*  JCI - Epiregulin and EGFR interactions are involved in pain processing
EGFR was nonhomogeneously expressed by all DRG neurons within the cytoplasm of individual DRG cells, and neuronal size did not ... Statistical outliers were defined via Studentized residuals of more than 3 and excluded before analyses were run. ... Mouse lumbar DRG neurons (L3-L5; at least n = 4 mice per condition) were harvested and cultured as previously described (45). ... In the DRG, EREG or formalin increased the phosphorylation of both S6 and 4E‑BP1, the 2 main downstream targets of mTOR. ...
  https://gimee-gz.com.www.mobile.jci.org/articles/view/87406
*  Circular Letter No. 8 (1989): Reimbersement for Hospital Inpatient Services Under No-Fault for Treatment Rendered on and After...
8). High Cost Outliers. This calculation is used when a hospital's actual charges are far in excess of a calculated Inliers DRG ... 4) NO-FAULT PAYMENT CALCULATION OF SHORT STAY OUTLIER DRG. (5) NO-FAULT TRANSFER PAYMENT WITH ALTERNATE LEVEL OF CARE COMPARED ... 3). Short Stay Outlier Stay Outlier. This calculation is used for an inpatient hospitalization where the stay is longer than ... LONG STAY OUTLIER DRG WITH ALTERNATE LEVEL OF CARE. ( ... of inlier, short stay outlier or long stay inlier DRG.. ( ...
  http://www.dfs.ny.gov/insurance/circltr/1989/cl1989_08_w.htm
*  List of MeSH codes (N03) - Wikipedia
... outliers, drg MeSH N03.219.521.710.305.200.500 --- Medicare Payment Advisory Commission MeSH N03.219.521.710.305.200.605 --- ...
  https://en.wikipedia.org/wiki/List_of_MeSH_codes_(N03)
*  MHCP Provider Manual - Billing Policy - Payment Methodology - Hospital
Fixed-loss amount: The amount added to the base DRG payment to establish the outlier threshold amount. For rates set using 2014 ... Cost Outlier Payment - MHCP pays high cost claims using a Medicare-like, cost-outlier payment. Claims with costs that exceed ... Hospital outlier index: A hospital adjustment factor used to calculate outlier payments to prevent the artificial increase in ... The relative values of APR-DRG hospitals and rehabilitation hospitals are based on APR-DRG "standard" national weights, ...
  http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=DHS16_146905
*  PPT - Advanced Medicare Cost Reporting PowerPoint Presentation - ID:399476
The IME factor is then multiplied by the DRG payment, excluding any outliers to calculate reimbursement for IME (includes " ... Future Considerations - Currently frozen by statue, but could incorporate DSH payment into DRG payment for larger hospitals and ...
  https://www.slideserve.com/Lucy/advanced-medicare-cost-reporting
*  Mark McClellan - Wikipedia
This has been primarily driven through outliers and treatment-driven DRG's developed during the admission, rather than ... Outlier payments allow for supplemental payments for unusually lengthy or expensive admissions and make up no more than 5% of ... September-October, 2009). Outlier payments-A major source of abuse in the healthcare system. Market Research Letter. Retrieved ... Bielby, J. (2010). The evolution of DRG's (updated). Journal of American Health Information Management Association. Retrieved ...
  https://en.wikipedia.org/wiki/Mark_McClellan
*  Data Products and Services
The report lists all hospitals that discharge 11 or more Medicare patients (excluding out-liers) within a given diagnosis ... related group (DRG) during the federal fiscal year. *KHA Average Hospital Charges for Medicare Patients ...
  http://kha-net.org/DataProductsandServices/Default.aspx?plain=true
*  Financial Measurement Tools
The report lists all hospitals that discharge 11 or more Medicare patients (excluding out-liers) within a given diagnosis ... related group (DRG) during the federal fiscal year. *KHA MED PAR Order Form ...
  http://kha-net.org/DataProductsandServices/FinancialMeasurementTools/default.aspx
*  REQUEST FOR PROPOSALS
The average daily fee should take into consideration the application of any outliers. Average DRG Code Average Med/Surg Daily ...
  https://www.slideshare.net/Mike97/request-for-proposals-4361506
*  Inter-DRG Resource Allocation in a Prospective Payment System: A Stochastic Kernel Approach
In addition, a reduction in the high outlier episodes indicates existence of potential selection effect even in a continuing ... Inter-DRG Resource Allocation in a Prospective Payment System: A Stochastic Kernel Approach. ...
  https://ideas.repec.org/p/yor/hectdg/07-21.html
*  tenet healthcare 2ndQTR 0310QFY032d - English
... to limit outlier payments to between five and six percent of total DRG payments. In order to bring expected outlier payments ... OUTLIER PAYMENTS As part of the DRG-PPS, Congress established additional payments to hospitals for the treatment of patients ... The settlement could result in our eventually receiving additional outlier payments or having to repay some of the outlier ... DRG payments $ 432 $ 471 $ 852 $ 927 Capital cost payments 58 54 112 102 Outlier payments 162 213 352 473 Outpatient payments ...
