Thursday, August 28, 2008

Hospital administrators use to make decisions about inpatient service? -

Which of the following would hospital administrators most likely use to make decisions about inpatient services? A. medicare fee schedule B. case-mix group data C. payment status indicators D. revenue codes They would actually use all those statistics although revenue codes is generally a product of the hospital accounting system. I guess of the 4 the case-mix group data would be the most relevant followed by the medicare fee schedule in determining appropriate inpatient services to provide. A politically correct answer would be that hospitals should not be looking at cost prior to evaluating a patients care. In theory they should be measuring the patients need for level of care without financial considerations. Revenue codes would be the most reliable data in my opinion as this would give the hospital administrator a broad metric to rely upon rather then non-specific medicare, case mix and payment status indicators. Medicare pretty well dictates all aspects of medical care by setting the standards/indicators. If Medicare doesn't cover something most insurances refuse as well. This in turn would have impact on case data, payment indicators and revenue codes. While I can't answer A,B,C, or D, I do answer that only an M.D. should be able to make decisions about medical service. The last thing I want is for some M.B.A. or M.S.H.A. to decide what is right in terms of treatment. People are not just entries on spreadsheets that tie into ERP financial statements.

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