Medicare Cost Report (MCR)

A Medicare Cost Report (MCR) collects descriptive data, both Financial and Statistical in nature to identify if a facility has been over or Underpaid for Medicare patients. The data is also utilized to set Prospective payments. MCRs are in place for Institutional Providers, not Physicians, and remain the ONLY national data available for all types of providers, Profit, Not for Profit, and Governmental.

Typical providers are: Hospitals, SNFs, HHA, Hospice, Renal Dialysis centers, FQHC, and CAH (Critical Access Hospitals)

For this week, your assignment is to explore the role the MCR plays in a value-based health care system. Specifically, address issues included in the report like facility characteristics, utilization data, cost, and charges by cost center. Furthermore, choose two utilization metrics (data) and address how it has impacted the facility of your choice.

Please select a hospital setting. You must reference an actual MCR and Identify the facility you have chosen.

You will find all Indiana facilities (Feel free to also use a state of your choice) and their MCRs listed at this site—https://www.in.gov/isdh/27214.htm

To prepare for this Discussion:

Review the following website for more help in starting your paper: https://www.in.gov/isdh/27214.htm

Using the MCR Analyze the current economic trends both producing a loss and producing Revenue. What economic principles (macro and micro) are driving this shift? What element of the Medicare Cost Report did you find most valuable and why?

Post a cohesive response to the following:

Select a specific institution. Identify this institution and utilizing its published MCR to analyze costs and revenue of at least 3 specific departments. Then, evaluate the implications of this volume to the facility’s future income stream.

Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.