Acute services - State of Illinois

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Revised Inpatient Model With Policy AdjustersAcute services (continued)» Policy adjuster of 15% applied to DRG base payments fornewborn/OB services as follows:› Normal newborn DRGs: identified based on APR-DRGs 626 and 640› Neonate DRGs: identified based on non-normal newborn DRGs in MDC 15(Newborns and other neonates with condition originating in perinatal period)› Obstetric DRGs: identified based on MDC 14 (Pregnancy, childbirth and thepuerperium)» Acute pediatric services were also evaluated, but because theseservices already had a projected payment increase, no policyadjuster was applied in the modelPage 8
Revised Inpatient Model With Policy AdjustersPsychiatric services» For COS 21 psychiatric services, revised model components include:› Psychiatric-specific standardized per diem rate of $366.45,adjusted for FFY 2012 Medicare IPF-PPS wage index and ruralstatus› Removed relative weight and graduated day adjustments» Baseline model (without policy adjusters) projected a $19.6 milliondecrease in payments (23.0% reduction) for pediatric psychiatricservices› Policy adjuster of 30% applied to per diem payments forpsychiatric pediatric services to maintain current funding levelsPage 9
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 7: Revised Inpatient Model With Policy
Page 11 and 12: 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 and 20: Requested TAG AnalysesTransplant Se
Page 21 and 22: Requested TAG AnalysesCapital Cost
Page 23 and 24: Alternative Inpatient Model Update
Page 25 and 26: Transitional CorridorPage 25Example

Acute services - State of Illinois

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