MS-DRG Calculations Ex 202022 Ch 5 $$$$$$
.xlsx
keyboard_arrow_up
School
Northeast Wisconsin Technical College *
*We aren’t endorsed by this school
Course
10530162
Subject
Finance
Date
Feb 20, 2024
Type
xlsx
Pages
4
Uploaded by DukeRose10894
ded33b658972bb311ce90fe9818fe444ef81b043.xlsx
Basic MS-DRG Calculations
Hospital
Happy Hopsital
Base Rate
$6,200 MS-DRG 387 Inflammatory bowel disease w/o CC/MCC
RW
0.7007
Charges
$ 9,456.82 CCR
0.429
LOS
3
MS-DRG Reimbursment $ 4,344.34 Cost of the encounter $ 4,056.98 Profit/Loss
$ 287.36 Subtract the cost of the encounter from the MS-DRG Reimbursement
Multiply the fully adjusted hospital specific base rate ×
the MS-DRG Relative Weight (RW)
Multiply the charges ×
the cost to charge ration (CCR)
Example: This example shows how to calculate the MS-DRG reimbursment rate for an acute care inpatient admission. The hospital specific base rate we are using for this example includes adjustments for IME, DSH and wage index.
ded33b658972bb311ce90fe9818fe444ef81b043.xlsx
Basic MS-DRG Calculations
Hospital
Community Hopsital
Base Rate
$6,200 1
Hospital
Memorial Hospital
Base Rate
$7,300 6
MS-DRG 192
MS-DRG
192
RW
0.7092
RW
0.7092
Charges
$ 15,000.00 Charges
$17,500.00 CCR
0.429
CCR
0.531
LOS
3
LOS
4
MS-DRG Reimbursment $ 4,397.04 MS-DRG Reimbursment $ 5,177.16 Cost of the encounter $ 6,435.00 Cost of the encounter $ 9,292.50 Profit/Loss $ 2,037.96 Profit/Loss $ 4,115.34 Hospital
Community Hopsital
Base Rate
$6,200 2
Hospital
Memorial Hospital
Base Rate
$7,300 7
MS-DRG 190
MS-DRG
190
RW
1.144
RW
1.144
Charges
$ 14,975.24 Charges
$16,578.24 CCR
0.429
CCR
0.531
LOS
4
LOS
5
MS-DRG Reimbursment $ 7,092.80 MS-DRG Reimbursment $ 8,351.20 Cost of the encounter $ 6,424.38 Cost of the encounter $ 8,803.05 Profit/Loss
$ 668.42 Profit/Loss
$ 451.85 Hospital
Community Hopsital
Base Rate
$6,200 3
Hospital
Memorial Hospital
Base Rate
$7,300 8
MS-DRG 473
Cervical spinal fusion w/o CC/MCC
MS-DRG
473
Cervical spinal fusion w/o CC/MCC
RW
2.5124
RW
2.5124
Chronic obstructive pulmonary disease w/o CC/MCC
Chronic obstructive pulmonary disease w/o CC/MCC
Chronic obstructive pulmonary disease w MCC
Chronic obstructive pulmonary disease w MCC
Instructions: Calculate the MS-DRG reimbursement rate for each case. Notice the changes in base rate for each facility. Remember the hospital specific base rate includes adjustments for IME, DSH and wage index.
Record the calculations in the grey sections and then answer the questions on the Questions tab.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Related Questions
Period
No. of patients seen
Total costs
1
650
USD17,125
2
940
USD17,800
3
1260
USD18,650
4
990
USD17,980
5
1150
USD18,360
Based on the record above shows that the cost of carrying out health checks in the last five accounting periods and by using the high-low method and ignoring inflation:
What are the estimated cost of carrying out health checks on 850 patients in period 6?
arrow_forward
PART I
Brave Heart Hospital showed the following major hospital costs at various levels of activity for CY 2020:
Month
Hospital Admission Major Hospital Cost(P)
February
1,300
P850,000.00
March
8,500
P1,350,000.00
April
1,600
P1,150,000.00
May
1,400
P950,000.00
June
1,200
P800,000.00
July
200
P50,000.00
August
1,650
P1,200,000.00
September
1,550
P1,050,000.00
The breakdown of the major hospital costs in the month of May at 1,400 hospital admission is as follows:
Accommodation Expense (Variable)
P400,000.00
Utilities (Fixed)
P300,000.00
Medicine (Mixed)
P250,000.00
Total Overhead Cost
P950,000.00
Requirements:
1. Determine how much of major hospital cost for the month of August of P1,200,000.00 consisted of medicine
cost
2. Using high-low method, determine the cost function for Medicine
3. Using high-low method, determine the cost function for major hospital cost
4. What would be the total major hospital cost if hospital admission is at 2,000?
arrow_forward
13
arrow_forward
H3.
