OBJECTIVE: The NE1 Wound Assessment Tool (NE1 WAT; Medline Industries, Inc, Mundelein, Illinois), previously called the N.E. One Can Stage, was shown to significantly improve accuracy of pressure ulcer (PrU) staging. Improved PrU staging has many potential benefits, including improved care for the patient and better reimbursement. Medicare has incentivized good care and accurate identification of PrUs in the acute care hospital through an additional payment, the Medicare Severity–Diagnosis Related Group (MS-DRG). This article examines the financial impact of NE1 WAT use on the acute care hospital relative to MS-DRG reimbursement.
DESIGN: PrU staging accuracy with and without use of the NE1 WAT from previous data was compared with acute care hospital PrU rates obtained from the 2006 National Inpatient Sample. Hill-Rom International Pressure Ulcer Prevalence Survey data were used to estimate the number of MS-DRG–eligible PrUs.
MAIN RESULTS: There are between 390,000 and 130,000 MS-DRG–eligible PrUs annually. Given current PrU staging accuracy, approximately $209 million in MS-DRG money is being collected. With the improved staging afforded by the NE1 WAT, this figure is approximately $763.9 million. Subtracting the 2 reveals $554.9 million in additional reimbursement that could be generated by using the NE1 WAT.
CONCLUSION: There is a tremendous financial incentive to improve PrU staging. The NE1 WAT has been shown to improve PrU staging accuracy significantly. This improvement has the potential to improve the financial health of acute care hospitals caring for patients with PrUs.
This study examines the financial impact of NE1 Wound Assessment Tool use in the acute hospital relative to MS-DRG reimbursement.
Daniel L. Young, PT, DPT, is Assistant Professor, Department of Physical Therapy, School of Allied Health Sciences, and Jay J. Shen, PhD, is Associate Professor, Department of Health Care Administration and Policy, School of Community Health Sciences, both at the University of Nevada, Las Vegas.
Nancy Estocado, PT, BS, CWS, is Program Supervisor/Rehab Therapy, Sunrise Hospital and Medical Center, Las Vegas, Nevada.
Merrill R. Landers, PT, DPT, OCS, is Associate Professor, Department of Physical Therapy, School of Allied Health Sciences, University of Nevada, Las Vegas.
Dr Young has disclosed that he is/was a consultant/advisor to Medline Industries, Inc.
Dr Shen has disclosed that he has no financial relationships related to this article. Ms Estocado is the owner of NE Solutionz, LLC, and the NE1 Assessment Tool.
Dr Landers has disclosed that he has no financial relationships related to this article.