CASE 2-25
Medicare-Severity Diagnosis-Related Group (MS-DRG) Comparisons
Your chief financial officer (CFO) has asked you to gather some information for him. He wants
to compare the average length of stay (ALOS), average charges, and average reimbursement for
specific MS-DRGs at your facility to the geometric mean length of stay and determine if there
are any statistically significant differences at the 0.5 level.
1.
Identify the MS-DRG geometric mean length of stay for the MS-DRGs in Table 2-8 to
the average total day in Table 2-11. Compare the two figures. Determine if the difference
between them is statistically significant.
2.
Determine the national average charges information for the MS-DRGs in Table 2-11 and
compare it to the local data using Table 2-9. Determine if the difference between them is
statistically significant.
3.
Determine the average reimbursement data for the MS-DRGS in Table 2-10. The national
data can be found in Table 2-11. Compare the 2 figures. Determine if the difference
between them is statistically significant
4.
Complete Tables 2-8 through 2-10 and write a memo to the CFO describing your
findings.
Table 2-8 Geometric Mean Length of Stay (GMLOS)
Average LOS
Medicare-Severity
Patient
Diagnosis Related
ALOS
Group
4.6
6.4
061
5.9
5.7
5.0
5.6
6.8
062
4.2
5.8
5.0
3.1
2.7
063
3.4
3.3
3.9
4.2
4.3
088
5.4
5.1
Geometric
Statistically
Mean LOS
Significant
4.1
3.1
3.0
089
2.7
3.0
2.6
Table 2-9 Average Charges
Average Charges
MS-Diagnosis-Related
Hospital Charges
Statistically
National
Group
by Patient
$74,842
$70,565
061
$68,555
$75,563
$69,441
$51,235
$50,889
062
$50,985
$51,224
$53,684
$40,789
063
$38,220
Significant
$37,500
$41,885
$35,687
$40,210
$39,852
088
$38,005
$34,236
$40,568
$23,100
$20,001
089
$20,211
$19,150
$23,105
Table 2-10 Average Reimbursements
Average Reimbursements
Hospital
MS-Diagnosis-
Statistically
Reimbursement by
Related Group
Significant
Patient
$14,564
061
National
$15,556
$13,556
$14,665
$12,556
$7,900
$8,952
062
$8,556
$8,554
$8,548
$8,425
$7,054
063
$7,055
$8,156
$8,554
$6,521
$7,685
088
$7,258
$7,885
$6,255
$4,753
$4,024
089
$4,358
$4,123
$4,025
Table 2-11 Medicare Provider Analysis and Review (MEDPAR) 2010 Diagnosis-Related Groups
Centers for Medicare and Medicaid services 100% MEDPAR Inpatient Hospital National Data
for Fiscal Year 2010 Short Stay Inpatient Diagnosis-Related Groups
MSDRG
061
062
063
088
089
Total
Charges
$233,301,461
$227,498,941
$72,775,862
$52,123,005
$92,022,041
Covered
Charges
$231,801,852
$225,539,528
$72,224,663
$51,635,662
$90,873,741
Medicare
Reimbursement
$50,216,062
$45,424,709
$12,597,821
$10,009,231
$15,145,663
Total
Days
25,900
25,473
6,892
6,832
12,051
Number of
Discharges
3,144
4,533
1,753
1,307
3,487
Average
Total Day
8.2
5.6
3.9
5.2
3.5