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Medicare reimbursement is generally fixed price based on diagnosis (DRG == diagnostic related groups) Table 5 here shows a "weight" . That's the number of unit
by OliverJones 9y ago
Medicare reimbursement is generally fixed price based on diagnosis (DRG == diagnostic related groups)
Table 5 here shows a "weight" . That's the number of units of reimbursement a hospital gets for each particular diagnosis / procedure / whatever. (LOS is length of stay) (CC is complications) (MCC is major complications)
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2018-IPPS-Final-Rule-Home-Page-Items/FY2018-IPPS-Final-Rule-Tables.html https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen...
Hospitals negotiate with CMS the number of dollars per unit of weight. Sometimes aggressively. It would be good to have that number of dollars posted publicly and explained. Does the hospital hate serving Medicare patients because they don't make enough?