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
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