- Care Hospital
- Outpatient Hospital
- Drug Related Groups
- Acute Care Hospitals
- Capital Ratios
- Long Term Acute Care Hospital
Capital Ratios For Acute Care Hospitals
This dataset is used to determine whether a case qualifies for outlier payments under the hospital inpatient prospective payment system (IPPS), hospital-specific cost-to-charge ratios are applied to the total covered charges for the case. Operating and capital costs for the case are calculated separately by applying separate operating and capital cost-to-charge ratios and combining these costs to compare them with the fixed-loss outlier threshold.
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The CCRs are also used in determining outpatient hospital outlier payments, payments for passthrough devices and monthly interim transitional corridor payments under the outpatient prospective payment system (OPPS). The CCRs for OPPS will be addressed in a separate Program Memorandum (PM).
In the August 1, 2002, Federal Register, CMS stated that for Federal fiscal year (FY) 2003, those hospitals for which operating cost-to-charge ratios (CCR) are lower than 0.194 or greater than 1.258, or capital cost-to-charge ratios lower than 0.012 or greater than 0.163, fiscal intermediaries (FIs) will use statewide average ratios to calculate costs to determine whether a hospital qualifies for outlier payments. These ranges represent 3.0 standard deviations (plus or minus) from the mean of the log distribution of cost-to-charge ratios for all hospitals.
About this Dataset
John Snow Labs; Centers for Medicare & Medicaid Services;
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Acute Care Hospitals, Capital Ratios, Long Term Acute Care Hospital
Care Hospital, Outpatient Hospital, Drug Related Groups
|State||Acute Care State||string||-|
|Ratio||Ratios for Acute Care Hospitals||number||level : Nominal|
|District of Columbia||0.02|