The case mix of ambulatory surgery as measured by ambulatory visit groups

Lion, Joanna; Vertrees, James C.; Malbon, Alan; Harrow, Brooke; Collard, Ann F.; Mowschenson, Peter

doi:10.1097/00004479-199002000-00007

Cited by 5 publications

(5 citation statements)

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“…For example, the Medicare system determines cost for procedures by categorizing procedures/ interventions into diagnosis-related groups (DRGs) in the hospital. 18,19 The DRG is a weighted system, where there is a direct correlation with the weight assigned to a procedure and cost. 18,19 Utilization of CPT coding establishes cost Visualization of the increasing implant cost in relation to the changing net revenue, the difference between the total reimbursed cost of care and the TDABC-estimated cost of care, for the hospital.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 The DRG is a weighted system, where there is a direct correlation with the weight assigned to a procedure and cost. 18,19 Utilization of CPT coding establishes cost Visualization of the increasing implant cost in relation to the changing net revenue, the difference between the total reimbursed cost of care and the TDABC-estimated cost of care, for the hospital. The left vertical axis aligns with the implant cost (blue).…”

Section: Discussionmentioning

confidence: 99%

“…18,19 The DRG is a weighted system, where there is a direct correlation with the weight assigned to a procedure and cost. 18,19 Utilization of CPT coding establishes cost for procedures/interventions in the outpatient surgical setting. The payment derived from DRG weighting in the hospital setting can then be analyzed to determine whether the economics of proceeding with the procedure in the hospital setting are more efficient than switching to an outpatient facility.…”

Section: Discussionmentioning

confidence: 99%

“…The payment derived from DRG weighting in the hospital setting can then be analyzed to determine whether the economics of proceeding with the procedure in the hospital setting are more efficient than switching to an outpatient facility. 18,19 Selection of surgical setting, while not at the expense of the patient, is important to optimize total cost. Previous research has shown reduced costs without sacrificing outcomes when ankle fractures are surgically managed in the outpatient setting.…”

mentioning

confidence: 99%

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Can Reducing Implant Costs Increase Revenue for Surgically Treated Ankle Fractures: Time-Driven Activity-Based Costing for 1-Year Episode of Care

Freking

Okelana

Only

et al. 2021

Foot & Ankle Specialist

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Background: The purpose of this study was to investigate whether decision-making regarding implant selection affects the reimbursement margins for the surgical fixation of ankle fractures. Methods: All ankle fractures treated between 2010 and 2017 within a single-insurer database were identified via Current Procedural Terminology codes by review of electronic medical record. Implant cost was determined via the implant record cross-referenced with the single contract institutional charge master database. The Time-Driven Activity-Based Costing (TDABC) technique was used to determine the costs of care during all activities throughout the 1-year episode of care. Statistical analysis consisted of multiple linear regression and goodness-of-fit analyses. Results: In all, 249 patients met inclusion criteria. Implant costs ranged from $173 to $3944, averaging $1342 ± $751. The TDABC-estimated cost of care ranged from $1416 to $9185, averaging $3869 ± $1384. Finally, the total reimbursed cost of care ranged between $1335 and $65 645, averaging $13 954 ± $9445. The implant costs occupied an estimated 34.7% of the TDABC-estimated cost of care per surgical encounter. Implant cost, as a percentage of the overall TDABC, was estimated as 36.2% in the inpatient setting and 33% in the outpatient setting, which was the second highest percentage behind surgical costs in both settings. We found a significant increase in net revenue of $1.93 for each dollar saved on implants in the outpatient setting, whereas the increase in net revenue per dollar saved of $1.03 approached significance in the inpatient setting. Conclusion: There is a direct relationship between intraoperative decision-making, as evidenced by implant choices, and the revenue generated by surgical fixation of ankle fractures. Intraoperative decision-making that is cognitive of implant cost can facilitate adoption of institutional cost containment measures and prompt increased healthcare value. Level of Evidence: Level III: Retrospective cohort study

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Can Reducing Implant Costs Increase Revenue for Surgically Treated Ankle Fractures: Time-Driven Activity-Based Costing for 1-Year Episode of Care

Freking

Okelana

Only

et al. 2021

Foot & Ankle Specialist

View full text Add to dashboard Cite

show abstract

“…6 The purposes and characteristics of these systems have been described elsewhere. [7][8][9] Briefly, AVGs were developed using clusters of related diagnoses, with groups subdivided on the basis of variations in costs for procedure groups, or variations in physician time for medical groups. APGs were derived on the basis of cost variation, after clustering of clinically related ambulatory procedures (procedure APGs), and clinically similar ICD-9-CM diagnoses (medical APGs).…”

mentioning

confidence: 99%