LA Hospital Inform -Inpatient definitions
 

Definitions
Inpatient Services

Information in this report is taken from the Medicare Provider Analysis and Review (MedPAR) file which is updated annually by the Centers for Medicare and Medicaid Services (CMS), the federal organization that oversees the programs.  The file provides billing data for all Medicare fee-for-service claims. It does not, however, contain data for other patients.

Each patient is categorized into Medicare Severity-adjusted Diagnosis Related Groups (Base MS-DRGs) according to diagnostic information, the procedures performed, patient age, and other factors.  Our report is based on Base MS-DRGs, but uses modified descriptions to make them easier to read and understand.  The Base MS-DRGs with the largest numbers of admissions (as ranked by volume for Louisiana hospitals) are reported:

  • Categories - the most common Base MS-DRGs are categorized for review.  These categories are unique to this website.
  • Description - simplified descriptions are used instead of the technical terminology associated with Base MS-DRGs.  Base MS-DRG numbers are included within parentheses as part of the description.
  • Patients - the total number of Medicare patients in the Base MS-DRG category for the 12 month period being reported.
  • ALOS - the average length of stay (in days) for patients in the Base MS-DRG category.
  • Charge Range - Average hospital charges for a Base MS-DRG are reported as the "Higher" and "Lower" ends of the range representing about 68% of all patients.  (Statistically, this is referred to as +/- one standard deviation from the mean.)  PLEASE NOTE: In some situations (e.g. when there are only a small number of patients in a Base MS-DRG) a blank will appear if it is not possible to calculate a reasonable "Lower" end.

IT IS IMPORTANT TO REMEMBER THAT ACTUAL PAYMENTS TO THE HOSPITAL MAY DIFFER SIGNIFICANTLY FROM CHARGES.  THE MEDICARE PROGRAM MAKES FIXED PAYMENTS FOR BASE MS-DRG'S REGARDLESS OF A HOSPITAL'S CHARGES AND INSURANCE COMPANIES MAY NEGOTIATE DISCOUNTED PAYMENT ARRANGEMENTS.


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