FY2011 IPPS Info

edited May 2016 in CDI Talk Archive
I have been looking at the FY2011 final rule, playing specifically with the data in table 7A & B
(which takes the FY2009 Medpar data and runs those cases through the V27 & V28 groupers (for FY10 & FY11) and provides how those cases would distribute among DRGs as well as show the LOS distribution at various percentiles -- I am only using the DRG distribution information).

Appears for the cases affected by MCC's (both the MCC w/ or w/o pair and the triplet):
The 'with MCC' cases decrease by 20% for the pair and by 16% for the triplet -- total -17.4%.

Also, apply the respective weights to both tables, the CMI for
v27 is 1.625753555
v28 is 1.58845736
a decrease of -2.35%

I also looked at the weights of FY10 vs FY11, keeping the DRG distribution constant with the v27 distribution. For me, I am answering the question "If the only change is the relative weight year to year, what would the impact be?"
Again, for the FY2009 Medpar data, looks like a +2.1% -- comes close to balancing out the decrease of the MCC loss (see below about the Impact File).

Finally, download and look at the FY 2011 Final Rule - IPPS Impact File. This is the easiest and quickest high level look at the impact of the IPPS final rule changes for your facility.
Find your facility and compare the columns CMIV27 & CMIV28 -- shows what your individual facility CMI for FY2009 data run through the respective FY10 & FY11 groupers (for me, about -0.5%).

And of course, there is still the -0.5% between the DCA and market basket adjustment to the actual reimbursement.......

Don

Donald A. Butler, RN, BSN
Manager, Clinical Documentation
PCMH, Greenville NC
dbutler@pcmh.com


Never give in. Never, never, never, never--in nothing, great or small, large or petty--never give in, except to convictions of honor and good sense. Never yield to force. Never yield to the apparently overwhelming might of the enemy
Sir Winston Churchhill




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