Case Example: MS-DRGs 291-292-293
The analysis discussed in Benchmarking Tools for Reducing Costs of Care can be used to quickly identify whether costs are in line with peer facilities. The exhibit depicts the heart failure and shock MS-DRG triad from facilities in a four-state area with similar acute and CCU bed sizes, teaching programs, and significant volumes for the MS-DRGs studied. Figures are both CMI- and wage-adjusted. Departmental costs are expressed as a percentage of total cost, and departments not detailed are summarized into the "other" category.
View exhibit 1
If Provider 1 were the focus of the study, it would be immediately clear that its average cost per case is significantly higher than that for peer hospitals, including those with a substantially higher CMI. A quick glance across the percentages discloses that Provider 1's costs associated with intensive care are remarkably high compared with those of peer facilities. These data suggest that an analysis of routine versus intensive care utilization would be a good place to start a more in-depth analysis.
Publication Date: Wednesday, April 01, 2009