Payment per Day is Higher for DRGs with Greater 30-Day Readmission Contribution to Revenue than 30-Day Readmission Contribution to LOS at Henry Ford Macomb Hospital - Clinton Township
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By: Saparja Nag Nov. 30, 2017
A recently conducted analysis by Dexur found that payments per day are greater for DRGs when the 30-day readmission contribution to revenue is greater than the 30-day readmission contribution to total days hospitalized, as demonstrated at Henry Ford Macomb Hospital - Clinton Township. This study examined the top 4 DRGs by contribution of 30-day readmissions to revenue and LOS: DRG-065, DRG-190, DRG-291, and DRG-292. The data analyzed was sourced from CMS administrative claims collected between October 2015 and September 2016. For a background on how 30-day readmissions affect revenue and days spent in the hospital, please continue to this article.
For DRG-065 (intracranial hemorrhage or cerebral infarction with CC or TPA in 24 hours) discharges, there was a 5.1% difference between contribution to revenue and LOS for DRG-065. This suggests that patients readmitted within 30 days were disproportionately utilizing hospital resources by spending more time in the hospital, causing a potential revenue loss around 5%. Looking at the graph below comparing revenue per day, the revenue per day due to 30-day readmissions is noticeably less than that of all Medicare inpatient discharges.
DRG-190 (chronic obstructive pulmonary disease with MCC) had the 2nd greatest 30-day readmission contributions to revenue and LOS. The contribution to revenue was slightly higher than the contribution to days hospitalized, as indicated by a mere $6 difference between revenue per day from 30 day readmissions and from all Medicare inpatient discharges.
The next two DRGs with the greatest 30-day readmission contributions to revenue and LOS were DRG-291 (heart failure and shock with MCC) and DRG-292 (heart failure and shock with CC). They are essentially the same except DRG-291 includes major complications and comorbidities whereas DRG-292 is less severe. DRG-291 had a 2.96% difference between readmissions contribution to revenue and LOS, which is reflected in a lower revenue per day from 30-day readmissions than from all Medicare inpatient discharges. DRG-292 had higher 30-day readmissions revenue per day than all Medicare inpatient revenue per day; this was due to the fact that 30-day readmission contribution to revenue was greater than the contribution to LOS.
DEXUR PRO MEMBERS GET ACCESS TO:
- Total Medicare inpatient and all major DRG 30-day readmission contributions to revenue and LOS at Henry Ford Macomb Hospital - Clinton Township
- Revenue per day values from 30-day readmissions and from all Medicare inpatient discharges for all Medicare inpatients and major DRGs
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