Burn center reimbursement analysis.

If burn centers are to survive in the current fixed-payment environment, managers and physicians must be knowledgeable of the parameters and regulators of reimbursement. The purpose of this study was to assess the reimbursement status of a burn center in a private, not-for-profit facility. The analysis included both internal and external constraints imposed on the hospital. Data from fiscal year 1989-90 were used to identify the most frequently coded burn diagnosis-related groups and third-party payers. Actual reimbursement rates per diagnosis-related group were examined, and the average charge per patient discharge was compared with reimbursement per patient. Total billed charges versus received revenue for Medicaid patients were explored. Problems and solutions were identified and discussed after completion of the assessment.