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Related Experiment Videos

Burn center reimbursement analysis.

G Maxwell1, P Silverstein

  • 1Baptist Burn Center, Oklahoma City, OK.

The Journal of Burn Care & Rehabilitation
|September 1, 1992
PubMed
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Burn center financial survival depends on understanding reimbursement. This study assessed a burn center's reimbursement status, identifying key diagnosis-related groups and payers to improve financial viability.

Area of Science:

  • Healthcare Management
  • Health Economics
  • Burn Care Reimbursement

Background:

  • Burn centers face financial challenges in a fixed-payment healthcare system.
  • Understanding reimbursement parameters and regulators is crucial for operational survival.
  • This study focuses on a private, not-for-profit burn center's financial landscape.

Purpose of the Study:

  • To assess the current reimbursement status of a specific burn center.
  • To identify internal and external financial constraints affecting the burn center.
  • To analyze financial data for fiscal years 1989-90 to inform strategies.

Main Methods:

  • Analysis of diagnosis-related groups (DRGs) and third-party payers.
  • Examination of actual reimbursement rates per DRG.

Related Experiment Videos

  • Comparison of average patient charges versus reimbursement per patient.
  • Exploration of billed charges versus revenue for Medicaid patients.

    • Main Results:

    • Identification of most frequent burn diagnosis-related groups and payers.
    • Analysis of reimbursement rates indicating financial performance.
    • Comparison revealing discrepancies between charges and reimbursement.
    • Specific findings on revenue from Medicaid patients.

    Conclusions:

    • Burn center financial health is directly tied to reimbursement knowledge.
    • Identifying high-frequency DRGs and payers is key for strategic planning.
    • Addressing the gap between billed charges and received revenue is essential for sustainability.
    • Solutions for identified financial problems were discussed.