Assumption for Part 2 Table D: Assumptions for Mt. St. Heavens Gate Hospitals Existing Charge Code-Based Commercial Payment and Utilization Data: Type of Medical Service, Pct. of Admissions, ALOS, Average Payment Per Day for Type of Service, Maternity 15%, 2.6, $1,823. Surgical 25%, 5.6, $4,160. Medical 60%, 4.6, $2,037. Respectively

Table E: Assumptions for Flat Per Diems by Type of Service. Type of Service, Payment per Day: Maternity $1,750.00, Surgical $4,225.00, Medical $2,000.00.

Table F: Assumptions for Front Loaded Per Diems by Type of Service: Type of Service, Payment 1st Day, Payment After 1st Day: Maternity $3,100.00, $925.00

Surgical $13,250.00, $2,200.00

Medical $5,200.00, $1,450.00

Using the assumptions above, calculate below:

Existing Charge Code-Based Commercial Payment Per Day:

Fill in the Blank Cells for Existing Payment Per Day by Type of Service: Type of Service & Weighted Payment Per Day for: Medical/Surgical$, Maternity$, ICU$.

Overall Average Hospital Payment Per Day: $

2: Payment Under Flat Per Diems by Type of Service Methodology.

Fill in the Blank Cells for Payment Under a Flat Per Diem by Type of Service Methodology for Type of Service, Average Payment Per Day, Weighted Payment Per Day. Medical/Surgical$, $ Maternity, $$, ICU$$.

Overall Average Hospital Payment Per Day: $, Dollar Comparison to Charges-Based Payment: $

3: Payment Under Front Loaded Per Diem by Type of Service. Fill in the Blank Cells for Payment Under Front Loaded Per Diem by Type of Service. Type of Service, Average Payment Per Day, Weighted Payment Per Day. Medical/Surgical$$, Maternity$$, ICU$$.

Overall Average Hospital Payment Per Day: $

Dollar Comparison to Charges-Based Payment: $