A nice summary on Medicare’s valuation approach to compiling a “price” it pays to a hospital for a stay. If you recall, there are 746 DRG’s CMS tweaks to an infinitely granular level to arrive at a reimbursement total.
As Reinhardt relays, CMS pays for costs, as close as it can approximate, not value.
If you are a hospitalist and have even a hint of skin in the game, i.e., you take care of patients, play with data, or are one of those advanced types who sit behind a desk and tell the rest of us what to do, this one is worth your time.
Take a look!
Also note, as reform advances, DSH payments will be clipped, labor costs will be contested and defended (“the unions are killing us,” “you are missing hidden costs in our city,” and non EBM-based political meddling), and GME dollars will be ratcheted up or down based on residency program performance. The wealth pie is shrinking and institutions will surely fight for every nickel.
Algorithm for a Hospital Episode Price
In 2011-2012, an undergrad pre-med student performed an ingeniously simple but enlightening health policy study. Jamie Rosenthal called 122 hospitals across the U.S. (2 randomly selected hospitals from each state, plus Washington D.C., along with the 20 top-ranked orthopedic hospitals according to the US News and World Report rankings that year) and asked them what […]
Prices from a chargemaster are “what a drunken billionaire would pay a hospital if his wife were not around to control the bastard.” — Uwe Reinhardt You might be asking why such an outlandish quote? Last week CMS proposed* to change the way patients see the costs of hospital bills. So what you might utter. […]
“We Need Creative Solutions” When I read or hear the sentence above, I think of one thing and one thing only. The solution is long in coming, involves input from multiple parties, has no obvious fix, is costly–in either money or time, and we undergird it by a whopper of a collective action problem. How […]