Procedure Summary Overview + Video
This is a detail report for all procedures of interest performed by the top facilities in Core-Based Statistical Area (CBSA). Each section details relevant procedures from each of Inpatient, outpatient and office setting. Each section includes the procedure volumes, average lengths of stay, charges and revenue.
- The locations from which other facilities are drawn is determined in the report settings. Options for different geographies include Hospital Referral Region, Core-based Statistical Area, County or State.
- The focal facility may not realize how other facilities in their area are performing in terms of how many services delivered, patients treated, and revenue generated. Therefore, it can stimulate sales meetings.
This section details the relevant procedures, relevant patients, and facility revenue for inpatient procedures. A map with the locations pinned is also provided.
The table provides the DRG codes, the type of procedure, the number of services, the number of patients, the averages number of days per stay, the average amount of money charged per stay, the average revenue per stay, and the total revenue.
We calculate the Medicare revenue per stay by taking the average of all claims reimbursed for the DRG of interest. More specifically, we take the average of the "Claim Total Payment Amount" found on each Medicare claim. In addition, we account for other possible payments that may be applied to the Medicare beneficiary's claim as a source of reimbursement, including:
- NCH Primary Payer signals a payment from a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's health insurance bills.
- Claim Paid Amount (Claim Pass Thru Per Diem Amount * Acute Inpatient Covered Days) = Special payments above the normal per diem, typically made available in special situations such as for critical access hospitals.