Acute services - State of Illinois

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Requested TAG AnalysesMedical Education Evaluation» Current inpatient methodology does not include separate claim-based direct or indirectmedical education payments; IME factor used to reduce outlier payments whencalculating claim costs» In the Revised Model (using SFY 2009 data), the 10 in-state general acute teachinghospitals with the highest FFY 2013 Medicare intern-to-bed ratio have a projected a$26.0 million combined payment increase (6.5% change) for acute services› 8 hospitals with a projected gain, 2 with a projected loss» In the Revised Model (using SFY 2009 data), the 10 in-state general teaching hospitalswith the highest Medicaid direct medical education costs (based on SFY 2009 claims)have a projected $23.3 million combined payment increase (3.9% change) for acuteservices› 6 hospitals with a projected gain, 4 with a projected lossPage 20
Requested TAG AnalysesCapital Cost Evaluation» Current inpatient methodology includes a capital per discharge add-onpayment (not acuity or length of stay adjusted)» In the Revised Model (using SFY 2009 data), the 10 in-state generalacute hospitals with the highest Medicaid capital costs (based on SFY2009 claims) have a projected $28.4 million combined paymentincrease (4.8% change) for acute services› 6 hospitals with a projected gain, 4 with a projected lossPage 21
Page 1 and 2: Illinois Department of Healthcarean
Page 3 and 4: Revised Inpatient Model withPolicy
Page 5 and 6: Revised Inpatient Model With Policy
Page 13 and 14: Shadow Pricing ModelsShadow Pricing
Page 15 and 16: Shadow Pricing ModelsShadow Pricing
Page 17 and 18: Requested TAG AnalysesRequested ana
Page 19: Requested TAG AnalysesTransplant Se
Page 23 and 24: Alternative Inpatient Model Update
Page 25 and 26: Transitional CorridorPage 25Example

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