Read the Real World Case 14.2 on p. 417. After reading the case calculate the case mix using the information below

View the explanation of the calculations required for this assignment below

A facility is looking into the possibility of adding or deleting procedures to their surgery product line in thecardiothoracic area. The following table lists the types of procedures they are reviewing

MS-DRG	Description	Relative Wt.	National LOS
2	Heart Transplant or Implant of Health Assist System w/o MCC	15.6820	15.7
216	Cardiac Valve & Other Maj Cardiothoracic Proc w Card Cath w MCC	9.2380	13.0
232	Coronary Artery Bypass w PTCA w/o MCC	5.5976	7.9
237	Major Cardiovas proc w MCC	5.0843	6.7

Complete the information below to determine the case mix of these surgery patients in your facility.

DRG	Your hospital's Actual LOS	Number of Patients (estimate)	Your hospital's average charges
2	20.9	3	$89,500
216	12.1	107	$49,500
232	7.1	240	$32,000
237	11.6	156	$25,000

1. Determine the case mix for this group of procedures

MS-DRG	Number of Patients	Total Weights
2	3
216	107
232	240
237	156
Totals
Case mix

2. Complete the estimated per patient payment from third parties for these MS-DRGs. Round to the whole number.

MS-DRG	Number of Patients (estimate)	Estimated per patient revenue from third parties (based on a hospital payment rate of $5,500)	Your hospital's Actual average charge
2	3		$89,500
216	107		$49,500
232	240		$32,000
237	156		$25,000

3. Compute the difference in LOS

MS-DRG	Your hospital's Actual LOS	National Average LOS	Difference
2	20.9	15.7
216	12.1	13.0
232	7.1	7.9
237	11.6	6.7

4. Compute the difference in reimbursement or charges

MS-DRG	Estimated revenue from third parties (based on a hospital payment rate of $5500)	Your hospital's average charges	Difference
2		$89,500
216		$49,500
232		$32,000
237		$25,000

5. For thisgroupof patients only, what would the estimated income be?

MS-DRG	Estimated revenue from third parties (based on a hospital payment rate of $5500)	No. of patients (estimate)	Estimated reimbursement
2		3	$258,753
216		107	$5,436,563
232		240	$7,388,880
237		156	$4,362,384

6. Based on this information, if you had to choose one procedure to add to your surgical product line, which one would it be and why?

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