Part 1A

CPA Payment = Total MS-DRG Payment + Total High-Cost Drug Payment

= (3,390 x 1.54x 7,200) + (3,390 x 10% x 27,000 x 50%)

= 37,588,320 + 4,576,500

= 42,164,820

Part 1B

CPB Payment = Per diem Payment + Stop Loss Payment

= (3,390 X 98% X 4.5 X 2,800) + ( 3,390 X 2% X 142,000 X 70%)

= 41,859,720 + 6,739,320

= 48,599,040

Part 1C

CPC Payment = Volume x Average charge per case x percentage of charge rate

= 3,390 x 32,500 x 75%

= 82,631,250

QUESTION;Provide a comparison statement between the three commercial payers above. If UC Hospital looks at renegotiating these contracts with the Commercial payers which Commercial Payer contract(s) would you recommend that the organizationcontinue and which one(s) would you renegotiate. What is one other factor that was not considered within these calculations that would impact the financial bottom line of a healthcare?

HIM 4016 FINANCIAL MANAGEMEN Average charge for high-cost drugs $27,000 Percentage of cases with LOS over 21 days 2% Percentage of cases with LOS