Background
Methods
Study data and methods
Calculation of TRICARE payments
Statistical analysis
Results
1 (lowest) | 2 | 3 | 4 | 5 (highest) | Difference (% of 1st quintile) | ||
---|---|---|---|---|---|---|---|
PHR | Price standard | $14,228 | $15,796 | $16,989 | $18,706 | $28,613 | $14,385 (101%) |
+ case-mix | $15,039 | $16,042 | $17,049 | $18,486 | $26,216 | $11,177 (74%) | |
PKR | Price standard | $15,562 | $16,851 | $18,151 | $19,718 | $29,512 | $13,950 (90%) |
+ case-mix | $16,046 | $17,111 | $18,157 | $19,559 | $28,037 | $11,990 (75%) | |
CABG | Price standard | $33,205 | $38,170 | $43,085 | $49,830 | $68,076 | $34,870 (105%) |
Surgery | + case-mix | $35,801 | $39,256 | $42,980 | $47,518 | $59,360 | $23,558 (66%) |
Lumbar | Price standard | $26,253 | $29,777 | $32,641 | $35,928 | $49,961 | $23,707 (90%) |
Spinal Fusion | + case-mix | $27,271 | $30,337 | $32,694 | $35,256 | $47,210 | $19,939 (73%) |
Colectomy | Price standard | $18,458 | $23,940 | $27,761 | $33,850 | $46,939 | $28,480 (154%) |
+ case-mix | $23,152 | $25,726 | $28,340 | $31,670 | $37,994 | $14,842 (64%) |
DRG | Cost | Quintile (Total payments, by HRR quintile ($)) | Difference | ||||
---|---|---|---|---|---|---|---|
1 (Lowest) | 2 | 3 | 4 | 5 (Highest) | |||
Colectomy | Index hosp. | 13,466 | $15,591 | $17,509 | $20,067 | $27,141 | $13,674 |
Readmissions | $1626 | $9949 | $10,892 | $12,722 | $18,883 | $17,257 | |
Phys. fees | $5019 | $5457 | $5814 | $6371 | $7320 | $2301 | |
Post-acute | $1179 | $1370 | $1539 | $1750 | $2194 | $1014 | |
PKR | Index hosp. | $10,568 | $11,434 | $12,172 | $13,393 | $21,893 | $11,324 |
Readmissions | $0 | $8449 | $9645 | $10,818 | $14,278 | $14,278 | |
Phys. fees | $3830 | $4259 | $4521 | $4762 | $5306 | $1475 | |
Post-acute | $840 | $952 | $986 | $1031 | $1138 | $298 | |
PHR | Index hosp. | $10,588 | $11,403 | $12,165 | $13,324 | $21,611 | $11,022 |
Readmissions | $0 | $10,793 | $11,528 | $12,262 | $13,885 | $13,885 | |
Phys. fees | $3303 | $3494 | $3597 | $3767 | $4026 | $722 | |
Post-acute | $534 | $593 | $625 | $656 | $732 | $197 | |
Lumbar | Index hosp. | $18,872 | $21,506 | $22,994 | $25,793 | $37,705 | $18,833 |
Spinal | Readmissions | $0 | $6970 | $8507 | $10,082 | $14,607 | $14,607 |
Fusion | Phys. fees | $6463 | $7343 | $7882 | $8418 | $9746. | $3282 |
Post-acute | $421 | $550 | $629 | $743 | $974 | $553 | |
CABG | Index hosp. | $26,339 | $28,848 | $32,877 | $36,945 | $48,867 | $22,527 |
Surgery | Readmissions | $0 | $7175 | $8827 | $9946 | $13,289 | $13,289 |
Phys. fees | $5877 | $6596 | $7088 | $7714 | $8571 | $2693 | |
Post-acute | $1110 | $1298 | $1433 | $1615 | $2129 | $1019 |