| 4289 - Heart failure, unspecified - as a primary diagnosis code | 4289 - Heart failure, unspecified - as a primary or secondary diagnosis code | |
|---|---|---|
| OUTCOMES | ||
| Avg. LOS | 5.64 | |
| Readmission Rate (%) | 24.03 | |
| Unplanned Readmission Rate (%) | 13.32 | |
| 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 | ||
| DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK 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) | |
|---|---|---|---|---|
| Total Hospitalizations at DRG | 414,616 | |||
| Total Hospitalizations with ICD 4289 - Heart failure, unspecified | 253 | |||
| DRG Share of Total Hospitalizations | 1.81 | |||
| % of Total ICD 4289 - Heart failure, unspecified in DRG | 37.26 | |||
| Avg LOS at DRG | 4.4 | |||
| Avg LOS with ICD 4289 - Heart failure, unspecified | 3.25 | |||
| Readmission Rate at DRG | 25.69 | |||
| Readmission Rate with ICD 4289 - Heart failure, unspecified | 18.26 | |||
| Unplanned Readmission Rate at DRG | 19.35 | |||
| Unplanned Readmission Rate with ICD 4289 - Heart failure, unspecified | 9.59 | |||
| Total Medicare payments at DRG | $2,579,957,747 | |||
| Total Medicare payments with ICD 4289 - Heart failure, unspecified | $1,684,809 | |||
| Total Medicare payment per Day at DRG | $1,415 | |||
| Total Medicare payment per Day with ICD 4289 - Heart failure, unspecified | $2,052 | |||
| Total Medicare payment per Hospitalization at DRG | $6,223 | |||
| Total Medicare payment per Hospitalization with ICD 4289 - Heart failure, unspecified | $6,659 | |||
| Total Medicare Charges at DRG | $11,090,898,185 | |||
| Total Medicare Charges with ICD 4289 - Heart failure, unspecified | $4,390,174 | |||
| Avg Charges at DRG | $26,750 | |||
| Avg Charges with ICD 4289 - Heart failure, unspecified | $17,352 | |||
| Mortality Rate at DRG | 1.33 | |||
| Mortality Rate with ICD 4289 - Heart failure, unspecified | 6.72 | |||
| SNF Discharge Rate at DRG | 17.4 | |||
| SNF Discharge Rate with ICD 4289 - Heart failure, unspecified | 11.07 | |||
| Home Discharge Rate at DRG | 45.44 | |||
| Home Discharge Rate with ICD 4289 - Heart failure, unspecified | 50.2 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| MCLAREN THUMB REGION | 1100 S VAN DYKE RD | BAD AXE | MI | 48413 | 12 |
| DRG 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 945: REHABILITATION WITH COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 292: HEART FAILURE AND SHOCK WITH COMPLICATION OR COMORBIDITY (CC) | DRG 291: HEART FAILURE AND SHOCK WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 189: PULMONARY EDEMA AND RESPIRATORY FAILURE | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 901,552 | ||||
| Total Hospitalizations with ICD 4289 - Heart failure, unspecified | 1,187 | ||||
| DRG Share of Total Hospitalizations | 3.95 | ||||
| % of Total ICD 4289 - Heart failure, unspecified in DRG | 5.28 | ||||
| Avg LOS at DRG | 6.79 | ||||
| Avg LOS with ICD 4289 - Heart failure, unspecified | 6.02 | ||||
| Readmission Rate at DRG | 25.38 | ||||
| Readmission Rate with ICD 4289 - Heart failure, unspecified | 25.97 | ||||
| Unplanned Readmission Rate at DRG | 17.1 | ||||
| Unplanned Readmission Rate with ICD 4289 - Heart failure, unspecified | 17.63 | ||||
| Total Medicare payments at DRG | $11,142,976,193 | ||||
| Total Medicare payments with ICD 4289 - Heart failure, unspecified | $14,731,592 | ||||
| Total Medicare payment per Day at DRG | $1,821 | ||||
| Total Medicare payment per Day with ICD 4289 - Heart failure, unspecified | $2,063 | ||||
| Total Medicare payment per Hospitalization at DRG | $12,360 | ||||
| Total Medicare payment per Hospitalization with ICD 4289 - Heart failure, unspecified | $12,411 | ||||
