Healthcare Resource Groups 4 (HRG4)

HRG4 was introduced as the currency of costing in 2006 and for payment in 2009.

What's new in HRG4?

HRG4 is a major revision that increases the number of groupings from 650 to over 1,400. It delivers:

  • a portfolio of new and updated HRG groupings that accurately record patient treatment to reflect current practice and anticipated trends in healthcare
  • additional specialty and service coverage, including:
    • diagnostic imaging
    • chemotherapy
    • radiotherapy
    • specialist palliative care
    • rehabilitation
    • critical care
  • setting independence to accurately reflect care given, regardless of where it is given
  • refinement of complexity and complication splits to better reflect variations in severity
  • 'unbundling' of high cost elements of care that can be reimbursed as additions to base HRGs
  • spell-based HRGs that cover the whole stay from admission to discharge and enable fairer reimbursement

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What are the benefits of HRG4?

  • HRG4 extends coverage to recognise a wider group of clinical professions and services delivering essential care, such as radiotherapy
  • it supports fairer and equitable reimbursement by differentiating more effectively between routine and complex cases
  • unbundling of high cost elements improves the performance of HRGs so that they can better represent activity and costs by:
    • identifying specialist services to ensure funding for priority areas
    • supporting service redesign (e.g. locally commissioned rehabilitation)
    • supporting patient choice by introducing increased flexibility to allow separate elements of the care pathway to be delivered by different providers.
  • unbundling helps to make HRGs 'setting independent' so that healthcare can be provided and funded across a variety of settings. This supports the NHS Plan to modernise service by ensuring that a uniform payment will be made for treatment given, regardless of setting. This will enable choice for PCT commissioners and, by extension, the patient
  • HRG4 enables NHS organisations to meet specific DH policies such as reform of financial flows and ensure that the PbR policy is based on up-to-date data
  • the improvement in the match of classification and casemix activity to clinical practice helps managers to plan, commission, budget and resource care services
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How do I use it?

The main deliverable of the service is the classification HRGs. You can take advantage of the benefits of HRGs by using our products. These include:

  • local grouper applications
  • local grouper documentation
  • analysis products.

Access all of these products via our downloads area.

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