Diagnosis Related Group Hospital Inpatient Payment Methodology
Kev them nyiaj los ntawm Diagnosis Related Group (DRG) txhawb kev nkag mus rau kev saib xyuas, muab nqi zog ua haujlwm zoo, txhim kho pob tshab, thiab txhim kho kev ncaj ncees los ntawm kev them nyiaj zoo sib xws hauv tsev kho mob rau kev saib xyuas zoo sib xws. Kev them nyiaj los ntawm DRG kuj tseem ua kom yooj yim rau cov txheej txheem them nyiaj, txhawb kev tswj hwm kev ua haujlwm zoo, thiab kev them nyiaj hauv paus ntawm cov neeg mob thiab cov peev txheej hauv tsev kho mob ntau dua li qhov nyob ntev.
Keeb kwm ntawm DRG
Senate Bill 853 (Txoj Cai ntawm 2010) tau ntxiv Tshooj 14105.28 rau Txoj Cai Welfare thiab Institutions Code uas tau txib kom tsim thiab siv cov txheej txheem them nyiaj tshiab rau cov kev pab cuam hauv tsev kho mob muab rau cov neeg tau txais txiaj ntsig Medi-Cal raws li Diagnosis Related Groups (DRGs).
DRG Payment Method
Txoj kev them nyiaj rov qab DRG tau hloov pauv txoj kev them nyiaj dhau los rau txhua lub tsev kho mob ntiag tug nrog kev nkag mus rau lossis tom qab Lub Xya Hli 1, 2013, thiab rau cov tsev kho mob pej xeem tsis raug xaiv nrog kev nkag rau lossis tom qab Lub Ib Hlis 1, 2014.
Ib txoj kev them nyiaj ib hnub yog siv rau kev them nqi kho mob rov qab thiab cov kev pabcuam hnub ua haujlwm tau muab los ntawm DRG tsev kho mob.
Txoj Kev Them Nyiaj Yav dhau los
Raws li txoj kev them nyiaj dhau los, cov tsev kho mob tsis muaj ntawv cog lus tau them rov qab raws li Medi-Cal tso cai, cov nqi kuaj xyuas. Cov tsev kho mob tau them tus nqi ib ntus siv tus nqi-rau-tus nqi raws li daim ntawv tshaj tawm cov nqi xa tawm tam sim no. Cov txheej txheem kev them nqi kho mob rov qab qhov sib txawv ntawm cov nyiaj them ib ntus thiab cov nqi tso cai ntawm kev muab kev pabcuam.
Ib tus nqi tuag rau cov tsev kho mob cog lus tau sib tham los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv yav dhau los ntawm California Medical Assistance Commission raws li Selective Provider Contracting Program (SPCP). SPCP tau tsim muaj kev cai lij choj hauv xyoo 1982 thiab ua haujlwm raws li tsoomfwv zam. Nrhiav cov ntaub ntawv ntxiv txog SPCP.
Tiv tauj peb
Rau cov lus nug txog DRG, cov lus pom thiab kev txhawj xeeb, lossis sau npe rau DRG ListServ, thov xa email tuaj rau peb ntawm DRG@dhcs.ca.gov.
DRG Information
Txhawm rau paub txog DRG cov ntaub ntawv tshwj xeeb, thov xaiv los ntawm cov nplooj ntawv hauv qab no:
