By: Sampath Kumar  Jun. 01, 2021

Henry Ford Macomb Hospital in Clinton Charter Township, MI, reported a CMS Value Based Purchasing (VBP) adjustment factor of 0.996 in the year 2021, which could result in an estimated penalty of $222,090. Medicare Spending Per Beneficiary (MSPB) accounts for 25% of overall VBP score and is a significant factor in driving VBP payments. MSPB costs include the costs from 3 days before hospitalization, index hospital stays, and 30 days post-discharge. The measure score of the Efficiency & Cost Reduction domain for Henry Ford Macomb Hospital during the period was 0/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Henry Ford Macomb Hospital can avoid VBP penalties by reducing MSPB Cost by 4.6%.

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.