Transcript www.healthcareaffiliates.com

Area Wage Index
September 17, 2003
Outline
Session I



Overview
Current Area Wage Index Facts & Calculations
MSA Specifics and Profiles
Session II





Sleeping Dogs and Edit Checks
Hot Topics & Changes on the Horizon
Geographic Reclassification
Occupational Mix Survey
S-3 Samples
Overview
Healthcare Affiliates, Inc is a national healthcare
reimbursement consulting firm specializing in
governmental reimbursement issues associated with
Medicare/Medicaid , Blue Cross and other payors.
Since 1992 we have performed close to 1,000 consulting
engagements associated with wage index issues alone.
Our primary services are:
 Area Wage Index (AWI) annual reviews
 Disproportionate Share Reviews and SSI appeals
 Cost Report IME, DGME and ESRD Reviews
 Healthcare Employee Benefit Reviews
 Specialized Billing Issues
CURRENT WAGE INDEX
FACTS & CALCULATIONS
Presented by
Healthcare Affiliates, Inc
Cost Reporting Data Used For the
Wage Index By Year
Data for FFY 2001 (cost reporting periods beginning October
1, 2000 through September 30, 2001) will be used for FFY
2005 wage index computation.
For short periods beginning October 1, 2000 through
September 30, 2001, CMS uses the longest period, or if two
periods are the same length, the most recent period. CMS
annualizes short period data.
Table of Hospitals with Various
Fiscal Year Ends
Hospital FYE
Inpatient Acute Care
Acute Outpatient, Home
Rehab& Long Term Care
Health, Hospice & SMF
Sept 30, 2000
FFY 2004
Calendar 2004
Dec 31, 2000
FFY 2004
Calendar 2004
April 30, 2001
FFY 2004
Calendar 2004
June 30, 2001
FFY 2004
Calendar 2004
Aug 31, 2001
FFY 2004
Calendar 2004
Sept 30, 2001
FFY 2005
Calendar 2005
Dec 31, 2001
FFY 2005
Calendar 2005
April 30, 2002
FFY 2005
June 30, 2002
FFY 2005
Aug 31, 2002
FFY 2005
For Medicare geographic reclassification purposes the wage index data is used to satisfy the
criteria for a wage index reclassification for the subsequent FFY to the payment year. This
means that the most recent wage index data available at the filing date is used for
reclassification purposes.
AWI Facts
AWI factor is multiplied times the labor portion of
the DRG base amount. This is 71% of the base
DRG calculation. (Proposed to be higher)
AWI will, in FFY 2005, impact DRG’s, Outpatient
PPS, SNF, etc.
In FFY 2005 the reduction for Medical Education
cost will be at 100%. (Part of “Behind the Sheet
Adjustment)
Changes have been made in the overhead
calculation (Part of “Behind the Sheet Adjustment)
AWI Facts
National average has been moving approximately
3% a year. It grew by 6.8% last year.
CMS has shortened time frames for Hospital
corrections from May to March to February to
November. Because of the reduced time frame,
these months play havoc with a hospital’s
