*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code | I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.84 | |
| Readmission Rate (%) | 25.68 | |
| Unplanned Readmission Rate (%) | 15.14 | |
| Mortality Rate (%) | ||
| SNF Discharge Rate (%) | ||
| Home Discharge Rate (%) | ||
| PAYMENTS AND CHARGES | ||
| Total Medicare Payments | ||
| Payment Per Day | ||
| Payment Per Hospitalization | ||
| Total Medicare Charges | ||
| Avg. Charges | ||
| MARKET SIZING & INCIDENCE RATES | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - All) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - All) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Yes) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) | ||
| Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Not Y) | ||
| Total Medicare Hospitalizations after Exclusion | ||
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 4,164 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 36.04 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 5.38 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 23.96 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 17.13 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $38,485,367 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,719 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $9,242 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $183,600,471 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $44,092 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 5.07 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 21.71 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 37.58 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 247: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 283: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 250,159 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 367 | ||||
| DRG Share of Total Hospitalizations | 0.76 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 3.18 | ||||
| Avg LOS at DRG | 5.47 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 5.94 | ||||
| Readmission Rate at DRG | 27.88 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 22.77 | ||||
| Unplanned Readmission Rate at DRG | 19.94 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 15.69 | ||||
| Total Medicare payments at DRG | $2,661,443,545 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $3,885,039 | ||||
| Total Medicare payment per Day at DRG | $1,946 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,781 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,639 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $10,586 | ||||
| Total Medicare Charges at DRG | $13,270,497,724 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $18,961,951 | ||||
| Avg Charges at DRG | $53,048 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $51,667 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| SNF Discharge Rate at DRG | 21.63 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 20.71 | ||||
| Home Discharge Rate at DRG | 34.87 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 32.7 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 264: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | DRG 216: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 282: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 252: OTHER VASCULAR PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 37,449 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 48 | ||||
| DRG Share of Total Hospitalizations | 0.11 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 0.42 | ||||
| Avg LOS at DRG | 10.01 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 10.71 | ||||
| Readmission Rate at DRG | 31.36 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 26.67 | ||||
| Unplanned Readmission Rate at DRG | 20.04 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| Total Medicare payments at DRG | $793,793,345 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $868,415 | ||||
| Total Medicare payment per Day at DRG | $2,118 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,690 | ||||
| Total Medicare payment per Hospitalization at DRG | $21,197 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $18,092 | ||||
| Total Medicare Charges at DRG | $3,956,370,459 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $4,025,561 | ||||
| Avg Charges at DRG | $105,647 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $83,866 | ||||
| Mortality Rate at DRG | 5.33 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| SNF Discharge Rate at DRG | 23.77 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 29.17 | ||||
| Home Discharge Rate at DRG | 33.21 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 39.58 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 248: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 243: PERMANENT CARDIAC PACEMAKER IMPLANT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 270: OTHER MAJOR CARDIOVASCULAR PROCEDURES W MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 227: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 987: NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 15,799 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 22 | ||||
| DRG Share of Total Hospitalizations | 0.05 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 0.19 | ||||
| Avg LOS at DRG | 6.14 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 11.05 | ||||
| Readmission Rate at DRG | 29.11 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| Unplanned Readmission Rate at DRG | 20.1 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| Total Medicare payments at DRG | $311,271,577 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $458,896 | ||||
| Total Medicare payment per Day at DRG | $3,210 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,888 | ||||
| Total Medicare payment per Hospitalization at DRG | $19,702 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $20,859 | ||||
| Total Medicare Charges at DRG | $1,825,154,704 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $3,472,024 | ||||
| Avg Charges at DRG | $115,523 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $157,819 | ||||
| Mortality Rate at DRG | 7.82 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| SNF Discharge Rate at DRG | 14.98 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| Home Discharge Rate at DRG | 50.02 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| LEHIGH VALLEY HOSPITAL - HAZLETON | 700 E BROAD ST | HAZLETON | PA | 18201 | 48 |
| BETHESDA NORTH | 10500 MONTGOMERY RD | CINCINNATI | OH | 45242 | 41 |
| COMMUNITY MEDICAL CENTER | 99 ROUTE 37 W | TOMS RIVER | NJ | 08755 | 34 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. PHILIP J. BENYO | 144 S OLD TURNPIKE RD | DRUMS | PA | 18222 | 30 |
