*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| N185 - Chronic kidney disease, stage 5 - as a primary diagnosis code | N185 - Chronic kidney disease, stage 5 - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 6.42 | |
| Readmission Rate (%) | 29.72 | |
| Unplanned Readmission Rate (%) | 13.67 | |
| 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 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 652: KIDNEY TRANSPLANT | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 684: RENAL FAILURE WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 673: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 434,264 | ||||
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 166 | ||||
| DRG Share of Total Hospitalizations | 1.32 | ||||
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 39.62 | ||||
| Avg LOS at DRG | 3.94 | ||||
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 4.26 | ||||
| Readmission Rate at DRG | 22.76 | ||||
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 22.45 | ||||
| Unplanned Readmission Rate at DRG | 16.46 | ||||
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 12.24 | ||||
| Total Medicare payments at DRG | $2,472,138,198 | ||||
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $1,317,223 | ||||
| Total Medicare payment per Day at DRG | $1,444 | ||||
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $1,863 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,693 | ||||
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $7,935 | ||||
| Total Medicare Charges at DRG | $12,478,361,060 | ||||
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $4,134,689 | ||||
| Avg Charges at DRG | $28,735 | ||||
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $24,908 | ||||
| Mortality Rate at DRG | 0.91 | ||||
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | NA | ||||
| SNF Discharge Rate at DRG | 22.02 | ||||
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 15.66 | ||||
| Home Discharge Rate at DRG | 46.68 | ||||
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 48.8 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|
| Total Hospitalizations at DRG | 17,122 |
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 14 |
| DRG Share of Total Hospitalizations | 0.05 |
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 3.34 |
| Avg LOS at DRG | 7.0 |
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 5.29 |
| Readmission Rate at DRG | 26.1 |
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | NA |
| Unplanned Readmission Rate at DRG | 18.72 |
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | NA |
| Total Medicare payments at DRG | $258,914,062 |
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $207,881 |
| Total Medicare payment per Day at DRG | $2,160 |
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $2,809 |
| Total Medicare payment per Hospitalization at DRG | $15,122 |
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $14,849 |
| Total Medicare Charges at DRG | $1,311,882,981 |
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $790,693 |
| Avg Charges at DRG | $76,620 |
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $56,478 |
| Mortality Rate at DRG | 0.41 |
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | NA |
| SNF Discharge Rate at DRG | 17.23 |
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | NA |
| Home Discharge Rate at DRG | 58.05 |
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | NA |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| VIRGINIA MASON MEDICAL CENTER | 925 SENECA ST | SEATTLE | WA | 98101 | 16 |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER | 2315 STOCKTON BLVD | SACRAMENTO | CA | 95817 | 11 |
*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 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 1,013,774 | ||||
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 12,462 | ||||
| DRG Share of Total Hospitalizations | 3.08 | ||||
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 11.39 | ||||
| Avg LOS at DRG | 5.34 | ||||
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 5.81 | ||||
| Readmission Rate at DRG | 28.25 | ||||
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 29.43 | ||||
| Unplanned Readmission Rate at DRG | 21.93 | ||||
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 22.84 | ||||
| Total Medicare payments at DRG | $9,469,067,156 | ||||
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $122,810,544 | ||||
| Total Medicare payment per Day at DRG | $1,751 | ||||
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $1,695 | ||||
| Total Medicare payment per Hospitalization at DRG | $9,340 | ||||
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $9,855 | ||||
| Total Medicare Charges at DRG | $43,343,716,813 | ||||
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $573,037,583 | ||||
| Avg Charges at DRG | $42,755 | ||||
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $45,983 | ||||
| Mortality Rate at DRG | 3.72 | ||||
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | 4.49 | ||||
| SNF Discharge Rate at DRG | 20.84 | ||||
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 17.0 | ||||
| Home Discharge Rate at DRG | 37.68 | ||||
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 38.25 |
*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 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM , FLUIDS AND ELECTROLYTES WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 250,159 | ||||
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 2,213 | ||||
| DRG Share of Total Hospitalizations | 0.76 | ||||
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 2.02 | ||||
| Avg LOS at DRG | 5.47 | ||||
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 6.23 | ||||
| Readmission Rate at DRG | 27.88 | ||||
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 31.19 | ||||
| Unplanned Readmission Rate at DRG | 19.94 | ||||
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 23.12 | ||||
| Total Medicare payments at DRG | $2,661,443,545 | ||||
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $25,144,466 | ||||
| Total Medicare payment per Day at DRG | $1,946 | ||||
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $1,825 | ||||
| Total Medicare payment per Hospitalization at DRG | $10,639 | ||||
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $11,362 | ||||
| Total Medicare Charges at DRG | $13,270,497,724 | ||||
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $127,006,783 | ||||
| Avg Charges at DRG | $53,048 | ||||
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $57,391 | ||||
| Mortality Rate at DRG | NA | ||||
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | NA | ||||
| SNF Discharge Rate at DRG | 21.63 | ||||
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 18.35 | ||||
| Home Discharge Rate at DRG | 34.87 | ||||
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 33.8 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 417,755 | ||||
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 1,403 | ||||
| DRG Share of Total Hospitalizations | 1.27 | ||||
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 1.28 | ||||
| Avg LOS at DRG | 3.9 | ||||
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 4.27 | ||||
| Readmission Rate at DRG | 16.53 | ||||
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 24.46 | ||||
| Unplanned Readmission Rate at DRG | 11.52 | ||||
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 19.19 | ||||
| Total Medicare payments at DRG | $2,493,587,688 | ||||
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $8,824,794 | ||||
| Total Medicare payment per Day at DRG | $1,529 | ||||
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $1,473 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,969 | ||||
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $6,290 | ||||
| Total Medicare Charges at DRG | $11,318,800,289 | ||||
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $41,535,031 | ||||
| Avg Charges at DRG | $27,094 | ||||
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $29,604 | ||||
| Mortality Rate at DRG | 0.87 | ||||
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | 1.78 | ||||
| SNF Discharge Rate at DRG | 17.03 | ||||
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 15.61 | ||||
| Home Discharge Rate at DRG | 53.31 | ||||
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 53.6 |
*Readmission Rate is calculated from Oct 2015 to Aug 2018 and all other Quality Outcomes are calculated from Oct 2015 to Sep 2018.