responses.
Hospitals in their respective MSAs need to work
together. Now!
AWI Facts
FIs have edit checks that direct their attention to increases above
a certain percentage, their edit checks do not direct them to
decreases of any size. (For instance, in FFY 2000, there were
147 hospitals nationwide with $0 for fringes. Forty-seven (47)
of those hospitals were in Texas. In FFY 2001,there were still 34
w/o Fringes. In FFY 2003 there were 3 hospitals with $1 in
WRC. In FFY 2004, there is 1 hospital with $1 in WRC and 60
with under 10% WRC.
The data supplied herein is from various data sources, most from
CMS.
Of 4,784 hospitals in the latest PUF, 333 were not adjusted
1759 were adjusted after 1/1/03 with all but 124 after 2/2/03
Florida had 94 after 1/1/03 – out of 182 hospitals
Additional “errors”: there are 13 hospitals with over 40% WRC
and 1 at 72%.
There is a hospital in Texas with a $9.25 rate.
Sample Area Wage Index
Hosp A
Salaries/WRCs
$40,000,000
%
40
Hours
2,000,000
AHW
$20.00
Impact
$8.00
Hosp B
$20,000,000
20
1,100,000
$18.18
$3.62
Hosp C $30,000,000
30
1,600,000
$18.75
$5.61
Hosp D
$10,000,000
10
505,000
$19.80
$1.98
Total
$100,000,000
100
5,205,000
$19.21
$19.21
National Average
MSA’s AWI
$19.21/$20.00 0.9605
$20.00
If Hospital A increases by $1.00, this would equal a $0.40 increase (40% X $1) to MSA and an AWI
change to .9805 ($19.61/$20.00). This is a positive increase of 2% to entire MSA.
To get this same impact we would have to move Hospital D $4.00, or Hospital B $2.00, or Hospitals
C + D $1.00 each.
Uses of Medicare Wage Index
INPATIENT
Standardized Amount (eff) 10/1/03) – Applicable to DRG Payment pre Discharge
Other Urban and Rural
(same as Large Urban 4/1/03 – 9/30/03)
Large Urban (over 1 Million)
71%
Labor
Related
$3,145
X .9807
$2,963.98
29%
Non-Labor 100%
Related
Total
$1,279
$4,424
$1,226.48
$4,192.46
71%
29%
Labor
Non-Labor
Related
Related
$3,095
$1,259
X .9807
$2863.98
$1,228.48 $4,192.46
Note: Congress is expected to legislate use of large urban standardized amount for all hospitals.
“Geographic adjustment factor” (GAF) is computed from the wage index. Wage index to
the power .6848.
The wage index also affects Disproportionate Share Payments (DSH) and Indirect
Medical Education (IME) and the adjustment factor for the labor
related portion of outpatient prospective payment is 60% rather than 71%.
100%
Total
$4,354
Uses of Medicare Wage Index
OTHER
The wage index is also used for SNF, Home Health, Hospice,
ambulatory surgical centers, and rehabilitation hospitals (or units).
In Summary
The wage index is a primary determinant of Medicare Payments.
Wage Index Examples:
Highest: Oakland, CA
Average:
Lowest: Dothan, AL
Wage Index
1.5058
1.0000
.7734
Wage Data Corrections
4 Year Old Data from Worksheet S-3

