Please provide assistance with this assignment. Please provide in Excel with the formulas. Thank you.

1. OPPS/ASC: Use the information found in figures 1-5 below to complete the OPPS payment calculations in table 1 and the ASC PPS payment calculations in table 2. Determine the OPPS and ASC reimbursement rates for a cataract procedure. Answer the discussion question. Figure 1: Hospital Information Bed size: Teaching status: 300 beds Non-teaching Cost to Charge Ratios (CCRs) RC 250 Pharmacy, general RC 270 Supplies, general RC 271 Nonsterile supply RC 272 Sterile supply Wage index: .9971 0.408344 0.796788 0.796788 0.796788 RC RC RC RC RC RC RC RC 276 301 312 360 370 710 730 920 Intraocular lens Chemistry Pathology, surgical Operating room Anesthesia Recovery room EKG Diagnostic services 0.796788 0.291546 0.291546 0.404314 0.321246 0.404314 0.38251 0.88447 Figure 2: Claim Information Hospital Outpatient Department Admit date 2/20/2015 Discharge date 2/20/2015 Sex: F Age: 70 LOS: 1 day Admit diagnosis 366.9 Principal 366.10 diagnosis: Principal 66984 procedure: Charge Detail Revenue Code CPT/HCPCS Code 250 270 271 272 276 312 88304 360 370 710 730 920 66984 93005 Cataract, unspecified Senile cataract, unspecified Cataract extraction with IOL insertion Code Description Tissue exam by pathologist Cataract extraction w/IOL Electrocardiogra m, tracing 90772 Ther/proph/diag inj, sc/im TOTAL Charges Medicare beneficiary copayment amount: Charge $475.2 5 $380.2 5 $1178.1 8 $1297.0 7$551.0 0$83.5 0 $2,801.33 $574.0 0 $341.0 0 $124.5 0 $75.5 0 $7,881.5 8 $531.8 8 Figure 3: Claim Information Ambulatory Surgery Center CPT Code: 66984 Cataract extraction Charges: $2,500.00 with IOL Medicare beneficiary copayment $192.76 amount: Figure 4: Fee Schedule Information (CY 2012; to get current year see www.cms.gov) Fee Statu Revenue CPT/HCPCS Sched s Code ule $3.0 Indicat 301 36415 A 0 301 82565 $7.2 A 6 301 84132 $6.5 A 1 301 85014 $3.3 A 5 Figure 5: APC Information (CY 2012; to get current year see www.cms.gov) Revenue CPT Code APC Relati Statu Code ve s Weigh Indicat 312 88304 0343 0.526 X 2 360 66984 0246 23.878 T 6 730 93005 0099 0.382 S 3 920 90772 0436 1.8104 S HOPPS Payment Determination Steps Step One: Calculate APC payment rate(s) Step Two: Wage index adjust APCs Step Three: Sum of fees for status indicator A procedures Step Four: Sum of reasonable cost amount(s)(only applicable for CPT/HCPCS codes with status indicators L and H) Step Five: Sum Medicare payments Table 1 Step Methodology One APC relative weight conversion factor ($74.17) Two (APC pymt rate 0.60 WI) + (APC pymt rate 0.40) Three Fee schedule amount A + fee schedule amount B, etc. Four (Charge CCR) Five TOTAL Reimbursement - Sum of steps 2-4 ASC Payment Determination Steps Step One: Calculate APC payment rate(s) Step Two: Wage index adjust APCs Total Step Three: Calculate the APC payment rate for any allowed secondary procedures Step Four: Wage index adjust allowed secondary procedure APCs Step Five: Sum Medicare payments Table 2 Step Methodology One APC relative weight conversion factor ($44.07) Two Total (APC pymt rate 0.50 WI) + (APC pymt rate 0.50) Three APC relative weight conversion factor ($41.401) Four (APC pymt rate 0.50*WI) + (APC pymt rate 0.50) Five TOTAL Reimbursement - Sum of steps 2-4 Discussion Question Discuss the parity and disparity between the payment levels at the ASC and Hospital- based surgery center. Why is parity and disparity an important topic to discuss? How does it affect the average Medicare beneficiary? OPPS payment Wage index RC 250 Pharmacy, general 0.408344 RC 270 Supplies, general 0.796788 RC 271 Nonsterile supply 