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Wolters Kluwer Collaborates with New Health Analytics to Simplify the Inpatient Prospective Payment System

MS-DRG Grouper, Calculator & Analyzer is a one-of-a-kind solution for reimbursement professionals

NEW YORK, May 16, 2017 -- Wolters Kluwer Legal & Regulatory U.S. has partnered with New Health Analytics (NHA) to develop the most cost-effective stand-alone MS-DRG Grouper, Calculator & Analyzer on the market. As a constantly shifting regulatory environment presents new challenges for healthcare professionals, this updated workflow solution simplifies the Inpatient Prospective Payment System (IPPS).

The already complicated CMS Inpatient Prospective Payment System (IPPS), compounded by the constant changes brought on by health reform and the transition to ICD-10, has left healthcare professionals struggling to grasp the complexity of MS-DRG grouping and payment. With this updated workflow solution, providers, payers, consultants and regulators will gain a clearer understanding of the latest developments and regulations to ensure claims accuracy.

"We knew that by combining Wolters Kluwer's expertise with NHA's up-to-date IPPS data and logic we could take IPPS understanding to a new level," said Maria Bounos RN, MPM, COC, CSPO, and Practice Lead for Coding and Reimbursement Solutions at Wolters Kluwer. "A high-level federal government office uses our Grouper to review claims. Specifically, they are looking to see whether providers are 'gaming the system' to increase their reimbursement. When providers use our tools, they are working with the some of the same solutions that federal regulators use to assess claims. Being on the same page as the government helps providers protect themselves before a claim is ever submitted to the CMS."

The MS-DRG Grouper, Calculator & Analyzer empowers reimbursement professionals to:

  • Understand how a claim will be grouped and paid in a single step. Group and calculate for any provider in the country, for any point in time over the past five years, and benchmark against national unadjusted and state/regional averages.
     
  • Surface retroactive payment changes and quickly verify outlier eligibility. Service line management and contract negotiations become evidence-based with accurate, data that is difficult to glean from published CMS content and encoder systems.
     
  • Quickly analyze Medicare Expected Payment, including per diem and ACA impact, using the batch grouper.

"Hospitals, health systems and accountable care organizations need be able to track and predict financial and clinical performance," said Warren Brennan, Managing Partner of New Health Analytics. "This is especially true for bundled payments and some ACO schemes. The Analyzer lets you easily lookup and compare what Medicare would pay any hospital in the country."

Find out more about this SaaS tool from Wolters Kluwer, available through the Coding Suite and the Compliance Suite or as a stand-alone subscription. To learn more, sign up for the demonstration at https://attendee.gotowebinar.com/rt/6116551681704126721

About Wolters Kluwer Legal & Regulatory U.S.
Wolters Kluwer Legal & Regulatory U.S. is a part of Wolters Kluwer N.V. (AEX: WKL), a global leader in information services and solutions for professionals in the health, tax and accounting, risk and compliance, finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer reported 2016 annual revenues of €4.3 billion. The company, headquartered in Alphen aan den Rijn, the Netherlands, serves customers in over 180 countries, maintains operations in over 40 countries and employs 19,000 people worldwide.

For more information about Wolters Kluwer Legal & Regulatory U.S., visit www.WoltersKluwerLR.com, follow us on FacebookTwitter and LinkedIn.

About New Health Analytics 
New Health Analytics offers hospitals, ambulatory surgery centers, integrated delivery systems, health plans and physician organizations health information applications to support clinical integration. NHA provides day-to-day data analysis to help managed care companies, accountable care organizations and pay-for-performance systems succeed both clinically and financially. With customers in 32 states, the company's expertise in analytics and economics provides an organized approach to hospital data analysis.