2.1 Sources for cost data

Analogous to "list price" or "sticker price"

Average Wholesale Price (AWP)

Found in readily available sources such as the Redbook

Average Wholesale Price (AWP)

Much higher than actual acquisition cost

Average Wholesale Price (AWP)

Estimates of costs to wholesalers from the manufacturer

Wholesale Acquisition Cost (WAC)

Estimates do not include discounts

Wholesale Acquisition Cost (WAC)

Average amount paid to manufacturers by wholesalers after discounts are included

Average Manufacturer's Price (AMP)

More precise estimate of what buyers (pharmacies) pay for medications

Average Manufacturer's Price (AMP)

Calculations are proprietary and not available to the general public

Average Manufacturer's Price (AMP)

Which are some examples of Medical Services costs?

- Office visits

- Surgery

- Outpatient laboratory and surgical procedure

Medical Services: Which are some common sources for US reimbursement rates?

- The physician's Fee Reference

- Medicare reimbursement rate by CMS

What do Personnel costs include?

- The amount time spent in the activity

- Salary

- Fringe benefits

Hospitalization costs have _____ by the level of ________

4 methods, level of precision

Which of the following Hospitalization costs is the MOST PRECISE?

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

b. Micro-costing

Which of the following Hospitalization costs is the LEAST PRECISE?

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

c. Per diem

Which of the following Hospitalization costs is the SECOND LEAST PRECISE?

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

a. Disease-specific per diem

Which of the following Hospitalization costs is a relatively available and often-used method?

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

d. Diagnosis-related group

Hospitalization costs: For each day that a patient is in a hospital setting, an average cost per day for ALL types of hospitalizations is used by a multiplier

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

c. Per diem

Hospitalization costs: If the average cost reimbursement per day for hospitalizations of the cardiac bypass surgery case = $10,000 per day

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

a. Disease-specific per diem

Hospitalization costs: The average reimbursement for each ___ can be used to approximate the cost to the payer.

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

d. Diagnosis-related group

Hospitalization costs: Involve collecting information on resource use for each component of a hospitalization (Medications, Laboratory services, Procedures).

a. Disease-specific per diem

b. Micro-costing

c. Per diem

d. Diagnosis-related group

b. Micro-costing