The Grouper program works in conjunction with coding and abstracting modules. Once the abstract contains the necessary information, the appropriate Grouper automatically assigns relevant CMG/DPG/CACS and calculates the weight. Specific data is edited, identifying errors and flagging inappropriate procedures or unusually long lengths of stay.
Health Based Allocation Model (HBAM) Inpatient Grouper (HIG™)
The HBAM Inpatient Grouper is aligned with the grouping methodology used across Canada; however it is specific to Ontario only. The HIG information will play an important role in the development and implementation of Patient Based Payment (PBP). At the heart of this methodology is the CMG+™ grouper. Cell determination in the HIG methodology consists primarily of modifications to existing CMG+™ cells that can be divided into the following three categories:
- Cell refinement
- Comorbidity splits
- Grouping reassignment
All records that are not affected by the above changes are assigned to a HIG™ cell that is equivalent to the cell they were assigned to under the CMG+™ methodology.
Comprehensive Ambulatory Classification System – Ontario (CACS-ON™) Grouper
As with the HIG Grouper, the CACS-ON™ Grouper is aligned with the CACS™ Grouper methodology but is specific to Ontario. The CACS-ON™ Grouper information will play an important role in the development and implementation of Patient Based Payment. Cell determination in the CACSON™ methodology consists primarily of modifications to existing CACS™ cells. All records that are not affected by the above changes are assigned to a CACS-ON™ cell that is equivalent to the cell they were assigned to under the CACS™ methodology.
Case Mix Grouper (CMG™+)
The Case Mix Grouper (CMG™) incorporates a methodology designed to aggregate acute care in-patients with similar clinical resource utilization characteristics. It assigns acute care in-patients to groups based on clinical and administrative data collected via the DAD. The CMG™+ Grouper allows MED2020 clients to singularly, or in a batch routine, group patients seen on an Inpatient basis into clinically relevant groups or cells.
Comprehensive Ambulatory Classification System (CACS™)
The Comprehensive Ambulatory Care Classification System (CACS™) is a national grouping methodology for ambulatory care patients that includes emergency departments, clinics and same day surgery. Patients are grouped according to procedure, main diagnosis and visit disposition data collected via the National Ambulatory Care Reporting System (NACRS). The CACS™ grouper offers the ability to singularly, or in a batch routine, group patients into clinically relevant groups or cells. Associated with each of these cells is a calculated ACW (Ambulatory Case Weight), the Average Cost of Care in relation to patient types. MED2020’s CACS™ Grouper allows for management decision making at the facility level and resource allocation decisions to be made at a global and facility level. As well, the CACS™ Grouper allows for facilities to compare themselves to Provincial and National counterparts.