MS-DRG Calculations Ex 202022 Ch 5 $$$$$$

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Northeast Wisconsin Technical College *

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10530162

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Finance

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Feb 20, 2024

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xlsx

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4

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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.
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