a hospital treats a Medicare patient who is classified as drg 134, hypertension,

Question

a hospital treats a Medicare patient who is classified as drg 134, hypertension, with a case weight of .58. assume the standardized labor rate is $3000 and the standardized non labor rate is $1200. what amount will the hospital be paid, excluding outlier, capital costs, and other items, if the wage index is 1.5? a hospital treats a Medicare patient who is classified as drg 134, hypertension, with a case weight of .58. assume the standardized labor rate is $3000 and the standardized non labor rate is $1200. what amount will the hospital be paid, excluding outlier, capital costs, and other items, if the wage index is 1.5? a hospital treats a Medicare patient who is classified as drg 134, hypertension, with a case weight of .58. assume the standardized labor rate is $3000 and the standardized non labor rate is $1200. what amount will the hospital be paid, excluding outlier, capital costs, and other items, if the wage index is 1.5?

Explanation / Answer

Medicare is a social welfare system where medicare unit pays cost of treatment of a patient covered under this scheme to hospital.The term DRG will mean diagnosis-related groups. It is a standrardsed term included in Medicare system. In this term patients that are clinically treated in a similar mannere are grouped together. Standard cost of their treatment is calculated under this term and paid by the medicare to hospital.

In this problem, you have to diagnose hypertension. It is a standard disease which is equally treated cliically. Money payable for this standard disease is calculated in the following manner:

Step1: First ascertain standard labor cost and standard non-labor cost of the diaognisis. Here standard labor rate is $3,000 and standard non labor rate of $1,200.

Step 2: Wage rate varies from one locality to another.It is indicated by the wage index. Hence standard labor rate should be adjusted according to wage index. Here wage index is 1.5. Hence adjusted labor rate is $3,000 x 1.5=$4,500.

Step 3: Now add standard non labor rate to get total cost. The amount is $4,500+$1,200=$5,700

Step 4: Finally consider case weight 0.58. This weight indicates complications in the treatment of illness. Here illness has case weight of 0.58. Thus you require only 0.58 of $1 for its treatment. Multiply figure of step 3 by this case weight to get actual cost that Medicare will pay to Hospital. The amount is $5,700 x 0.58=$3,306.

Answer: Medicare will pay $3,306 to hospital for treatment of Hypertension classified under drg 134.

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