. 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 69.9% 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 Oswego Hospital Vegas Hospital Honolulu COLA GAF COLA Wageindex COLA Wage index Wageindex Discharges Weight Total Payment Discharges Weight Total Payment MS DRG Discharges Weight Total PaymentMS DRG 576 349 APC APC Weight Total Payment Visits 116 VisitsWeiht Total PaymentCPT-code CPT-code 31505 VisitsWeight Total PaymentCPT-Code 24105 49460 35881 66930 21497 958 19340 49553 89343 157 CMI SMI SMI Inpatient Inpatient Inpatient outpatient Outpatie Outpatient 3,924,000 $4497,500 $A497,500) Inpatient Outpatient $2,604,000 Inpatient 946,000 Outpatien $1336,500 $4,282,500 Inpatient Outpatient 220,500 $3,224,500 Profit ($4,282,500) Profit per patlient Profit per palient Hospital Oswego Hospital Vegas Hospital Honolulu COLA GAF COLA Wageindex COLA Wage index Wageindex Discharges Weight Total Payment Discharges Weight Total Payment MS DRG Discharges Weight Total PaymentMS DRG 576 349 APC APC Weight Total Payment Visits 116 VisitsWeiht Total PaymentCPT-code CPT-code 31505 VisitsWeight Total PaymentCPT-Code 24105 49460 35881 66930 21497 958 19340 49553 89343 157 CMI SMI SMI Inpatient Inpatient Inpatient outpatient Outpatie Outpatient 3,924,000 $4497,500 $A497,500) Inpatient Outpatient $2,604,000 Inpatient 946,000 Outpatien $1336,500 $4,282,500 Inpatient Outpatient 220,500 $3,224,500 Profit ($4,282,500) Profit per patlient Profit per palient