Sacramento Memorial Hospital has the following financial data and operational metrics: Number of beds--> 250 Total inpatient stays--> 12,250 Total outpatient visits--> 90,754 Total patient revenues--> $111,900,050 Outpatient mix--> 16.2% Medicare payment percentage(revenues)--> 28.0% Average length of stay--> 5.8 days Net price per discharge--> $7,653 Cost per discharge--> $6,292 f. What is the hospital’s occupancy rate? (Hint: Start by calculating available bed days.)
Show proper step by step calculation
arrow_forward
Health Care Choices. You have a choice of two health insurance plans with the following terms. Assume that both plans cover 100% of expenses after the deductible and co-payments.
Plan A
Plan B
Monthly premium: $300
Monthly premium: $700
Annual deductible: $5000
Annual deductible: $1500
Office visit co-payment: $25
Office visit co-payment: $25
Emergency room co-payment: $500
Emergency room co-payment: $200
Surgical operations co-payment: $250
Surgical operations: no co-payment
Suppose that during a one-year period your family received the following medical bills.
Service
Total cost (before insurance)
Jan. 23: Emergency room
$800
Feb. 14: Office visit
$100
Apr. 13: Surgery
$1400
June 14: Surgery
$7500
July 1: Office visit
$100
Sept. 23: Emergency room
$1200
Determine your annual health care expenses if you have Plan A.
Determine your annual health care expenses if you have Plan B.
Determine your health care expenses for the year if you have…
arrow_forward
3. Two different insurance agents present you two health insurance policies as follows.
AIA: It covers at most 10 outpatient visits with maximum reimbursement of 80%.
For specialty, the policy would not be effective until your expenses exceed $2000.
Each claim receives $800 for a maximum of 10 claims.
HSBC Life: For outpatient visits, a maximum 20 visits are covered with the first 5
visits are of co-insurance rate of 80% and the next 15 visits are subject to 60% co-
insurance rate. For specialty, you are allow to claim at most 5 with each claim
capped at $1000.
Your health care services consumed are as follows:
Outpatient visits of 12 with each costs $300;
Specialty of 3 with each costs $2500.
Which agent's policy would
! you prefer? Explain.
arrow_forward
Instructions: Complete the table below.Discounting Costs and Savings for An Asthma Clinic (3% discount rate, not discounting for first-year costsand savings)
arrow_forward
plz solve!!
arrow_forward
O
-
n
at
all
General Counseling
Family Counseling
Psychiatry
$983
$546
The lead janitor, who oversees janitorial services for all three divisions, has a monthly salary of $4,095. If the lead janitor's salary is
allocated according to the number of square feet occupied, what portion of the salary will be allocated to the Psychiatry division?
(Round to the nearest whole dollar, e.g.. $123.)
$1,365
Number of patient visits Square feet occupied
1,395
2,115
990
O $901
154
264
132
arrow_forward
Prepare the Receipts and Payment account of Sigma Hospital from the following information:
arrow_forward
Type the formulas to calculate the following: In cell B9, calculate the grand total amount owing for all
customers. In ce E KBC DFGHJ1 Cost Retail 2 Mussels R12,40 R21, 70 3 Crabs R25, 60 R44,804
Markup % 75,0% 5 Discount % 8,5% EFT 6 VAT % 15 89 Total Sales 10 Cost of Sales 11 Profit or Loss No of
12 Customers No of Crab 13 Customers Sales of Mussel 14 Customers 15 Can
arrow_forward
6. Determine the maximum operating income possible with the expanded plant.$fill in the blank 8
7. If the proposal is accepted and sales remain at the current level, what will the operating income or loss be for the following year?$fill in the blank 9
arrow_forward
payment is Multiple Choice $11, 900 $10, 200 $5,100 $5,950 so.
arrow_forward
Subject :- Account
As part of a grant you are writing, you need to order 25 cases of paper. A company sells paper for $27.30 per case. How much money will you need to request to cover the cost of paper?