| DRG 638: DIABETES WITH COMPLICATION OR COMORBIDITY (CC) | DRG 812: RED BLOOD CELL DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 853: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH COMPLICATION OR COMORBIDITY (CC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 174,196 | ||||
| Total Hospitalizations with ICD N185 - Chronic kidney disease, stage 5 | 1,151 | ||||
| DRG Share of Total Hospitalizations | 0.53 | ||||
| % of Total ICD N185 - Chronic kidney disease, stage 5 in DRG | 1.05 | ||||
| Avg LOS at DRG | 3.86 | ||||
| Avg LOS with ICD N185 - Chronic kidney disease, stage 5 | 3.94 | ||||
| Readmission Rate at DRG | 23.62 | ||||
| Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 25.75 | ||||
| Unplanned Readmission Rate at DRG | 17.61 | ||||
| Unplanned Readmission Rate with ICD N185 - Chronic kidney disease, stage 5 | 19.68 | ||||
| Total Medicare payments at DRG | $959,872,570 | ||||
| Total Medicare payments with ICD N185 - Chronic kidney disease, stage 5 | $6,621,186 | ||||
| Total Medicare payment per Day at DRG | $1,426 | ||||
| Total Medicare payment per Day with ICD N185 - Chronic kidney disease, stage 5 | $1,459 | ||||
| Total Medicare payment per Hospitalization at DRG | $5,510 | ||||
| Total Medicare payment per Hospitalization with ICD N185 - Chronic kidney disease, stage 5 | $5,753 | ||||
| Total Medicare Charges at DRG | $4,945,131,055 | ||||
| Total Medicare Charges with ICD N185 - Chronic kidney disease, stage 5 | $34,024,627 | ||||
| Avg Charges at DRG | $28,388 | ||||
| Avg Charges with ICD N185 - Chronic kidney disease, stage 5 | $29,561 | ||||
| Mortality Rate at DRG | 0.24 | ||||
| Mortality Rate with ICD N185 - Chronic kidney disease, stage 5 | NA | ||||
| SNF Discharge Rate at DRG | 14.83 | ||||
| SNF Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 11.56 | ||||
| Home Discharge Rate at DRG | 53.93 | ||||
| Home Discharge Rate with ICD N185 - Chronic kidney disease, stage 5 | 55.52 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| MONTEFIORE MEDICAL CENTER | 111 E 210TH ST | BRONX | NY | 10467 | 364 |
| MAYO CLINIC HOSPITAL - SAINT MARYS CAMPUS | 1216 2ND ST SW | ROCHESTER | MN | 55902 | 359 |
| CEDARS-SINAI MEDICAL CENTER | 8700 BEVERLY BLVD | LOS ANGELES | CA | 90048 | 318 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. MSONTHI B LEVINE | 3560 DELAWARE ST | BEAUMONT | TX | 77706 | 45 |
| Dr. DENNIS MICHAEL BLANKENSHIP | 422 BEECH ST | TEXARKANA | AR | 71854 | 33 |
| Dr. STEVE FRANK MONTOYA | 136 E CONCHO AVE | SAN ANGELO | TX | 76903 | 29 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Oct 2015 to Sep 2018 ) |
|---|---|---|---|---|---|
| Dr. SERGIO ZAMORA | 2450 EL INDIO HWY | EAGLE PASS | TX | 78852 | 55 |
| Dr. MUSTAFA RAHIM | 250 STANAFORD RD | BECKLEY | WV | 25801 | 47 |
| Dr. MSONTHI B LEVINE | 3560 DELAWARE ST | BEAUMONT | TX | 77706 | 46 |