Self-Developed Groupers
What are self-developed groupers?
Self-developed groupers are custom service line groupings created by a health system for internal use. These groupers categorize patient care into specific cohorts based on factors like disease type, patient demographics (such as age or gender), or population health attributes. They are tailored to reflect the unique needs and characteristics of the health system’s patient population and the services it provides.
These groupers consider various elements including service locations, ICD-10 procedure codes, and diagnosis-related groups. Procedure-based groupings are particularly common, as they align closely with the health system’s services and reimbursement structures. By developing their own groupers, health systems can create a personalized system that accurately represents their patient population, the conditions they treat, and the specific demographics they serve.
What are the benefits of self-developed groupers?
The primary benefit of self-developed groupers is their alignment with the health system’s specific financial and operational needs. By focusing on the areas most relevant to their analysis, these groupers allow health systems to track and trend revenues and costs more effectively. This customization helps eliminate unnecessary data, providing a clearer and more relevant picture of performance and resource utilization. Additionally, self-developed groupers enable more targeted analysis and decision-making, enhancing the health system’s ability to optimize care delivery and financial management.