0.796788 RC 272 RC 276 RC 301 Sterile supply Intraocular lens Chemistry 0.796788 0.796788 0.291546 RC 312 Pathology, surgical 0.291546 RC 360 RC 370 RC 710 RC 730 Operating room Anesthesia Recovery room EKG 0.404314 0.321246 0.404314 0.38251 RC 920 Diagnostic services 0.88447 Conversion factor 0.9971 74.17 0.9971 74.17 0.9971 0.9971 0.9971 0.9971 74.17 74.17 74.17 74.17 0.9971 0.9971 0.9971 0.9971 0.9971 74.17 74.17 74.17 74.17 74.17 0.9971 74.17 300 300 300 300 300 300 300 300 300 300 300 300 The ASC PPS payment Wage index Conversion factor RC 250 Pharmacy, general 0.408344 RC 270 Supplies, general 0.796788 RC 271 Nonsterile supply 0.796788 RC 272 RC 276 RC 301 Sterile supply Intraocular lens Chemistry 0.796788 0.796788 0.291546 RC 312 Pathology, surgical 0.291546 RC 360 RC 370 RC 710 RC 730 Operating room Anesthesia Recovery room EKG 0.404314 0.321246 0.404314 0.38251 RC 920 Diagnostic services 0.88447 0.9971 44.07 0.9971 44.07 0.9971 0.9971 0.9971 0.9971 44.07 44.07 44.07 44.07 0.9971 0.9971 0.9971 0.9971 0.9971 44.07 44.07 44.07 44.07 44.07 0.9971 44.07 300 300 300 300 300 300 300 300 300 300 300 300 Total amount 9059.712763202 17677.91473161 17677.91473161 17677.91473161 17677.91473161 6468.377194867 6468.377194867 8970.301280639 7127.315416237 8970.301280639 8486.547442971 19623.26897829 145885.8604782 Total amount 5383.05974753 10503.78457897 10503.78457897 10503.78457897 10503.78457897 3843.351529969 3843.351529969 5329.933631357 4234.876505239 5329.933631357 5042.498932341 11659.66649418 86681.81031782 Status CPT Code Indicator* 66984 88304 93005 96372 T Q1 Q1 S APC APC Copayme Relative nt Weight Amount 233 342 99 437 23.6288 $350.53 0.7318 $10.86 1.0579 $15.70 0.7218 $10.71 Total $1,929,846.56 $2,717.99 $1,644.29 $3,378.22 $1,937,587.07 Provision for Cataract extraction w/IOL Status CPT Code Indicator* 66984 T APC APC Copayme Relative nt Weight Amount 233 21.79 $350.53 Total $1,779,665.35 $150,181.21 Adjustment for ASC PPS complexity Status CPT Code Indicator* 88304 93005 96372 Q1 Q1 S APC 342 99 437 APC Copayme Relative nt Weight Amount 0.7318 1.0579 0.7218 $10.86 $15.70 $10.71 Total $2,717.99 $1,644.29 $3,378.22 $7,740.51 Table 1 Step One Two Methodology APC relative weight conversion factor ($74.17) (APC pymt rate 0.60 WI) + (APC pymt rate 0.40) Three Four Five Fee schedule amount A + fee schedule amount B, etc. (Charge CCR) TOTAL Reimbursement - Sum of steps 2-4 Table 2 Step One Two Three Four Five Methodology APC relative weight * conversion factor ($44.63) (APC pymt rate * 0.50*WI) + (APC pymt rate * 0.50) APC relative weight * conversion factor ($41.401) (APC pymt rate * 0.50*WI) + (APC pymt rate * 0.50) TOTAL Reimbursement - Sum of steps 2-4 Total 465.523 $2,785,222.58 20.12 7881.58 8427.27 Total $1,133.85 $5,653,383.21 $46,942.57 $234,055,629.09 12853.765 The Affordable Care Act needs the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing program for payments under the Medicare program for ambulatory surgical centers. The Secretary shall submit the report containing this plan to Congress. In ASC there is no much risk and fear of service but In the surgery center there is a lot of risk involved. ASC is more cheap than in the surgical center which is very expensive The Report to Congress describes the current efforts to improve quality and payment efficiency in ASCs. In addition, it considers the steps required in designing and implementing an ASC VBP program for payments under the Medicare program. CMS views VBP as an important step forward in revamping how Medicare pays for health care services; moving the program towards rewarding better value, outcomes, and innovations