Page 18 - 2013 Hospitals/Systems Digest US.NMH.13.02.007
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HOSPI TALS
HOSPITALS/SYSTEMS DIGEST 2013
SANOFI / MANAGED CARE DIGEST SERIES
®
/ WHERE INFORMATION BECOMES INTELLIGENCE.
™
Data source: IMS Health © 2013
Key Takeaway
In light of rising inpatient charges, the Centers for Medicare and Medicaid Services has begun
implementing the Bundled Payment for Care Improvement initiative,which emphasizes coordinated
care and cost savings by paying providers based on expected costs across an entire medical
episode. This initiative, which applies to up to four dozen episodes of care ranging from amputation to
stroke, places shared financial responsibility on hospitals and their providers.
2
F INANCIALS
• In 2011, inpatient charges for acute myocardial
infarction (AMI) were substantially higher when
such patients were likewise diagnosed with
diabetes mellitus, regardless of MHS ownership.
• For instance, at non-MHS owned hospitals,
inpatient charges for AMI patients with diabetes
($67,760) were more than twice that of patients
without such a secondary diagnosis ($33,338).
Average Charges Are Higher for AMI Patients Who Also Have Diabetes Mellitus
Inpatient Charges per acute myocardial infarction (AMI) Case, by mhs ownership, 2011
1
$18,000
$36,000
$54,000
$72,000
$90,000
Average Charges
$68,288
$33,338
$60,737
$80,851
$67,760
$79,328
MHS Owned
Not MHS Owned
Total
AMI
AMI, Co-occurring with Diabetes Mellitus
1
Charge data are per-case averages for inpatients with a particular diagnosis of interest. Charges may be for treatment related to other diagnoses.
2
Centers for Medicare and Medicaid Services. (2013). Bundled Payments for Care Improvement (BPCI) Initiative. Retrieved from
.
• For all 12 featured disease states, inpatient
charges per case grew between 2010
and 2011, with notable increases for such
treatment of breast cancer (up 10.5%)
and prostate cancer (up 8.6%) cases.
• Despite a relatively moderate 4.4% rise between
2010 ($48,309) and 2011 ($50,441), inpatient
charges were highest for osteoarthritis cases.
Prostate cancer, at $41,539 per inpatient case,
was second highest among the diseases listed.
INPATIENT CHARGES PER CASE
1
disease state
2010
2011
Acute Coronary Syndromes (ACS)
$24,008
$25,930
Angina
21,253
22,811
Asthma
24,445
26,131
Atrial Fibrillation/Atrial Flutter
29,215
30,764
Breast Cancer
36,815
40,664
Depression
22,371
23,552
Diabetes Mellitus
34,505
36,624
Hypertension
19,082
20,574
Multiple Sclerosis (MS)
29,192
29,671
Osteoarthritis
48,309
50,441
Prostate Cancer
38,261
41,539
Stroke
37,406
40,177
Charges Rise For Inpatient Treatment of Chronic Diseases
CHRONIC DISEASE
