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Casemix and Funding Models - PDF

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Added on  2019-10-30

Casemix and Funding Models - PDF

   Added on 2019-10-30

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Running head: REPORT1MANAGEMENT AND APPLICATION OF HEALTH DATA FOR DECISION-MAKINGREPORTStudent Name Student ID Date
Casemix and Funding Models - PDF_1
REPORT2SummaryCasemix and per diem funding definitions In the hospital context, per diem refers to funding for inpatient services that provides a fixed cash amount for a patient`s day in the hospital [ CITATION Tur12 \l 2057 ]. They add that this is regardless of the hospital`s charges or expenses incurred for caring for that given patient. Casemix funding depicts a method of assigning funds based on the activities that hospitals execute and on the number and types of patients treated [ CITATION Tur12 \l 2057 ]. According to them, this model has the following fundamental requirements namely: counting the number of treated patients, classifying patients treated and the costing of patients treated.Diagrammatic representation of the casemix system considerationsConsiderationsResource estimate accuracy offered by the casemix methodCapacity to monitor hospital behaviour adjustmentsPresence of dependable clinical data to back casemix system implimentationClinical trasparency and validity of the casemix groups
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REPORT3Differences between the two funding models According to [ CITATION ORe12 \l 2057 ], there exist monumental differences between the two health funding models as illustrated in the table below.Per diem modelCasemix modelIt offers a fixed amount of cash for a patient`s day in the hospitalProvides funds for the overall number ofpatients treated in the hospitalIt does not consider the type of patients treated at the hospitalConsiders the type of patients attended to at the hospitalIt does not consider the expenses incurred for those particular patientsConsiders the incurred care expenses forthe patientsPros and Cons of the two funding models According to [ CITATION Via12 \l 2057 ], the three most common pros and cons of the per diem funding model are as follows;Per diem pros and cons tableStrengthsWeaknessesThey have facilitated straightforward administration and contracting for over many years. Hospitals lack the incentive to avert needless days during hospitalizationThis payment method offers somelimitations on cost-generating hospital conduct, since daily amount payment is perpetually set(while the actual sum payment is retrospective). They do not offer adequate transparency about hospitals` real clinical activities. They do not allow comparisons among hospitals on outputs or activities producedThey can offer increased transparency for consumers to enable them to compare lengths and prices of stay among hospitals, as a measure of the overall hospital costsEfforts to curb costs may need third parties which monitor per diems to identify medical necessity via aggressive, persistent stay medical review. This causes administrative intricacy and at times unsuitable clinical care intrusion
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