Healthcare Technology Featured Article

March 23, 2015

Wolters Kluwer Law & Business Launches New Health Analytics-Developed MS-DRG Grouper, Calculator & Analyzer

Wolters Kluwer Law & Business, a global information services and publishing company, has entered into a partnership with New Health Analytics (NHA) to develop the healthcare industry’s first stand-alone MS-DRG (Medicare Severity Diagnosis Related Group) Grouper, Calculator & Analyzer. NHA provides a complete health information system for clinical integration to support hospitals, ambulatory surgery centers, integrated delivery systems, health plans and physician organizations.

The Software-as-a-Service (SaaS) solution aims to simplify the Inpatient Prospective Payment System (IPPS) and MS-DRG grouping process, which is notorious for its complexity in terms of both general workflows and regulations. Revenue Cycle Specialists have struggled to increase claims accuracy through testing of grouping and DRG scenarios due to all existing solutions being not transparent, overly costly or lacking in key functionality.

“We saw a need in the market for this kind of decision support tool,” said Maria Bounos RN, MPM, CPC-H, and Practice Lead for Coding and Reimbursement Solutions at Wolters Kluwer. “The timing of this launch couldn't be better, as all inpatient coders need to practice ICD-10 coding and grouping to prepare for the implementation of ICD-10. Providers need to model how a typical patient stay coded in ICD-9 would shift to a different MS-DRG when coded in ICD-10 in order to understand the related financial risk.”

Users of the tool can perform a comparative analysis of Medicare Expected Payments from multiple providers through its batch grouping capability and intuitively compare reimbursements for any MS-DRG. It also provides data for analysis of quality reporting, meaningful use, readmissions and other measures as well as illuminating outlier eligibility and calculations for payment increases.

“An essential element of revenue cycle management and financial health is the ability to accurately calculate payments,” said NHA CEO and Co-founder Warren Brennan. “We have extensive experience with the pace of regulatory releases and the increasing complexity of the underlying algebra of CMS payments.”

The MS-DRG Grouper, Calculator & Analyzer is currently available through Wolters Kluwer’s Coding Suite and Compliance Suite or as a standalone subscription. Wolters Kluwer Law & Business publishes content and offers a range of integrated compliance, risk management, reimbursement and workflow solutions, especially for legal and healthcare organizations.

Edited by Dominick Sorrentino

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