| Total Medicare Charges at DRG | $48,288,426,708 | ||||
| Total Medicare Charges with ICD 4289 - Heart failure, unspecified | $57,887,651 | ||||
| Avg Charges at DRG | $53,561 | ||||
| Avg Charges with ICD 4289 - Heart failure, unspecified | $48,768 | ||||
| Mortality Rate at DRG | 15.16 | ||||
| Mortality Rate with ICD 4289 - Heart failure, unspecified | 25.95 | ||||
| SNF Discharge Rate at DRG | 28.41 | ||||
| SNF Discharge Rate with ICD 4289 - Heart failure, unspecified | 24.85 | ||||
| Home Discharge Rate at DRG | 23.21 | ||||
| Home Discharge Rate with ICD 4289 - Heart failure, unspecified | 19.29 |
| DRG 194: SIMPLE PNEUMONIA AND PLEURISY WITH COMPLICATION OR COMORBIDITY (CC) | DRG 683: RENAL FAILURE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH COMPLICATION OR COMORBIDITY (CC) | DRG 193: SIMPLE PNEUMONIA AND PLEURISY WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 368,552 | ||||
| Total Hospitalizations with ICD 4289 - Heart failure, unspecified | 424 | ||||
| DRG Share of Total Hospitalizations | 1.61 | ||||
| % of Total ICD 4289 - Heart failure, unspecified in DRG | 1.89 | ||||
| Avg LOS at DRG | 4.42 | ||||
| Avg LOS with ICD 4289 - Heart failure, unspecified | 4.54 | ||||
| Readmission Rate at DRG | 18.07 | ||||
| Readmission Rate with ICD 4289 - Heart failure, unspecified | 20.26 | ||||
| Unplanned Readmission Rate at DRG | 12.45 | ||||
| Unplanned Readmission Rate with ICD 4289 - Heart failure, unspecified | 11.32 | ||||
| Total Medicare payments at DRG | $2,243,342,846 | ||||
| Total Medicare payments with ICD 4289 - Heart failure, unspecified | $2,675,155 | ||||
| Total Medicare payment per Day at DRG | $1,376 | ||||
| Total Medicare payment per Day with ICD 4289 - Heart failure, unspecified | $1,390 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,087 | ||||
| Total Medicare payment per Hospitalization with ICD 4289 - Heart failure, unspecified | $6,309 | ||||
| Total Medicare Charges at DRG | $9,706,587,516 | ||||
| Total Medicare Charges with ICD 4289 - Heart failure, unspecified | $10,228,234 | ||||
| Avg Charges at DRG | $26,337 | ||||
| Avg Charges with ICD 4289 - Heart failure, unspecified | $24,123 | ||||
| Mortality Rate at DRG | 1.44 | ||||
| Mortality Rate with ICD 4289 - Heart failure, unspecified | 4.48 | ||||
| SNF Discharge Rate at DRG | 19.19 | ||||
| SNF Discharge Rate with ICD 4289 - Heart failure, unspecified | 16.51 | ||||
| Home Discharge Rate at DRG | 50.54 | ||||
| Home Discharge Rate with ICD 4289 - Heart failure, unspecified | 44.1 |
| DRG 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 310: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT COMPLICATION OR COMORBIDITY (CC)/MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 682: RENAL FAILURE WITH MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 470: MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 368,382 | ||||
| Total Hospitalizations with ICD 4289 - Heart failure, unspecified | 313 | ||||
| DRG Share of Total Hospitalizations | 1.61 | ||||
| % of Total ICD 4289 - Heart failure, unspecified in DRG | 1.39 | ||||
| Avg LOS at DRG | 3.76 | ||||
| Avg LOS with ICD 4289 - Heart failure, unspecified | 4.06 | ||||
| Readmission Rate at DRG | 18.51 | ||||
| Readmission Rate with ICD 4289 - Heart failure, unspecified | 21.93 | ||||
| Unplanned Readmission Rate at DRG | 12.91 | ||||
| Unplanned Readmission Rate with ICD 4289 - Heart failure, unspecified | 15.95 | ||||
| Total Medicare payments at DRG | $1,761,365,865 | ||||
| Total Medicare payments with ICD 4289 - Heart failure, unspecified | $1,597,243 | ||||
| Total Medicare payment per Day at DRG | $1,270 | ||||
| Total Medicare payment per Day with ICD 4289 - Heart failure, unspecified | $1,257 | ||||
