Back to Blog
In response, 3M developed the 3M EAPGs which were first released in 2007 and have since become the industry standard alternative to APCs.ģM EAPGs are designed to categorize, in a clinically meaningful way, the resources used to provide different types of care in various outpatient settings. Because APCs took a fee schedule approach and had a high degree of Medicare specificity, there was demand from other payers and health care organizations for a different approach. Payment based on APCs was implemented in August 2000. In 1999, however, congressional action required the new Medicare method to take more of a fee schedule approach. Throughout the 1990s, six major payers implemented payment methods based on APGs. The contract to develop APGs was awarded to 3M. Congress required the Centers for Medicare & Medicaid Services (CMS) to develop an outpatient prospective payment system (OPPS). In 1990, following the success of the Medicare Inpatient Prospective Payment System (IPPS) based on DRGs, the U.S. For example, 3M EAPG 086 (Pacemaker and Other Cardiovascular Device Insertion and Replacement) triggers Patient Focused Episode 0860 (Pacemaker Insertion and Replacement). For example, 3M EAPG 450 observation is considered a potentially preventable service when the diagnosis is other family psycho/social circumstances.ģM EAPGs are used to define certain 3M™ Patient-focused Episodes (PFE) Software. The 3M PPS methodology compares services with its indicated diagnoses to identify potentially preventable ancillary services. A common example is 3M EAPG 562 Infections of Upper Respiratory Tract and Otitis Media. The 3M PPV methodology uses 3M EAPGs to define potentially preventable emergency department visits. This alignment allows analysis of charges, costs, payments and utilization by service line across both inpatient and outpatient settings. The 3M EAPGs are integrated with other 3M patient classification methodologies.ģM has aligned the service line definitions between 3M EAPGs for outpatient care and the 3M™ All Patient Refined Diagnosis Related Groups (APR DRGs) for inpatient care.
0 Comments
Read More
Leave a Reply. |