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Requested TAG Analyses“Current Outlier Level” Approach» Alternative model requested to maintain outlier payments at current levels foracute <strong>services</strong> ($471.4 million for SFY 2009 acute COS 20 claims):AlternativeModelVersionOutlierPayments(Using SFY2009 Claims)OutlierPayment % <strong>of</strong>Total DRGPaymentsModeledOutlier FixedLossThresholdModeledOutlierMarginalCost FactorPercent <strong>of</strong> <strong>Acute</strong>COS 20 Claimswith SimulatedOutlier PaymentCurrent System $471.4 million 27.2% $28,981(SFY 2009 average)Revised Model withPolicy Adjusters0.80 5.7%$251.4 million 14.5% $22,385 0.80 2.3%Alternative Baseline Model 1 $471.4 million 27.2% $6,475 0.80 10.9%Alternative Baseline Model 2 $471.4 million 27.2% $8,537 0.90 8.0%Alternative Baseline Model 3 $471.4 million 27.2% $22,385 1.457 2.4%Page 18
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