Medicare : alternatives for computing payments for hospital outpatient surgery: report to the congressional requesters
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$1,000 In alternative $1,400 Less beneficiary $600 Blend factor $700 ASC payment 300 Medicare blended 400 Preblend amount Amount for Hospital amount to produce arrive at Medicare's ASC payment amount base beneficiary coinsurance beneficiary coinsurance 400 beneficiary coinsurance amount Beneficiary payment beneficiary share Billed charges $2,000 Blend factor x.5 blended amount $1,000 blended payment amount cataract surgery charges are converted coinsurance 400 Preblend computing the blended converted to Medicare-allowable cost-reporting period cost-to-charges x.7 Current law Alternative current payment methodology current payment system facility charge facility payment $740 factor x ficiary coinsurance final cost settlement hcfa officials hospital outpatient surgery hospital's cost-to-charge ratio Less beneficiary coinsurance Medicare blended amount Medicare facility payment Medicare payment Medicare program Medicare-allowable costs $1,400 outpa payment amount $480 payment to hospital Preblend amount $1,000 produce a blended prospective payment system ratio of cost-to-charges reduce Medicare surgery performed surgical procedure system for hospital three alternatives total hospital payment