*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure - as a primary diagnosis code | I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 7.2 | |
| Readmission Rate (%) | 29.79 | |
| Unplanned Readmission Rate (%) | 20.36 | |
| 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 I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 39,888 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 39.61 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5.97 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 29.43 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 22.34 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $383,556,187 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,610 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $9,616 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,836,289,482 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $46,036 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5.55 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 22.78 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 33.57 |
*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 264: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | DRG 227: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 250,159 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 2,456 | ||||
| DRG Share of Total Hospitalizations | 0.76 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 2.44 | ||||
| Avg LOS at DRG | 5.47 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 6.9 | ||||
| Readmission Rate at DRG | 27.88 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 29.07 | ||||
| Unplanned Readmission Rate at DRG | 19.94 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 21.44 | ||||
| Total Medicare payments at DRG | $2,661,443,545 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $28,329,042 | ||||
| Total Medicare payment per Day at DRG | $1,946 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,673 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,639 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $11,535 | ||||
| Total Medicare Charges at DRG | $13,270,497,724 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $140,932,426 | ||||
| Avg Charges at DRG | $53,048 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $57,383 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | NA | ||||
| SNF Discharge Rate at DRG | 21.63 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 26.14 | ||||
| Home Discharge Rate at DRG | 34.87 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 27.97 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 252: OTHER VASCULAR PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 001: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | 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) | DRG 226: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 115,984 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 371 | ||||
| DRG Share of Total Hospitalizations | 0.35 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 0.37 | ||||
| Avg LOS at DRG | 7.52 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 12.41 | ||||
| Readmission Rate at DRG | 33.13 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 42.72 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 26.21 | ||||
| Total Medicare payments at DRG | $2,639,352,445 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $9,333,088 | ||||
| Total Medicare payment per Day at DRG | $3,027 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $2,028 | ||||
| Total Medicare payment per Hospitalization at DRG | $22,756 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $25,157 | ||||
| Total Medicare Charges at DRG | $12,757,805,634 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $52,547,619 | ||||
| Avg Charges at DRG | $109,996 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $141,638 | ||||
| Mortality Rate at DRG | 4.68 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 13.48 | ||||
| SNF Discharge Rate at DRG | 20.97 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 23.72 | ||||
| Home Discharge Rate at DRG | 44.26 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 29.65 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 243: PERMANENT CARDIAC PACEMAKER IMPLANT WITH COMPLICATION OR COMORBIDITY (CC) | DRG 981: EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 282: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 273: PERCUTANEOUS INTRACARDIAC PROCEDURES W MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 55,775 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 243 | ||||
| DRG Share of Total Hospitalizations | 0.17 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 0.24 | ||||
| Avg LOS at DRG | 6.91 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 10.51 | ||||
| Readmission Rate at DRG | 23.54 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 24.66 | ||||
| Unplanned Readmission Rate at DRG | 14.61 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 18.83 | ||||
| Total Medicare payments at DRG | $1,347,495,990 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $6,363,533 | ||||
| Total Medicare payment per Day at DRG | $3,498 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $2,491 | ||||
| Total Medicare payment per Hospitalization at DRG | $24,159 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $26,187 | ||||
| Total Medicare Charges at DRG | $6,626,803,325 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $35,598,682 | ||||
| Avg Charges at DRG | $118,813 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $146,497 | ||||
| Mortality Rate at DRG | 2.32 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 6.58 | ||||
| SNF Discharge Rate at DRG | 27.28 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 29.22 | ||||
| Home Discharge Rate at DRG | 38.04 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 23.46 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 417 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 2401 S 31ST ST | TEMPLE | TX | 76508 | 376 |
| HOUSTON METHODIST HOSPITAL | 6565 FANNIN ST | HOUSTON | TX | 77030 | 345 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MARK J AULT | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 46 |
| Dr. KEERTHY K NARISETTY | 138 SERVICE RD | EAST LANSING | MI | 48824 | 23 |
| Dr. NKECHI PATRICIA UGWUH-MOSS | 500 S UNIVERSITY AVE | LITTLE ROCK | AR | 72205 | 22 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 126 |
| Dr. JOHN L HERZOG | 1257 HWY 61 S | HOLLANDALE | MS | 38748 | 81 |
| Dr. CHANDROTH VELANDY PURUSHOTHAMAN | 212 PENNY LN | MOREHEAD CITY | NC | 28557 | 48 |
