DRG-based cost management at Norwest Corporation

Area of Science:

• Healthcare Management
• Health Economics
• Data Analysis in Healthcare

Background:

• Employee health benefit utilization is a significant cost for large corporations.
• Accurate assessment of healthcare costs requires robust analytical methodologies.
• Understanding provider performance is crucial for optimizing healthcare spending.

Purpose of the Study:

• To evaluate employee health benefit utilization patterns.
• To assess healthcare provider performance.
• To identify key factors influencing health cost management.

Main Methods:

• Utilized a Diagnosis-Related Group (DRG)-based methodology.
• Compared actual healthcare experience against projected norms.
• Employed data analysis to study benefit utilization and provider performance.

Main Results:

• The DRG-based methodology revealed previously unknown facts about healthcare utilization.
• Analysis provided critical data for health cost management planning.
• Insights into provider performance were gained through comparative analysis.

Conclusions:

• A DRG-based approach offers valuable insights for financial holding companies.
• Effective health cost management relies on detailed analysis of utilization and provider data.
• The study highlights the importance of data-driven strategies in corporate health benefits.