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3M solutions for payers

Control healthcare costs

As you consider approaches to pay-for-performance (P4P), accountable care and transparent reporting, classification systems from 3M can give you greater insight into your claims data. Our solutions track and report on patient care and outcomes, giving you the information you need to collaborate successfully with providers in structuring an equitable P4P system.

Classification systems from 3M can help you:

  • Understand your patient population in terms of severity of illness and risk of mortality
  • Identify potentially preventable complications and readmissions
  • Measure, adjust for and manage risk
  • Design clinically precise tools for disease management, provider profiling and outcomes measurement
  • Align reimbursement incentives with clinical outcomes

Solutions for payers

Grouping software for preventable events

Using sophisticated clinical logic, 3M software identifies avoidable complications and readmissions as well as the hospital-acquired conditions (HACs) monitored by CMS.

3M™ Core Grouping Software

3M Core Grouping Software groups, edits, and prices claims data for inpatient and outpatient records to evaluate the accuracy and completeness of clinical data, identify potential coding errors and verity hospital claims for reimbursement.

3M™ All Patient Refined Diagnosis Related Groups (APR DRG) Software

This inpatient classification tool allows you to adjust for severity of illness and risk of mortality among inpatient populations. The most widely used severity-adjusted tool in the U.S., 3M APR DRGs can be used as the basis for payment systems as well as quality reporting.

Outpatient grouping software

3M offers solutions to identify the key procedures for ambulatory visits, group claims, calculate prospective payment and determine quality metrics for outpatient services.

3M™ Clinical Risk Grouping (CRG) Software

3M CRG Software is a risk-adjustment tool used to measure a population’s burden of illness. It can be used to track patient care and forecast future use of medical services, making it useful for contracting, disease management, provider profiling and quality reporting.

3M™ Clinical Claims Editor

3M Clinical Claims Editor processes provider-submitted patient claims to assign diagnosis related groups (DRGs), evaluate the accuracy and completeness of clinical data, identify potential coding errors and verify provider claims for reimbursement.

3M ICD-10 translation tools

3M offers over a decade of international ICD-10 experience to help payers and care providers in the U.S. translate the ICD-9 codes embedded in their documentation, applications, contracts, forms, work processes, statistical reports and treatment policies.

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