Transcript

Activity Based Funding
Name
Institution

Activity based funding is a motivational strategy that is used to encourage healthcare workers to treat more patients and complicated ailments as described by Eagar (2010). The activity-based funding model helps in the attainment of set goals, and it entails various processes (slide 3). The integration of ABF was made possible by the council of Australian Government as a reform in the approach used to fund health services, which fall in acute admitted care, emergency care, non-admitted care, sub-acute, care, or admitted mental health care categories. Certain diagnoses and cues (DRG factors) indicate the kind of healthcare services one should receive (refer to slide 8) as indicated in “Diagnosis Related Group” (2018). By now, it is evident that ABF has a significant impact on the kind of services provided as every healthcare facility aims to receive maximum funding. However, an efficient coding system is the pinnacle of ABF as it helps to keep tab of all the diagnoses, admissions, and procedures. The coding process consists of five main activities (see slide 12). The first three processes are executed by the clinical coders, who are guided by certain principles to ensure that the coding system is effective (“What is casemix and the clinical coder’s role?” 2015). Coding is guided by the ICD-10-AM, which guides the fourth activity/process and is a composite of various systems (see slide 15) as indicated by the Australian Consortium for Classification Development (2018).

We already reviewed the DRG factors and in reference to its features, it helps to generate a DRG code. DRG is an important nomenclature that helps to categorize conditions; thereby, guide allocation of resources, quality of health care, and funding. For example, E65A (slides 19, 20, and 21). CC used in the nomenclature refers to the complications, complications and/or co-morbidity and is modified based on usage (MCC and the others as indicated on slide 22). Here is an example of DRG code assignment based on the DRG component in question (slide 23). Here you can see an example of a discharge summary (slide 24). Thank you for listening and if you have any question, you are free to ask. These are the references (slide 26).
References
Australian Consortium for Classification Development. (2018). ICD-10-AM/ACHI/ACS. Retrieved from https://www.accd.net.au/icd10.aspx.
Diagnosis Related Group (DRG). (2018). Retrieved from https://hmsa.com/portal/provider/zav_pel.fh.DIA.650.htm.
Eagar, K. (2010). What is activity-based funding? ABF Information Series No. 1. HIM Interchange, 1(1), 22-23.
What is casemix and the clinical coder’s role? (2015). Retrieved from http://www.himaa2.org.au/education/?q=node/80.