Cardiac Valve & Cardiothoracic Procedures at Southeast Hospital Had an Average Payment per Day Over $1,000 More than the National and Missouri State Averages
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By: Saparja Nag Jan. 17, 2018
According to an analysis by Dexur, Southeast Hospital in Cape Girardeau, MO had the highest payment per day for cardiac valve and cardiothoracic procedures of all Missouri hospitals in 2016. The study included hospitals with over 3,500 total Medicare inpatient discharges during the time period, and analyzed cardiac valve and cardiothoracic procedures. Payment per day is used to measure the cost of healthcare utilization by a particular patient population. By measuring the average payment per day, hospitals in distinct geographic locations that serve different patient populations can be compared.
This report focused on 6 DRGs at Missouri hospitals: DRG-216, DRG-217, DRG-218, DRG-219, DRG-220, and DRG-221. These diagnosis-related groups represented cardiac valve and other major cardiothoracic procedures both with and without cardiac catheterization, as well as with and without complications or comorbidities. A complication or comorbidity can be major or less severe. A full list of DRG definitions can be found below.
| DRG-216 | Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complication or comorbidity |
| DRG-217 | Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with complication or comorbidity |
| DRG-218 | Cardiac valve and other major cardiothoracic procedures with cardiac catheterization without complication or comorbidity/major complication or comorbidity |
| DRG-219 | Cardiac valve and other major cardiothoracic procedures without cardiac catheterization with major complication or comorbidity |
| DRG-220 | Cardiac valve and other major cardiothoracic procedures without cardiac catheterization with complication or comorbidity |
| DRG-221 | Cardiac valve and other major cardiothoracic procedures without cardiac catheterization without complication or comorbidity/major complication or comorbidity |
Missouri, as a state, ranked below the national average payment per day for cardiac valve and cardiothoracic conditions by about $410 on average. Cardiac valve and cardiothoracic procedures at Southeast Hospital averaged over $1,000 more than both national and state averages; Southeast Hospital’s average payment per day for these procedures was $1,096 greater than the national metric and $1,506 greater than the Missouri state average. An analysis of national and state average payments per day at the DRG level can be seen in the graph below. It is clear that DRG-218 generally has a much higher payment per day, a trend that is particularly amplified at the state level. While all other DRG average payments per day are lower for Missouri, DRG-218’s payment per day is over $2,000 more than the national average.
Southeast Hospital also had an average payment per day nearly $400 more than the 2nd ranked hospital in Missouri, Heartland Regional Medical Center, which averaged $5,640 per day. Rounding out the top 5 hospitals with the highest payment per day for cardiac valve and cardiothoracic procedures were SSM Health St. Louis University Hospital with a $5,536 average payment per day, Mercy Hospital St. Louis with $5,459 per day, and Saint Luke’s Hospital of Kansas City averaging $5,400 per day.
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