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ISPS-US 23rd Annual Conference | November 1-3, 2024 | University of Pittsburgh & Duquesne University | Pittsburgh, PA & Hybrid Online | Preliminary Schedule
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Systemic Reforms for Sustainable Change in Psychosis Care: The Crucial Role of DRG 885 (Virtual Only)
Sunday November 3, 2024 1:00pm - 2:00pm EST
Virtual only (Zoom)
Diagnosis-Related Group 885 (DRG 885) is significant and pivotal in the healthcare system, particularly for classifying inpatient hospital cases involving psychosis. The causation for psychosis can range from being sleep deprived, a mental health misdiagnosis to a physical injury that manifests symptoms related to mental health As a component of the Medicare Severity-Diagnosis Related Group (MS-DRG) system, DRG 885 is extensively relied upon and utilized for billing and reimbursement. This ensures hospitals are compensated. Medicare and Medicaid are major payers for hospital services in the United States of America. As one with lived experience, a psychosis diagnosis is a gateway that leads to inpatient psychiatric care, whether needed or not. DRG 885 remains a leading cause of psychiatric admissions, underscoring its importance in the prospective payment and healthcare reimbursement landscape in psychiatric care. This is problematic, as it can create systemic fraud through the overuse of psychosis, shifting patient-centered care to a medical mode conflated payer-centered model. DRG 885 is an overused classification, reflecting the high prevalence of inpatient admissions for psychosis. It plays a crucial role in clinical reporting and analysis enabling healthcare organizations to monitor the quality of care, manage resource allocation, and improve clinical outcomes. Hospitals track DRG codes to analyze trends and enhance the efficiency of psychiatric services, and used to manipulate the judicial system. Medicare & Medicaid data consistently show DRG 885 among the top four used DRGs. In 2008, DRG 885 was recodified from the longstanding psychosis DRG 430 in use since 1983. Over the past 20-years psychosis remains in the top four for hospitalizations, demonstrating excessive use and the need for system reform. In conclusion, DRG 885 is essential for funding inpatient psychiatric care, whether needed or not. The widespread excessive use of psychosis signifies the substantial need for comprehensive system reform.
Speakers
avatar for Carolyn Green, BS

Carolyn Green, BS

BS, Environmental Science, Education minor, University of Washington
Carolyn Green holds a Bachelor of Science in Environmental Science, with a minor in Education, from the University of Washington. Carolyn is a Healthcare Solutionist, author, speaker, and an inventor.
Sunday November 3, 2024 1:00pm - 2:00pm EST
Virtual only (Zoom)
  Breakout Session, Virtual Only

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