Question
Cavallo Hospital is evaluating their profit/loss for their most common procedures. In order to do so, they are evaluating the following DRGs for actual reimbursement
Cavallo Hospital is evaluating their profit/loss for their most common procedures. In order to do so, they are evaluating the following DRGs for actual reimbursement vs their charges. ** Remember to round your numbers up when you are calculating.
MSDRG | Case Weight | Charges | ALOS |
---|---|---|---|
560 | 0.5295 | $7,532.22 | 2 |
775 | 0.525593 | $7,330.74 | 4 |
203 | 0.6501 | $7,300.17 | 2 |
897 | 0.651277 | $6,876.54 | 4 |
144 | 1.6989 | $23,525.11 | 3 |
541 | 0.911094 | $12,107.85 | 3 |
1. Assuming the base rate is $11,500, how is Cavallo Hospital performing according to their charges versus the DRG payment (quantify and show your work)?
2. What would the reimbursement need to be at a per diem rate to receive the same reimbursement as the DRG payment, that is, if the DRG payment is $5000, and ALOS 5, how much would the per diem rate need to be to receive the same $5000 payment? Show your work.
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