Medical device reimbursement is a critical aspect of the healthcare system that ensures hospitals and healthcare providers are fairly compensated for the use of innovative medical technologies like EndoShunt. Reimbursement refers to the process by which hospitals receive payment from insurers, such as Medicare and private insurance companies, for medical procedures and treatments. The reimbursement amount is typically based on specific codes assigned to each procedure, known as Diagnosis-Related Groups (DRGs).
As hospitals integrate EndoShunt into their trauma bays, they can expect to generate substantial revenue through medical device reimbursement. The MS-DRG code 907 (Other O.R. procedures for injuries w MCC) is designed to cover inpatient procedures for patients with significant medical complexities, such as traumatically injured individuals who require the use of advanced medical devices like EndoShunt.
With an established price point of $6000, hospitals can leverage the MS-DRG code 907 reimbursement to recoup a significant portion of the costs associated with EndoShunt deployment. Considering the FY 2019 National Average Hospital Reimbursement for Inpatient Procedures for MS-DRG, which stands at $25,800, hospitals can expect to recover a considerable portion of the expenses through reimbursement.
It’s essential to note that the MS-DRG code 907 reimbursement is designed to encompass not only the cost of EndoShunt but also other necessary medical interventions and post-procedure care for the patients. This comprehensive coverage ensures that hospitals can effectively manage and provide the best possible care for traumatically injured patients.
Through interviews with esteemed hospital value analysis committee members, a consensus has emerged regarding the potential for hospitals to achieve substantial profitability with the use of EndoShunt. As EndoShunt effectively controls incompressible bleeding in the abdomen, patients have a better chance of survival, enabling them to progress to post-procedure care. It is during this phase that hospitals can efficiently manage their resources and deliver follow-on care, ultimately leading to positive patient outcomes and increased hospital revenue.
