Pinnacle Hospital is under a single payor system which pays for all inpatient services based on...

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Pinnacle Hospital is under a single payor system which pays for all inpatient services based on DRG payments. Here is background information required to answer the questions which follow. DRG 1 DRG 2 DRG 3 DRG WGT Discharges 1.0 2,000 5,000 3,000 2.0 3.0 Direct Cost/Discharge $2,000 $7,000 $12,000 Total Cost/Discharge $4,000 $9,000 $15,000 Labor-related Costs $4,000 Non-labor related costs $1,000 Wage Index 0.9 CMI - 1.0 Assume DRG 3 is "Joint Replacement" and you have the following data points: Average implant cost/discharge = $8,000 Average Length of Stay (LOS) = 2 days The payer has agree to a carve-out for the implant to be paid at 100% of cost. In exchange, the payer wants to move to a per diem instead of a DRG. What is the minimum per diem Pinnacle should accept to ensure they will not lose reimbursement on this new deal? Pinnacle Hospital is under a single payor system which pays for all inpatient services based on DRG payments. Here is background information required to answer the questions which follow. DRG 1 DRG 2 DRG 3 DRG WGT Discharges 1.0 2,000 5,000 3,000 2.0 3.0 Direct Cost/Discharge $2,000 $7,000 $12,000 Total Cost/Discharge $4,000 $9,000 $15,000 Labor-related Costs $4,000 Non-labor related costs $1,000 Wage Index 0.9 CMI - 1.0 Assume DRG 3 is "Joint Replacement" and you have the following data points: Average implant cost/discharge = $8,000 Average Length of Stay (LOS) = 2 days The payer has agree to a carve-out for the implant to be paid at 100% of cost. In exchange, the payer wants to move to a per diem instead of a DRG. What is the minimum per diem Pinnacle should accept to ensure they will not lose reimbursement on this new deal?

Answer rating: 100% (QA)

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