Medical costs for newborns are some of the fastest growing in healthcare - mostly driven by infants requiring NICU services. Such cases represent a small percentage of the newborn population (approx. 15%) but consume a large percent of the total cost of care for this group (>40%). The increasing costs are partially attributed to cases where claims are submitted for the newborn’s NICU admission with a single revenue code level that reflects a higher resource use intensity than is documented in the records for the duration of care, resulting in higher than expected costs to the health plan.
NICU Cost Containment in DRG Environments: What ProgenyHealth Sees that Health Plans May Be Missing
Posted by
Jeremy Kreyling on Jul 22, 2019 10:28:25 AM
Topics: NICU case management, NICU length of stay, utilization management, APR DRG