Compute IPPS reimbursement $($both operating and capital$)$ ?for each hospital based on the presented MS$-$DRGs and discharges. Total reimbursement per line $=$ ?Reimbursement per MS$-$DRG x discharges. As we did in mini$-$lectures, assume that IME and DSH are zero and that the Large Urban Add$-$on is $1,$ ?for all hospitals. All hospitals are assumed to have reported quality data and are assumed to be meaningful EHR users. Remember that when the wage index is $>1,$ ?the labor share is $69\mathrm{.}9\%$ ?otherwise is $62\%.$

$2.$ ? Compute OPPS reimbursement of each hospital based on the presented CPT codes and visits. The labor share OPPS is always $60\%.$ ? Here the total reimbursement per line $=$ ?APC payment x visits

$3.$ ? Total revenue is the sum of inpatient and outpatient reimbursements.

$4.$ ? The average expense for inpatient care is estimated to be $$6,000$ ?per discharge. The average expense for outpatient care is estimated to be $$500$ ?per visit.

$5.$ ? Total expense is the sum of inpatient and outpatient expenses.

$6.$ ? Profit $=$ ?Total revenue $?$ ?total expense

$7.$ ? Now construct a simple income statement for each of these hospitals and compare their profit per patient adjusted to wage index, CMI, and SMI. What do you think?

Hospital Honolulu Hospital Vegas Inpatient Hospital Oswego Wage index GAF COLA Wage index GAF COLA Wage index GAF COLA MS-DRG Total MS-DRG Line MS-DRG Discharges Weight Payment MS-DRG Discharges Weight Total Payment MS-DRG MS-DRG Discharges Weight Total Payment 1 246 96 062 36 643 36 2 558 75 502 26 750 73 3 735 95 290 14 697 49 4 391 71 558 45 906 35 5 424 7 539 60 919 87 6 760 6 001 15 093 98 7 921 33 576 48 581 66 8 244 24 282 87 202 60 9 602 8 349 12 841 54 10 255 76 508 91 596 96 APC Total Outpatient APC Total APC CPT-code Visits Weight Payment CPT-code Visits Weight Payment CPT-code Visits Weight Total Payment 11 31505 245 62269 183 24105 116 12 15240 254 29130 75 69676 134 13 49460 176 49525 112 20680 55 14 35881 359 21497 52 66985 121 15 66930 244 21280 152 76830 108 16 95870 223 27330 72 64611 123 17 G0389 369 29046 160 94250 128 18 19340 108 27762 191 29851 152 19 49553 468 0267T 157 23330 78 20 89343 227 73020 87 36593 132 CMI SMI CMI SMI CMI SMI Revenue Revenue Revenue Inpati $0 Inpatient $0 Inpatient $0 Outpat $0 Outpatient $0 Outpatient $0 $0 $0 $0 Expenses Expenses Expenses Inpatie $2,946,000 Outpati $1,336,500 Inpatient Outpatient $2,604,000 $620,500 Inpatient Outpatient $3,924,000 $573,500 $4,282,500 $3,224,500 $4,497,500 Profit ($4,282,500) Profit ($3,224,500) Profit ($4,497,500) Profit per patient (adjusted)= Profit per patient (adjusted)= Profit per patient (adjusted)=