Question: Your hospital has just opened a new cardiac surgery program and you have been asked to calculate the net revenue per open heart surgery. Here
Your hospital has just opened a new cardiac surgery program and you have been asked tocalculate the net revenue per open heart surgery. Here is the relevant data: Cases: Medicare : Insurance MediCal Total Charges per Case is $ The length of stay for case is days The Medicare DRG payment for an openheart surgery simplified for this problem is $ of this amount is paid by the patients as their coinsurance and the hospital collects of that amount. Your hospital is subject to a cap on MediCal inpatient reimbursement MARL which is $ per case but they generally pay $ per day. Your insurance contracts pay off of a fee scheduled for this case at $ butyour contracts also have a stop loss provision that if charges are over $ theamount over $ is paid at of charges. What is the net reimbursement for cardiac case?Attach your spreadsheet.
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