title: Financial impact of improved pressure ulcer staging in the acute hospital with use of a new tool, the NE1 Wound Assessment Tool.
abstract: OBJECTIVE
  The NE1 Wound Assessment Tool (NE1 WAT; Medline Industries, Inc, Mundelein, Illinois), previously called the N.E. One Can Stage, was shown to significantly improve accuracy of pressure ulcer (PrU) staging. Improved PrU staging has many potential benefits, including improved care for the patient and better reimbursement. Medicare has incentivized good care and accurate identification of PrUs in the acute care hospital through an additional payment, the Medicare Severity-Diagnosis Related Group (MS-DRG). This article examines the financial impact of NE1 WAT use on the acute care hospital relative to MS-DRG reimbursement.
  
  
  METHODS
  PrU staging accuracy with and without use of the NE1 WAT from previous data was compared with acute care hospital PrU rates obtained from the 2006 National Inpatient Sample. Hill-Rom International Pressure Ulcer Prevalence Survey data were used to estimate the number of MS-DRG-eligible PrUs.
  
  
  RESULTS
  There are between 390,000 and 130,000 MS-DRG-eligible PrUs annually. Given current PrU staging accuracy, approximately $209 million in MS-DRG money is being collected. With the improved staging afforded by the NE1 WAT, this figure is approximately $763.9 million. Subtracting the 2 reveals $554.9 million in additional reimbursement that could be generated by using the NE1 WAT.
  
  
  CONCLUSIONS
  There is a tremendous financial incentive to improve PrU staging. The NE1 WAT has been shown to improve PrU staging accuracy significantly. This improvement has the potential to improve the financial health of acute care hospitals caring for patients with PrUs.
authors.affiliation: Department of Physical Therapy, School of Allied Health Sciences, University of Nevada, Las Vegas, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Young
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Shen
authors.forename: Nancy
authors.initials: N
authors.lastname: Estocado
authors.forename: Merrill R
authors.initials: MR
authors.lastname: Landers
mesh_terms: D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D004469:Economics, Hospital; D006801:Humans; D007902:Length of Stay / Q000191:economics; D006278:Medicare / Q000191:economics; D010346:Patient Care Management / Q000191:economics*; D010347:Patient Care Planning / Q000191:economics*; D003668:Pressure Ulcer / Q000145:classification* / Q000191:economics*; D012720:Severity of Illness Index; D017592:Skin Care / Q000191:economics; D014481:United States; D014945:Wound Healing