Group (DRG)-based prospective payment system introduces significant financial risks for healthcare providers.
• Survival in the evolving healthcare landscape necessitates robust internal systems for managing resources and costs.

Purpose of the Study:

• To outline a process for healthcare providers to identify and establish essential information systems.
• To support healthcare organizations in navigating financial risks associated with payment system changes.

Main Methods:

• The article illustrates a practical process for system development.
• Focuses on identifying needs for information on resource utilization and cost accounting.

Main Results:

• Healthcare providers can develop systems to track resource needs, consumption, and associated costs.
• The proposed process aids in establishing the necessary data infrastructure for financial management.

Conclusions:

• Establishing effective resource management and cost-tracking systems is vital for healthcare provider viability.
• Proactive system implementation enables providers to adapt to prospective payment system changes and mitigate financial risks.