PPS Hospital – Wage Index information, Bad Debt calculations. Critical Access Hospitals – Cost to Charge Ratio, Case Payer Mix, Bad Debt calculations. Each area of Health care has a set of key performance indicators, which relate to Costs of Delivering Care. ...
The CY2014 episode base rate is multiplied by the applicable HHRG case-mix weight to create the case-mix adjusted rate. The case-mix adjusted rate is then split between the labor-related share, which is multiplied by the wage index for Los Angeles, and the non-labor-related share. The f...
included in the calculation of payment rates; one or more proposals for the implementation of payment adjustments to M+C plans in counties where the payment rate has been affected due to failure to account for the cost of such services; and a ...
Medicare reimburses providers for each dialysis treatment performed using a single predetermined rate that is adjusted for patient characteristics (e.g., age and body mass index) and area wage differences. Prior to the MIPPA, Medicare provided dialysis payment on a per treatment basis, also known...
In an effort to avoid penalizing contracts that serve greater concentrations of individuals of low SES, in 2017 CMS implemented a Categorical Adjustment Index to adjust the calculation of star ratings based on the proportion of dual eligibility in a contract.14 This adjustment may make quality ...
Treatment Mix Scenarios Costs for a mix of treatments in current and projected scenarios were compared for both populations over 2 years. The current treatment mix included PTA, BMS, and SG for the index procedure. The breakdown of each treatment type was based on real-world physician claims da...