*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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH 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 I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 162,626 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 31.41 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5.7 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 29.39 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 22.72 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,539,292,397 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,661 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $9,465 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $7,261,333,541 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $44,651 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 3.98 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 20.27 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 37.07 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 293: HEART FAILURE AND SHOCK WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | DRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) OR 4+ VESSELS OR STENTS | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 149,454 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 15,733 | ||||
| DRG Share of Total Hospitalizations | 0.45 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 3.04 | ||||
| Avg LOS at DRG | 2.91 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 3.01 | ||||
| Readmission Rate at DRG | 19.06 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 19.88 | ||||
| Unplanned Readmission Rate at DRG | 13.94 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 15.1 | ||||
| Total Medicare payments at DRG | $634,267,172 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $65,180,484 | ||||
| Total Medicare payment per Day at DRG | $1,460 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,377 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,244 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $4,143 | ||||
| Total Medicare Charges at DRG | $3,009,861,593 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $334,241,375 | ||||
| Avg Charges at DRG | $20,139 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $21,245 | ||||
| Mortality Rate at DRG | 0.61 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 0.45 | ||||
| SNF Discharge Rate at DRG | 10.57 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 10.74 | ||||
| Home Discharge Rate at DRG | 58.05 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 58.64 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 266: ENDOVASCULAR CARDIAC VALVE REPLACEMENT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 208: RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | DRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 535,322 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 8,900 | ||||
| DRG Share of Total Hospitalizations | 1.63 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.72 | ||||
| Avg LOS at DRG | 4.68 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5.23 | ||||
| Readmission Rate at DRG | 23.65 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 30.69 | ||||
| Unplanned Readmission Rate at DRG | 18.66 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 24.65 | ||||
| Total Medicare payments at DRG | $3,844,806,408 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $66,549,340 | ||||
| Total Medicare payment per Day at DRG | $1,536 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,430 | ||||
| Total Medicare payment per Hospitalization at DRG | $7,182 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $7,477 | ||||
| Total Medicare Charges at DRG | $19,258,468,078 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $363,708,793 | ||||
| Avg Charges at DRG | $35,975 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $40,866 | ||||
| Mortality Rate at DRG | 1.27 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 1.54 | ||||
| SNF Discharge Rate at DRG | 14.61 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 16.6 | ||||
| Home Discharge Rate at DRG | 52.12 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 45.71 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 377: G.I. HEMORRHAGE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 219: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 209,527 | ||||
| Total Hospitalizations with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5,601 | ||||
| DRG Share of Total Hospitalizations | 0.64 | ||||
| % of Total ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure in DRG | 1.08 | ||||
| Avg LOS at DRG | 2.98 | ||||
| Avg LOS with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 5.83 | ||||
| Readmission Rate at DRG | 15.34 | ||||
| Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 23.28 | ||||
| Unplanned Readmission Rate at DRG | 8.56 | ||||
| Unplanned Readmission Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 14.42 | ||||
| Total Medicare payments at DRG | $1,394,352,541 | ||||
| Total Medicare payments with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $42,351,415 | ||||
| Total Medicare payment per Day at DRG | $2,234 | ||||
| Total Medicare payment per Day with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $1,298 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,655 | ||||
| Total Medicare payment per Hospitalization with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $7,561 | ||||
| Total Medicare Charges at DRG | $9,726,714,225 | ||||
| Total Medicare Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $321,662,806 | ||||
| Avg Charges at DRG | $46,422 | ||||
| Avg Charges with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | $57,430 | ||||
| Mortality Rate at DRG | 0.17 | ||||
| Mortality Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 0.64 | ||||
| SNF Discharge Rate at DRG | 3.41 | ||||
| SNF Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 7.02 | ||||
| Home Discharge Rate at DRG | 79.22 | ||||
| Home Discharge Rate with ICD I5043 - Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure | 61.95 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 2,813 |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 2401 S 31ST ST | TEMPLE | TX | 76508 | 2,042 |
| HOUSTON METHODIST HOSPITAL | 6565 FANNIN ST | HOUSTON | TX | 77030 | 1,931 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. RAJ R MAKKAR | 8700 WILSHIRE BLVD. | LOS ANGELES | CA | 90048 | 253 |
| Dr. MARK J AULT | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 226 |
| Dr. KAMRAN IJAZ MUHAMMAD | 1265 S UTICA AVE | TULSA | OK | 74104 | 136 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. ZIAD SOUS | 1145 S UTICA AVE | TULSA | OK | 74104 | 1,029 |
| Dr. JAMES M LALLY | 13193 CENTRAL AVE | CHINO | CA | 91710 | 326 |
| Dr. MORAD L EL-RAHEB | 1145 S UTICA AVE | TULSA | OK | 74104 | 311 |