Letha is a data analyst at Happy Hospital. She has been asked to look at some reimbursement data for MS-DRG 025, Craniotomy and Endovascular Intracranial Procedures with MCC. MS-DRG 025 has a relative weight of 4.3945. The fully adjusted base rate for Community Hospital is $7,500. Answer the 3 parts of this question (a, b, and c).

What is the expected payment rate for MS-DRG 025 for Community Hospital?

Letha is a data analyst at Happy Hospital. She has been asked to look at some reimbursement data for MS-DRG 025, Craniotomy and Endovascular Intracranial Procedures with MCC. MS-DRG 025 has a relative weight of 4.3945. The fully adjusted base rate for Community Hospital is $7,500.

Letha has identified that 2 percent of the cases for MS-DRG 025 have a payment rate higher than the expected payment rate. What provision(s) under IPPS could be the reason for the higher-than-expected payment rate?

Letha is a data analyst at Happy Hospital. She has been asked to look at some reimbursement data for MS-DRG 025, Craniotomy and Endovascular Intracranial Procedures with MCC. MS-DRG 025 has a relative weight of 4.3945. The fully adjusted base rate for Community Hospital is $7,500.

Letha has identified that 1.5 percent of the cases for MS-DRG 025 have a payment rate lower than the expected payment rate. What provision(s) under IPPS could be the reason for the lower-than-expected payment rate?