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OCA, RAND outline new inpatient and outpatient hospital spending measures and data steps
Summary
OCA and RAND proposed parallel measures — inpatient revenue per case‑mix adjusted discharge and outpatient revenue per intensity‑adjusted visit — and described facility crosswalks to HPD claims, APC‑based outpatient intensity, and next steps to validate samples and post a facility‑to‑NPI crosswalk.
The Office of Health Care Affordability on Wednesday unveiled a methodology to measure hospital inpatient and outpatient unit prices using hospital financial disclosures, HPD claims/encounter data and established intensity adjustments.
For inpatient services, OCA will calculate case‑mix adjusted discharges (CMAD) by multiplying inpatient discharges by a case‑mix index (CMI) from the patient discharge dataset and then dividing inpatient net patient revenue by CMAD to produce inpatient net patient revenue per CMAD.
For outpatient services, RAND and OCA described computing an Average Visit…
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