By: Yosh Thomas  Nov. 03, 2020

Dexur analyzed Medicare Claims data to calculate the Medicare Spending per Beneficiary (MSPB) cost for hospitals in the Las Vegas area for Hip and Knee Replacement surgeries and ranked the hospitals based on cost outcomes. MSPB weighs 25% in the CMS Value-Based Purchasing (VBP) program and is the only measure under the Efficiency and Cost domain. Hospitals have to wait more than a year to get aggregate MSPB numbers with no insight into DRG or service line specific costs. Dexur replicates CMS algorithms to update DRG and service line MSPB costs on a quarterly basis and with only a 5-6 month delay. For the analysis, Dexur considered hospitals in Las Vegas - Henderson - Paradise metro area that recorded more than 11 episodes of DRG 470 during the calendar year 2019. Dexur did the analysis based on Q1 2020 data, but the index hospitalization discharge date was taken into account till December 2019 to accommodate the 30-day post-discharge period in calculating rehospitalization, SNF, and HHA costs. The analysis was risk-adjusted and was done for DRG 470: Major Joint Replacement or Reattachment of Lower Extremity without Major Complication or Comorbidity.

Twelve hospitals in the Las Vegas area met the prerequisites for the study. Only two hospitals located outside of Las Vegas city qualified for the study. The two hospitals, namely Mesa View Regional Hospital, located in Mesquite, and St. Rose Dominican Hospitals - Siena Campus, in Henderson had lower average MSPB costs of $16,035 and $20,197, respectively. In fact, Mesa View Regional Hospital had the lowest average MPSB in the metropolitan region.

Mountain’s Edge Hospital, located in Las Vegas city, also had a low MSPB cost of $18,115 per episode. The average index hospitalization cost amounted to $12,867 while the average post discharge cost was $5,236. Among the post-discharge cost components, HHA cost was the major contributor with an average cost per episode of $2,330. The average rehospitalization and SNF costs per episode were $1,959 and $842, respectively. Centennial Hills Hospital Medical Center and Southern Hills Hospital and Medical Center also had lower hospitalization costs with the average MSPB costs of $20,784 and $22,328, respectively.

During the same 12-month period, University Medical Center had the highest MSPB costs in the metropolitan area with an average of $40,041 per episode. Similarly, Desert Springs Hospital Medical Center and Sunrise Hospital and Medical Center also had higher MSPB costs with average of $39,774 and $33,606, respectively. The analysis revealed that the post-discharge costs of these hospitals were higher than the index hospitalization costs. The average index and post-discharge hospitalization costs of Desert Springs Hospital Medical Center were $14,138 and $25,631, respectively. Sunrise Hospital and Medical Center’s average index and post-discharge costs were $16,089 and $17,506, respectively.