A. $2.30
B. $25.00
C. $27.30
D. $52.30
E. $682.50
arrow_forward
ABFHRL437 Corporation's info is below:
(Baruch College Exam)
Sales $843,000
VC $168,600
FC $14,350
NOI $660,050
(ID#63561)
Q) How much is ABFHRL437's Contribution Margin?
A) $
< P.hex
arrow_forward
What is Fairview clinic's costly trade credit?
arrow_forward
Part D please
arrow_forward
On July 1, 2021, Markwell Company acquired equipment. Markwell paid $167,500 in cash on July 1, 2021, and signed a $670,000 noninterest-
bearing note for the remaining balance which is due on July 1, 2022. An interest rate of 5% reflects the time value of money for this type of loan
agreement. (PV of $1, PVA of $1) (Use appropriate factor(s) from the tables provided.)
For what amount will Markwell record the purchase of equipment?
Multiple Choice
$705,595
$797,977.
$837.500.
{ Prev
15 of 15
Next
arrow_forward
Prepare the Receipts and Payment account of Sigma Hospital from the following information:
arrow_forward
e
Aggressive versus conservative seasonal funding strategy Dynabase Tool has forecast its total funding requirements for the coming year as shown in the following
table: E
otions
a. Divide the firm's monthly funding requirement into (1) a permanent component and (2) a seasonal component, and find the monthly average for each of these
components.
b. Describe the amount of long-term and short-term financing used to meet the total funds requirement under (1) an aggressive funding strategy and (2) a conservative
funding strategy. Assume that under the aggressive strategy, long-term funds finance permanent needs and short-term funds are used to finance seasonal needs.
c. Assuming that short-term funding costs 5% annually and that the cost of long-term funding is 10% annually, use the averages found in part a to calculate the total cost
of each of the strategies described in part b. Assume that the firm can eam 3% on any excess cash balances.
d. Discuss the profitability-risk trade-offs…
arrow_forward
Kk.33.
arrow_forward
QUESTION 3
XYZ Insurance Company uses class rating to determine the rate to charge for insurance.
For one type of insurance the pure premium XYZ actuaries calculated is $75 per unit.
If XYZ's expense ratio is 35%, what is the gross rate for this coverage?
O a. $37.50
O b.$100.00
Oc. $75.00
d. $55.25
arrow_forward
What is Fairview clinic's costly trade credit?
arrow_forward
SEE MORE QUESTIONS
Recommended textbooks for you
Individual Income Taxes
Accounting
ISBN:9780357109731
Author:Hoffman
Publisher:CENGAGE LEARNING - CONSIGNMENT
PFIN (with PFIN Online, 1 term (6 months) Printed...
Finance
ISBN:9781337117005
Author:Randall Billingsley, Lawrence J. Gitman, Michael D. Joehnk
Publisher:Cengage Learning
Related Questions
- Period No. of patients seen Total costs 1 650 USD17,125 2 940 USD17,800 3 1260 USD18,650 4 990 USD17,980 5 1150 USD18,360 Based on the record above shows that the cost of carrying out health checks in the last five accounting periods and by using the high-low method and ignoring inflation: What are the estimated cost of carrying out health checks on 850 patients in period 6?arrow_forwardPART I Brave Heart Hospital showed the following major hospital costs at various levels of activity for CY 2020: Month Hospital Admission Major Hospital Cost(P) February 1,300 P850,000.00 March 8,500 P1,350,000.00 April 1,600 P1,150,000.00 May 1,400 P950,000.00 June 1,200 P800,000.00 July 200 P50,000.00 August 1,650 P1,200,000.00 September 1,550 P1,050,000.00 The breakdown of the major hospital costs in the month of May at 1,400 hospital admission is as follows: Accommodation Expense (Variable) P400,000.00 Utilities (Fixed) P300,000.00 Medicine (Mixed) P250,000.00 Total Overhead Cost P950,000.00 Requirements: 1. Determine how much of major hospital cost for the month of August of P1,200,000.00 consisted of medicine cost 2. Using high-low method, determine the cost function for Medicine 3. Using high-low method, determine the cost function for major hospital cost 4. What would be the total major hospital cost if hospital admission is at 2,000?arrow_forward13arrow_forward
