Milwaukee Regional Health System [Case 30, P.193].
1. Using the template in exhibit 30.1, add one additional benchmark and one defect benchmark for each revenue cycle function listed.
b. Describe each metric in the completed template, and justify choosing these benchmarks over the alternatives listed in exhibit 30.2.
2. Compare the benchmark values in your completed template with the actual MRHS metric values given in exhibit 30.3. Discuss your results. Most important, suggest what actions might be implemented to improve revenue cycle performance.
3. Complete the reimbursement amount template provided in the case for CPT 73722 (MRI of the knee) and MS-DRG 470 (major joint replacement). Discuss the fairness and efficiency of the current fragmented reimbursement system to providers, insurers, patients, and society (the ultimate bearers of healthcare costs).
b. Assume that MRHS’s payer mix is 46 percent Medicare, 34 percent commercial/managed care, 16 percent Medicaid, and 4 percent self-pay/no insurance. Calculate the average expected payment for each of the two procedures
There are also questions in this google docs excel sheet. I have done the first page.
