For fiscal year 2008, CMS is proposing a significant overhaul of the diagnosis related group (DRG) classification system for inpatient hospitals. CMS is trying to make payments for inpatient hospital services more accurate by better accounting for the severity of illness of beneficiaries receiving the services.
CMS has proposed replacing the existing list of 538 DRGs by creating 745 new DRGs. This change, included in the proposed rule issued on May 3, 2007 (72 FR 24680, ¶220,461), would go into effect October 1, 2007. The final rule will be published sometime in late August or early September.
The CCH DRG Compare Chart is designed to help hospitals compare what they were paid for certain inpatient procedures in 2007, and what they will be paid for similar procedures in 2008. The chart provides a comparison of the national unadjusted total payments for each diagnosis related group (DRG) paid by Medicare in fiscal year 2007 and the proposed MS-DRGs for fiscal year 2008. The data for the chart comes from Table 5 of the inpatient prospective payment system (IPPS) final rule for FY 2007 and Table 5 of the IPPS proposed rule for FY 2008. (The text of the final rule for FY 2007 is in the CCH Medicare and Medicaid Guide at ¶180,571; Table 5 is displayed at ¶261,239A. The text of the proposed rule for FY 2008 is at ¶220,461; Table 5 is displayed at ¶220,461A).
The key columns in the chart show (1) the unadjusted operating payment, which is equal to the labor plus the nonlabor amounts, multiplied by the relative weight for that DRG; (2) the unadjusted capital amount, which is equal to the federal capital rate multiplied by the relative weight for that DRG; and (3) the unadjusted total payment, which is equal to the sum of the previous two amounts.
The payment amounts displayed in the chart have not been adjusted for geographic location, indirect medical education payments, or disproportionate share hospital status. To calculate adjusted payment rates, see the "IPPS Calculator" in the CCH Reimbursement Toolkit.
To access the CCH DRG Compare Chart, go to the CCH Internet Research Network and select “Interactive Charts.”
For more information, contact your account representative.
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