- H3. Sacramento Memorial Hospital has the following financial data and operational metrics: Number of beds--> 250 Total inpatient stays--> 12,250 Total outpatient visits--> 90,754 Total patient revenues--> $111,900,050 Outpatient mix--> 16.2% Medicare payment percentage(revenues)--> 28.0% Average length of stay--> 5.8 days Net price per discharge--> $7,653 Cost per discharge--> $6,292 f. What is the hospital’s occupancy rate? (Hint: Start by calculating available bed days.) Show proper step by step calculationarrow_forwardHealth Care Choices. You have a choice of two health insurance plans with the following terms. Assume that both plans cover 100% of expenses after the deductible and co-payments. Plan A Plan B Monthly premium: $300 Monthly premium: $700 Annual deductible: $5000 Annual deductible: $1500 Office visit co-payment: $25 Office visit co-payment: $25 Emergency room co-payment: $500 Emergency room co-payment: $200 Surgical operations co-payment: $250 Surgical operations: no co-payment Suppose that during a one-year period your family received the following medical bills. Service Total cost (before insurance) Jan. 23: Emergency room $800 Feb. 14: Office visit $100 Apr. 13: Surgery $1400 June 14: Surgery $7500 July 1: Office visit $100 Sept. 23: Emergency room $1200 Determine your annual health care expenses if you have Plan A. Determine your annual health care expenses if you have Plan B. Determine your health care expenses for the year if you have…arrow_forward3. Two different insurance agents present you two health insurance policies as follows. AIA: It covers at most 10 outpatient visits with maximum reimbursement of 80%. For specialty, the policy would not be effective until your expenses exceed $2000. Each claim receives $800 for a maximum of 10 claims. HSBC Life: For outpatient visits, a maximum 20 visits are covered with the first 5 visits are of co-insurance rate of 80% and the next 15 visits are subject to 60% co- insurance rate. For specialty, you are allow to claim at most 5 with each claim capped at $1000. Your health care services consumed are as follows: Outpatient visits of 12 with each costs $300; Specialty of 3 with each costs $2500. Which agent's policy would ! you prefer? Explain.arrow_forward
- Instructions: Complete the table below.Discounting Costs and Savings for An Asthma Clinic (3% discount rate, not discounting for first-year costsand savings)arrow_forwardplz solve!!arrow_forwardO - n at all General Counseling Family Counseling Psychiatry $983 $546 The lead janitor, who oversees janitorial services for all three divisions, has a monthly salary of $4,095. If the lead janitor's salary is allocated according to the number of square feet occupied, what portion of the salary will be allocated to the Psychiatry division? (Round to the nearest whole dollar, e.g.. $123.) $1,365 Number of patient visits Square feet occupied 1,395 2,115 990 O $901 154 264 132arrow_forward
- Prepare the Receipts and Payment account of Sigma Hospital from the following information:arrow_forwardType the formulas to calculate the following: In cell B9, calculate the grand total amount owing for all customers. In ce E KBC DFGHJ1 Cost Retail 2 Mussels R12,40 R21, 70 3 Crabs R25, 60 R44,804 Markup % 75,0% 5 Discount % 8,5% EFT 6 VAT % 15 89 Total Sales 10 Cost of Sales 11 Profit or Loss No of 12 Customers No of Crab 13 Customers Sales of Mussel 14 Customers 15 Canarrow_forward6. Determine the maximum operating income possible with the expanded plant.$fill in the blank 8 7. If the proposal is accepted and sales remain at the current level, what will the operating income or loss be for the following year?$fill in the blank 9arrow_forward
arrow_back_ios
SEE MORE QUESTIONS
arrow_forward_ios
Recommended textbooks for you
- Individual Income TaxesAccountingISBN:9780357109731Author:HoffmanPublisher:CENGAGE LEARNING - CONSIGNMENTPFIN (with PFIN Online, 1 term (6 months) Printed...FinanceISBN:9781337117005Author:Randall Billingsley, Lawrence J. Gitman, Michael D. JoehnkPublisher:Cengage Learning
Individual Income Taxes
Accounting
ISBN:9780357109731
Author:Hoffman
Publisher:CENGAGE LEARNING - CONSIGNMENT
PFIN (with PFIN Online, 1 term (6 months) Printed...
Finance
ISBN:9781337117005
Author:Randall Billingsley, Lawrence J. Gitman, Michael D. Joehnk
Publisher:Cengage Learning