  https://www.slideshare.net/finance42/tenet-healthcare-2ndqtr0310qfy032d
*  Medicare's Big Changes | Managed Care magazine
The original payment DRG system, known as CMS-DRG, was adopted in 1983 as a prospective system. Payments to hospitals were made ... "outlier payments that partially compensated hospitals for additional expenses incurred." ... Its new system, Medicare Severity DRG (MS-DRG), is weighted by the severity of diagnosis, paying more for sicker patients. Some ... Calling MS-DRG "the most significant revision to Medicare inpatient payment methods" in more than a quarter century," the ...
  http://managedcaremag.com/archives/2008/5/medicare%E2%80%99s-big-changes?page=358
*  TRICARE Manuals - Manual Information
... clarifying instructions for the CHAMPUS DRG-based payment system including payment of transfer cases with cost outliers and ...
  http://manuals.tricare.osd.mil/pages/v3/DisplayManual.aspx?SeriesId=POLICY&TP08=29
*  View all posts in Medical Reimbursement News
MS-DRG) payments to eligible hospitals for discharges this fiscal year. The base operating MS-DRG payments to eligible ... and increase the outlier fixed-loss threshold. In addition, the revisions require CMS to recalculate all of the budget ... diagnosis and procedure codes related to the FY 2017 Medicare Severity-Diagnosis Related Group and MS-Long-Term Care-DRG ...
  http://www.prgweb.com/news/?cat=3
*  Elements of LTCHPPS - Centers for Medicare & Medicaid Services
Under the LTCH PPS, payment for a Medicare patient will be made at a predetermined, per discharge amount for each MS-LTC-DRG. ... The update to the LTCH PPS rates, including the Federal rate, outlier threshold, wage index and budget neutrality factor, and ... The update to the MS-LTC-DRG classifications and relative weights to be effective for discharges occurring on or after October ... In the LTCH PPS, the MS-LTC-DRG relative weights are updated annually using the most recently available claims data. ...
  https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/elements_ltch.html
*  Brush up on sequencing as RAC complex audits begin - www.hcpro.com
And although correct coding is vital, sequencing codes is equally important because it affects MS-DRG assignment and payment. ... And although correct coding is vital, sequencing codes is equally important because it affects MS-DRG assignment and payment. ... What is Medicare?s definition of an ?outlier payment??. *Hospital Billing from A to Z: 3- and 1-day rules ...
  http://www.hcpro.com/HIM-247505-140/
*  Risk-adjusted payments offer some protection | 1999-08-01 | AHC Media: Continuing Medical Education Publishing
DRG Coding Advisor-HCFA delivers: Risk adjustment for capitation. For states with limited Medicaid resources, risk adjustment ... Physicians should update their reinsurance or stop-loss coverage to guard against liability for high-cost outliers. Also, they ...
  https://www.ahcmedia.com/articles/50190-risk-adjusted-payments-offer-some-protection
*  EX-99.1
Odds Ratio 95% Confidence Interval Total cost outlier 2.75 2.68-2.83 Length of stay outlier 3.17 3.09-3.26 30-day readmission ... be separately reimbursed based on the facility contract Hospital Inpatient Medicare patients Use J3490 Reimbursed based on DRG ... Adjusted* outcomes comparing ORAE vs no ORAE for all surgical proceduresϯ: Odds of being an outlier ORAE=opioid-related adverse ... Adjusted odds of being a total cost and LOS outlier were 2.8 (95% CI 2.7-2.8) and 3.2 (95% CI 3.1-3.3) times greater in the ...
  https://ir.recropharma.com/sec-filings/content/0001193125-18-062128/d544101dex991.htm??TB_iframe=true&height=auto&width=auto&preload=false
*  Influence of Professional Self-concept, Self-leadership on Elderly Care Performance of Geriatric Hospital Nurses
Nurses' cognition of diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of ... outliers-Cook's distance)를 보았을 때 통계적으로 유의미한 극단치는 없었고, 잔차의 검증을 통해 정상성(normality), 선형성(Linearity), 동변량성(homoscedasticity)을 검증하였다 ... DRG. J Korean Acad Nurs Adm 2012;18(2):176-188 (Korean). Doi: 1011111/jkana.2012.18.2.176.. ...
  http://e-jhis.org/journal/view.php?number=503
*  Respiratory Therapy Cave: Will losing weight make my asthma better
creed drg duoneb ego end stage COPD excercise fantasy sports fire department government programs helmet and seatbelt safety ... I'll be the outlier (my usual position in medicine it seems), weight loss makes my asthma worse.. But then I seem to be the ...
  http://respiratorytherapycave.blogspot.com/2011/02/will-losing-weight-make-my-asthma.html