Ingenix, a healthcare IT company based in Eden Prairie, Minn. , yesterday released its fourth annual report on the "Top 200 Coding Hospitals in the U.S. " The report ranks hospitals by the completeness and accuracy of their medical coding practices used to bill Medicare for inpatient medical services.
The report was released at the American Health Information Management Association (AHIMA) National Convention at the Philadelphia Convention Center.
To compile the Top 200 report and determine the rankings, Ingenix used its HospitalBenchmarks. com software to analyze the recently released 2006 Medicare Provider Analysis and Review (MedPAR) file.
A total of 2,921 hospitals were included in the analysis and divided into four categories to account for variations in the populations served by the different types of hospitals. The four categories and the top-ranking hospital in each category are:
- Rural, Non-Teaching: Springfield Hospital, Springfield, Vt.
- Urban, Non-Teaching: Kaiser Foundation Hospital, Fresno, Calif.
- Minor Teaching: Kaiser Foundation Hospital, Panorama, Calif.
- Major Teaching: John H. Stroger Jr. Hospital, Chicago.
The Ingenix HospitalBenchmarks.com software used to analyze the MedPAR data is a Web-based benchmarking tool that can be used for creating comparative performance profiles for any Medicare hospital in the nation. Ingenix says that these profiles provide a snapshot of how a hospital is performing in the areas of coding, compliance, reimbursement and outcomes. Data can be viewed at the patient level to determine whether documentation and coding practices accurately represent services provided.
"This year's Top 200 report comes at a pivotal time for the industry as hospitals prepare for Medicare's transition to a severity-adjusted reimbursement system that will substantially change coding practices," said Stephen Greenberg, senior vice president in the Provider Solutions Group at Ingenix. "These changes create an additional incentive for hospitals to improve their clinical documentation and coding efforts, as the hospitals that code more completely could get a larger share of the reimbursement pool than those that continue to code based on today's Medicare reimbursement rules."
The new Medicare Severity Diagnosis-Related Groups (MS-DRGs) being implemented by the Centers for Medicare & Medicaid Services (CMS) calculate reimbursement based on the severity of a patient's condition, detailed in the medical coding of claims. Under the new reimbursement system, hospitals also must track and report numerous quality indicators, and adapt to Medicare's new policy that disallows payment for specific hospital-acquired conditions. All of these factors will require substantial changes to existing coding practices.
Click here for the nationwide Ingenix study and analysis of the findings.