Healthcare providers generate volumes of patient information that result in coded medical records. This coded data helps providers, regulators, payers and consumers understand the value of patient care, giving insight into patient mix, expected reimbursement and quality outcomes.
3M has 30+ years of experience developing classification, grouping, edits, and reimbursement calculation systems for inpatient, outpatient, and professional settings. Whether you or your clients want to process claims for reimbursement or reporting, edit patient records in real-time, or analyze patient data, 3M is the source for innovative, cost-effective and up-to-date solutions.
Our products and services fit a number of needs, including:
3M’s inpatient and ambulatory care classification and grouping methodologies help you analyze coded data and claims, resulting in insights that help you keep up with regulatory changes and understand the true quality of patient care. Options include:
In addition to quantifying resources used during a specific admission or patient visit, our suite of grouping software can be applied to all inpatient and ambulatory encounters over time. The risk-adjusted measures represent patient health risk, episodes of care, community-based care, and ambulatory-care sensitive conditions, providing a longitudinal perspective that supports value-based care programs. Options include:
Our grouper software platforms process data sets and produce grouped data outputs from a single application for any grouping scheme you need, such as 3M APR DRGs, Ambulatory Payment Classifications (APCs) or 3M CRGs. Options include:
Payment reform has focused on improving outcomes and controlling costs, but how can this be done for more complex patients, such as those with serious mental health/substance abuse disabilities? Financial incentives combined with improved risk-adjustment may not be enough. Dr. Norbert Goldfield and Richard Fuller share recommendations on innovative payment models for complex populations.
Dr. Norbert Goldfield and Richard Fuller review a recent study of the validity of national quality measures in the journal Medical Care. They consider the study “old thinking” and propose a new way for the quality improvement community to work together to decrease complications, create fairer financial incentives, and, ultimately, save lives.
Are CMS’ penalty-based programs effective at reducing hospital-acquired conditions (HACs)? Richard Fuller and Dr. Norbert Goldfield review these programs, including the recently deployed HAC Program, and discuss possible changes that could truly decrease HACs.
Learn more about the ins and outs of our grouping and classification methodologies and applications.
3M Grouper Plus Content Services (GPCS) provides reliable, secure processing of patient claims and other coded data in the cloud. The web-based delivery system hosts a selection of classification and reimbursement content users need to group, edit and calculate reimbursement of claims.
3M Clinical Risk Groups (CRGs) measure illness and resource utilization of all patients, including children, low income or elderly individuals, commercial beneficiaries, and those with disabilities using inpatient, ambulatory, and pharmacy data.
3M "preventables" software identifies avoidable and unnecessary care. The focus on "potentially preventable" events gives organizations actionable information to make improvements where they can have the greatest impact.
The 3M EAPG System classifies outpatient care into patient groups and categories based by key procedures and primary diagnosis code. It consolidates multiple single procedures into a bundle and packages ancillary services together with the significant procedure, where appropriate.