Memorial Hospital of South Bend, IN, can earn VBP incentives by lowering MSPB prices by 2.2%
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By: Sampath Kumar  May. 04, 2021
Memorial Hospital of South Bend, IN, reported a CMS Worth Primarily based Buying (VBP) adjustment issue of 0.997 within the 12 months 2021, which might lead to an estimated penalty of $134,825. Medicare Spending Per Beneficiary (MSPB) accounts for 25% of total VBP rating and is a big think about driving VBP funds. MSPB prices embody the prices from 3 days earlier than hospitalization, index hospital stays, and 30 days post-discharge. The measure rating of the Effectivity & Price Discount area for Memorial Hospital of South Bend in the course of the interval was 0/10. Dexur is an accepted purchaser of CMS Medicare claims knowledge and based mostly on our simulator, we estimate that Memorial Hospital of South Bend can keep away from VBP penalties by lowering MSPB Price by 2.2%.
Memorial Hospital of South Bend’s common MSPB value per episode (danger adjusted and value standardized) in the course of the interval of January 2019 to December 2019 was $22,011. The typical value of Put up Index Stays was $7,796 with a complete of three,577 episodes.
Dexur Simulator for MSPB Price Discount
Memorial Hospital of South Bend can obtain the break-even VBP adjustment issue of 1 by incomes 2 factors in MSPB and thereby keep away from VBP penalties to realize incentives. Hospitals want to scale back publish Index hospitalization prices to fulfill these MSPB discount targets. Dexur’s simulator has recognized 4 fundamental levers and estimated discount in every of those levers to scale back MSPB to the goal ranges and finally obtain a constructive MSPB rating:
Discount in Rehospitalizations: 6% discount in rehospitalizations causes 0.5% discount in MSPB value and impacts 24 episodes.
Shift from SNF discharge to Residence: 6% shift causes 0.9% discount in common MSPB value and impacts 55 episodes.
In Abstract, the 4 levers impression 149 episodes and scale back the typical MSPB value by 2.2% and enhance the MSPB efficiency price to 0.969. This will increase the VBP adjustment issue to 1.0002 and helps attain an incentive of $8.9k.
A a lot increased discount in Put up Index keep prices can additional enhance VBP incentives. For instance, a ten% discount in publish index keep prices can scale back the typical MSPB value by 3.6%, and earn a VBP Adjustment Issue of 1.0018, thereby attaining an incentive of $80.8k.