| Total Medicare payment per Hospitalization at DRG | $4,781 | ||||
| Total Medicare payment per Hospitalization with ICD 4289 - Heart failure, unspecified | $5,103 | ||||
| Total Medicare Charges at DRG | $7,996,276,956 | ||||
| Total Medicare Charges with ICD 4289 - Heart failure, unspecified | $6,601,003 | ||||
| Avg Charges at DRG | $21,706 | ||||
| Avg Charges with ICD 4289 - Heart failure, unspecified | $21,089 | ||||
| Mortality Rate at DRG | 0.32 | ||||
| Mortality Rate with ICD 4289 - Heart failure, unspecified | NA | ||||
| SNF Discharge Rate at DRG | 27.88 | ||||
| SNF Discharge Rate with ICD 4289 - Heart failure, unspecified | 31.31 | ||||
| Home Discharge Rate at DRG | 42.37 | ||||
| Home Discharge Rate with ICD 4289 - Heart failure, unspecified | 30.67 |
| DRG 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 378: G.I. HEMORRHAGE WITH COMPLICATION OR COMORBIDITY (CC) | DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | DRG 885: PSYCHOSES | DRG 812: RED BLOOD CELL DISORDERS WITHOUT MAJOR COMPLICATION OR COMORBIDITY (MCC) | |
|---|---|---|---|---|---|
| Total Hospitalizations at DRG | 285,530 | ||||
| Total Hospitalizations with ICD 4289 - Heart failure, unspecified | 289 | ||||
| DRG Share of Total Hospitalizations | 1.25 | ||||
| % of Total ICD 4289 - Heart failure, unspecified in DRG | 1.29 | ||||
| Avg LOS at DRG | 4.72 | ||||
| Avg LOS with ICD 4289 - Heart failure, unspecified | 4.48 | ||||
| Readmission Rate at DRG | 18.55 | ||||
| Readmission Rate with ICD 4289 - Heart failure, unspecified | 19.38 | ||||
| Unplanned Readmission Rate at DRG | 12.87 | ||||
| Unplanned Readmission Rate with ICD 4289 - Heart failure, unspecified | 12.02 | ||||
| Total Medicare payments at DRG | $1,922,582,097 | ||||
| Total Medicare payments with ICD 4289 - Heart failure, unspecified | $1,939,665 | ||||
| Total Medicare payment per Day at DRG | $1,427 | ||||
| Total Medicare payment per Day with ICD 4289 - Heart failure, unspecified | $1,497 | ||||
| Total Medicare payment per Hospitalization at DRG | $6,733 | ||||
| Total Medicare payment per Hospitalization with ICD 4289 - Heart failure, unspecified | $6,712 | ||||
| Total Medicare Charges at DRG | $8,696,353,387 | ||||
| Total Medicare Charges with ICD 4289 - Heart failure, unspecified | $8,358,021 | ||||
| Avg Charges at DRG | $30,457 | ||||
| Avg Charges with ICD 4289 - Heart failure, unspecified | $28,920 | ||||
| Mortality Rate at DRG | 2.4 | ||||
| Mortality Rate with ICD 4289 - Heart failure, unspecified | 6.92 | ||||
| SNF Discharge Rate at DRG | 23.54 | ||||
| SNF Discharge Rate with ICD 4289 - Heart failure, unspecified | 25.61 | ||||
| Home Discharge Rate at DRG | 44.6 | ||||
| Home Discharge Rate with ICD 4289 - Heart failure, unspecified | 33.22 |
| Hospital Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| DCH REGIONAL MEDICAL CENTER | 809 UNIVERSITY BLVD E | TUSCALOOSA | AL | 35401 | 616 |
| UH CLEVELAND MEDICAL CENTER | 11100 EUCLID AVE | CLEVELAND | OH | 44106 | 346 |
| LICKING MEMORIAL HOSPITAL | 1320 W MAIN ST | NEWARK | OH | 43055 | 252 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. SCOTT PAUL SHISLER | 1100 S VAN DYKE | BAD AXE | MI | 48413 | 94 |
| Dr. R.C. STEWART FINNEY | 7505 OSLER DR | TOWSON | MD | 21204 | 17 |
| Dr. SUKIT C. MALAISRIE | 251 EAST HURON ST | CHICAGO | IL | 60611 | 15 |
| Physician Name | Address | City | State | Zip Code | Total Hospitalizations ( Jan 2013 to Dec 2014 ) |
|---|---|---|---|---|---|
| Dr. SCOTT PAUL SHISLER | 1100 S VAN DYKE | BAD AXE | MI | 48413 | 115 |
| Dr. WILLIAM EUGENE ALLDREDGE | 100 RICE MINE RD N | TUSCALOOSA | AL | 35406 | 47 |
| Dr. FUAD KULIYEV | 1800 SPRING RIDGE DR | SUSANVILLE | CA | 96130 | 38 |