| Dr. ASHRAF R MIHANNI | 3401 W GORE BLVD | LAWTON | OK | 73505 | 19 |
| Dr. VAN S BREEDING | 226 MEDICAL PLAZA LANE | WHITESBURG | KY | 41858 | 16 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 11,808 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 19.4 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 5.16 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 25.1 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 18.82 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $107,367,353 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,764 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $9,093 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $513,789,595 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $43,512 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 3.46 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 20.48 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 40.13 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 134,001 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 2,961 | ||||
| DRG Share of Total Hospitalizations | 0.41 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 4.86 | ||||
| Avg LOS at DRG | 5.32 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 5.81 | ||||
| Readmission Rate at DRG | 23.7 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 22.96 | ||||
| Unplanned Readmission Rate at DRG | 16.43 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 15.72 | ||||
| Total Medicare payments at DRG | $2,854,117,533 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $62,806,033 | ||||
| Total Medicare payment per Day at DRG | $4,006 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $3,653 | ||||
| Total Medicare payment per Hospitalization at DRG | $21,299 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $21,211 | ||||
| Total Medicare Charges at DRG | $16,607,700,460 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $360,442,046 | ||||
| Avg Charges at DRG | $123,937 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $121,730 | ||||
| Mortality Rate at DRG | 3.88 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 3.65 | ||||
| SNF Discharge Rate at DRG | 10.96 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 12.87 | ||||
| Home Discharge Rate at DRG | 62.82 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 60.82 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 233: CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 539,642 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 1,132 | ||||
| DRG Share of Total Hospitalizations | 1.64 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.86 | ||||
| Avg LOS at DRG | 6.42 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 8.11 | ||||
| Readmission Rate at DRG | 26.55 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 28.17 | ||||
| Unplanned Readmission Rate at DRG | 20.01 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 19.86 | ||||
| Total Medicare payments at DRG | $5,267,842,463 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $13,169,880 | ||||
| Total Medicare payment per Day at DRG | $1,520 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $1,434 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,762 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $11,634 | ||||
| Total Medicare Charges at DRG | $25,503,568,329 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $69,114,494 | ||||
| Avg Charges at DRG | $47,260 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $61,055 | ||||
| Mortality Rate at DRG | 5.62 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 7.24 | ||||
| SNF Discharge Rate at DRG | 19.26 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 22.79 | ||||
| Home Discharge Rate at DRG | 39.65 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 30.83 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 270: OTHER MAJOR CARDIOVASCULAR PROCEDURES W MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 216: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 283: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 269,064 | ||||
| Total Hospitalizations with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 764 | ||||
| DRG Share of Total Hospitalizations | 0.82 | ||||
| % of Total ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.26 | ||||
| Avg LOS at DRG | 13.18 | ||||
| Avg LOS with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 14.6 | ||||
| Readmission Rate at DRG | 37.51 | ||||
| Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 43.33 | ||||
| Unplanned Readmission Rate at DRG | 18.15 | ||||
| Unplanned Readmission Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 19.11 | ||||
| Total Medicare payments at DRG | $9,344,186,034 | ||||
| Total Medicare payments with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $29,928,091 | ||||
| Total Medicare payment per Day at DRG | $2,635 | ||||
| Total Medicare payment per Day with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $2,683 | ||||
| Total Medicare payment per Hospitalization at DRG | $34,728 | ||||
| Total Medicare payment per Hospitalization with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $39,173 | ||||
| Total Medicare Charges at DRG | $44,371,117,432 | ||||
| Total Medicare Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $169,641,402 | ||||
| Avg Charges at DRG | $164,909 | ||||
| Avg Charges with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | $222,044 | ||||
| Mortality Rate at DRG | 14.37 | ||||
| Mortality Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 16.23 | ||||
| SNF Discharge Rate at DRG | 31.8 | ||||
| SNF Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 31.15 | ||||
| Home Discharge Rate at DRG | 14.61 | ||||
| Home Discharge Rate with ICD I5041 - Acute combined systolic (congestive) and diastolic (congestive) heart failure | 11.91 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| SSM HEALTH ST. MARY'S HOSPITAL - MADISON | 700 S. PARK ST. | MADISON | WI | 53715 | 207 |
| ATLANTICARE REGIONAL MEDICAL CENTER - MAINLAND CAMPUS | 65 W JIMMIE LEEDS RD | POMONA | NJ | 08240 | 197 |
| BETHESDA NORTH | 10500 MONTGOMERY RD | CINCINNATI | OH | 45242 | 177 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ALAN H SINGER | 700 S PARK ST | MADISON | WI | 53715 | 41 |
| Dr. MOHAMMAD IMRAN DOTANI | 4050 W MEMORIAL RD | OKLAHOMA CITY | OK | 73120 | 37 |
| Dr. MARAY ROCHER | 11981 SW 97TH TER | MIAMI | FL | 33186 | 31 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MARAY ROCHER | 11981 SW 97TH TER | MIAMI | FL | 33186 | 69 |
| Dr. PHILIP J. BENYO | 144 S OLD TURNPIKE RD | DRUMS | PA | 18222 | 67 |
| Dr. DOUGLAS M HOY | 1265 W MAIN ST | BELLEVUE | OH | 44811 | 50 |