HSS was founded in 1982 under the name Information Strategies, Inc as a DRG management and multi-hospital casemix-database company. HSS was created as an off-shoot of the DRG research conducted at Yale University. While at Yale principals of HSS worked on the development of DRGs for the Health Care Financing Administration (HCFA) which resulted in the creation of one of the most far reaching changes in the financing of healthcare - the Medicare Prospective Payment System (PPS). Coincident with Medicare adopting DRGs for payment, HSS was founded to commercialize the use of DRGs. The HSS team led some of the seminal efforts in using casemix tools to drive healthcare management decision-making in areas such as utilization review, case management, marketing and financial management.
HSS principals were among the first in the industry to recognize and advocate the need for multi-hospital casemix databases to help hospitals respond to the demands of the new fiscal and regulatory health care environment. HSS principals and senior staff were catalysts in the healthcare industry's initiative to build casemix databases for hospital associations and state government to be used for research, strategic management, rate setting and general data retrieval.
In continuing the HSS tradition of innovation, HSS staff acted as consultants to the Yale University School Organization and Management, as part of the "DRG Refinement Project", to introduce severity adjustment to the DRG algorithm. This project was funded by the Health Care Financing Administration to investigate the practical implications of severity-adjusting DRGs. HSS participated in field testing the DRG Refinement methodology on large scale databases and provided feedback to Yale on methodological and systems implementation problems identified in this process. HSS also provided the fundamental statistical analyses in support of the development of the pediatric and neonatal models for the DRG Refinement project. This seminal research effort led to the development of several of the commercially available severity systems and is the cornerstone of the HSS "All Payer Severity-Adjusted DRGs" APS-DRGs®.
In 1992, HSS was acquired by HCIA INC. HCIA, with its mission to become the largest provider of healthcare information, was strategically interested in HSS' state data business. Coincident with the acquisition of HSS, HCIA acquired Healthcare Knowledge Resources (HKR) in Ann Arbor, Michigan. HKR was also in the database business as well as the medical encoding business. HKR through its predecessor company the Commission on Hospitals and Professional Activities (CHPA) defined the medical records abstracting industry and was the first company to develop encoder technology AccuCode®. AccuCode® is an outgrowth of the same development effort that produced 3M's CodeFinder, a logic-based encoding system. This provided HSS with a complete set of software tools and expertise to approach healthcare management and reimbursement from its beginning, as a case is being coded, through final payment and ultimately strategic decision support.
In March 1994, HSS was spun off from HCIA to form an independent, employee-owned company to focus on providing software for measuring and managing healthcare use and delivery. HSS has official designation as a minority-owned (woman) business.
The HSS team has a long history of applying innovative computer science techniques to rigorous healthcare research and discipline to develop competitive products and services. This tradition continues to be the foundation of HSS business. The management team of Chief Executive Officer - Robert Leary, Chief Operating Officer - Renee Leary and Vice President of Business Development - Kevin Lucey has been in place for over twelve years. Together with Dean Farley, Vice President of Healthcare Policy and Analysis, and Michael Goulette, Senior Casemix Consultant, the team brings over one hundred and thirty years of healthcare management, technical and analytic expertise and experience to provide solutions for today's healthcare problems.
HSS has conducted business in the healthcare reimbursement market since the advent of the Medicare Prospective Payment System (PPS) in 1983. HSS continues to be active in the ongoing development and enhancement of casemix and payment systems as they have been adapted for, and adopted by, other payers. Our experience spans building and updating DRG grouping algorithms to developing reimbursement systems for provider network management. HSS continues to stay on the leading edge of healthcare measurement and management by providing casemix tools for APGs and APCs for out-patient payment as well as risk-adjustment tools like DCGs for capitated pricing. Our coding and classification-systems expertise provide us with a unique understanding of the data available in the industry, its limitations, and its value.
HSS brings to the software industry a practical market-driven orientation to ensure that products and services are useful today and tomorrow. HSS has many significant accomplishments in its niche. Among them are:
HSS was among the first to implement knowledge-based systems for encoding
HSS was the first to implement Windows-based DRG management software
HSS is the only company with a portable software library for ProspectivePayment Systems
HSS is the only company to offer both logic- and dictionary-based encoders
As testimony to the quality and utility of HSS' products and services:
Over 20% of all hospital discharges are billed using HSS software
Over 40% of all hospitals over 500 beds use HSS products
HSS software is used to manage over 70,000,000 covered lives
32 premier healthcare information systems vendors rely on HSS for HEALTHCARE INTELLIGENCE
With decades of experience in providing coding, casemix measurement, and reimbursement software, HSS and its personnel are among the most knowledgeable in the industry. Hundreds of hospitals, government and managed care organizations throughout the United States turn to HSS for knowledge and support. – less – More from ZoomInfo »