3M Health Information Systems and TriZetto Corporation have signed a strategic agreement to provide optional integration of 3M grouping, edit, compliance and pay-for-outcomes logic into TriZetto’s industry leading NetworX Pricer® and NetworX Modeler® solutions. When integrated, 3M software promotes timely compliance with federal and state government payment regulations and enables TriZetto’s clients to implement programs that identify avoidable cost and reward efficiency, quality, and care coordination.
With this agreement, TriZetto customers will have the ability to perform inpatient hospital editing and grouping through the 3M All Patient Refined DRG (APR DRG) Classification System and Medicare Severity Diagnosis Related Groups (MS-DRGs). The agreement also provides editing, grouping and/or pricing for some outpatient hospital processes through the 3M Enhanced Ambulatory Patient Grouping System (EAPGS). Under the current agreement, NetworX clients have the option to work with TriZetto in expanding the offerings available to include 3M EAPGS or 3M Potentially Preventable Events, including Complications, Readmissions, Ancillary Services, Emergency Room Visits, and Hospital Admissions.
“Rules governing healthcare payment can change quarterly, monthly, even daily, so staying up-to-date can be crucial,” said Alan Stein, senior vice president, Solutions Management for TriZetto. “It’s also important for commercial payers to focus on improving healthcare quality and efficiency using unique payment methodologies such as those created by 3M.”
3M’s industry-leading content is created and maintained by a team of healthcare regulatory experts, including policy analysts, nosologists, physicians, registered nurses, certified coders, and reimbursement specialists. 3M proprietary methodologies are used to capture and analyze national and regional rule changes, and then to adjust or develop new edits and grouping technology.
Since 1983, 3M has focused on developing prospective payment systems that have revolutionized health care. Today, 3M supports grouping, editing and reimbursement configurations for over 50 federal, state, and commercial payer and reporting organizations implemented for payment, quality and public reporting.