FFY 2004 Wage Index based on FFY 2000 data
Increased Volume of Corrections
1997 Wage Index: 13% of hospitals
 2001 Wage Index: 32% of hospitals
 2002 Wage Index: 30% of hospitals

Desk Audit Issues
Inconsistencies among auditors, FIs
Definition of self-insurance.
Calculations of costs under GAAP.
Allocation of wage costs to exclude units
(salaries v. hours).
Reasonable, Sample, AWI vs. cost report,
Refiling CR, overall documentation, etc.
Appeal Rights
CMS policy: no appeal to PRRP to challenge
incorrect wage data if hospital failed to comply
with all steps of data verification process.
Expedited Judicial Review
Midyear Corrections
Only if hospital can show FI or CMS error in tabulating
data and hospital did not know or have opportunity to
correct prior to start of FFY
Corrected WI applied prospectively only.
Hospitals can not seek correction of another hospitals
wage data in this process.
Does not preclude hospitals from appealing to challenge
WI based on erroneous data (if procedures followed).
Comparability of Wage Data
Statute requires comparison of area’s wage leve
to national average wage level.
Wage Index Appeals
Timing: 180 days from publication of final
wage index.
Group Appeal?
Expedited Judicial Review?
Relief: Retrospective or Prospective.
Area Wage Index Calendar
Audit/desk review 10/1 to 11/15 Not Happening
Hospital review of adjustments 11/15 to 11/25 9/15 to 11/15
FI submits data to HCRIS file 11/26/02 Early Feb
Updated HCRIS file released 1/8/03 Adjustments to Adjustments 3/8
Last day for Hospital to update and document 2/8/03 Initial 11/15, A to A 3/8
Last day for FI to transmit final data 4/9/04
First “preliminary” release 6/5/04
Correction of transmission errors only 7/5/04
Final rate publication 8/1/04
Rates go into effect 10/1/04
Note: This schedule may be compressed because #’s 9 and 10 can not change
Area Wage Index Calendar
Our suggestions: Get your MSA organized
1.
Prioritize Hospitals and MSA’s
a.
Hospitals that dropped for FY 2004 or prior
b.
Hospitals with apparent issues
c.
Hospitals with “hits” (teach, I/R, CRNA, other)
2.
Prepare and perform field work now on #1’s.
3.
Handle all questions
4.
Review S-3’s as adjusted by FI for Hospitals not addressed in #1 above.
Reasons:
Data available now
Avoid delays from FI’s side
Ensures multiple levels of review
Still allows for additional changes later
Not yet
Still
No
No
AWI Calendar
Timeframe
Steps in Wage Index Development Process
Mid-September
Preliminary and unaudited wage data file published as a public use file (PUF) on
CMS website.
Mid-November
Deadline for hospitals to send requests for revisions to fiscal intermediaries.
Early February
Fiscal intermediaries review revisions and desk review wage data; notify
hospitals of changes and resolution of revision requests; and submit preliminary
revised data to CMS.
Early March
Deadline for hospitals to request wage data reconsideration of desk review
adjustments and provide adequate documentation to support the request.
Early AprilDeadline for the fiscal intermediaries to submit additional revisions resulting
from the hospitals' reconsideration requests.This is also the deadline for
hospitals to request CMS intervention in cases where the hospital disagrees with
the fiscal intermediary's policy interpretations.
Early May*
Release of final wage data PUF on CMS web site.
Early June*
Deadline for hospitals to submit correction requests, to both CMS and their
fiscal intermediary, for errors due to the mishandling of the final wage data by
CMS or the fiscal intermediary.
National Information
MSA
Location
FFY 04
FFY 03
FFY 04
variance Variance 8/1/2003 8/1/2002
8080-2 Steubenville-Weirton, OH-WV
6020-2 Parkersburg-Marietta, WV
1900-2 Cumberland, MD-WV
4600
Lubbock, TX
6740
Richland-Kennewick-Pasco, WA
6323
Pittsfield, MA
8003
Springfield, MA
1400
Champaign-Urbana, IL
2750
Fort Walton Beach, FL
7485
Santa Cruz-Watsonville, CA
0600
Augusta-Aiken, GA-SC
3350
Houma, LA
2985
Grand Forks, ND
9000-2 Wheeling, WV
8750
Victoria, TX
3620
Janesville-Beloit, WI
3520
Jackson, MI
0860
Bellingham, WA
3980
Lakeland-Winter Haven, FL
0875
Bergen-Passaic, NJ
8920
Waterloo-Cedar Falls, IA
1350
Casper, WY
4900
Melbourne-Titusville-Palm Bay, FL
5600
New York, NY
6280
Pittsburgh, PA
5280
Muncie, IN
3920
Lafayette, IN
6360
Ponce, PR
6340
Pocatello, ID
1540
Charlottesville, VA
C
8/1/01
8/1/00
7/30/1999
7/31/1998
8/29/1997
-0.8804
0.0167
0.8804
0.8637
.8548
0.8649
0.8537
0.8645
-0.8613
-0.0055
0.8613
0.8668
.8670
0.8414
0.8537
0.8434
-0.7975
-0.0331
0.7975
0.8306
.8369
0.9096
0.8574
0.8822
-0.1408
0.1183
0.8238
0.9646
0.8463
.8838
0.8411
0.8514
0.8400
-0.0925
0.0531
1.0566
1.1491
1.0960
1.1460
1.1224
1.0512
1.0221
-0.0898
-0.0166
1.0390
1.1288
1.1454
1.1204
1.1369
1.0857
1.0960
-0.0869
-0.0166
1.0419
1.1288
1.1454
1.1204
1.1369
1.0857
1.0718
-0.0768
0.1329
0.9867
1.0635
0.9306
.9198
0.9163
0.8789
0.8824
-0.0763
0.0691
0.8930
0.9693
0.9002
.9607
0.8986
0.8896
0.8838
-0.0756
-0.0324
1.2890
1.3646
1.3970
1.4095
1.3927
1.4011
1.4187
-0.0677
0.0294
0.9587
1.0264
0.9970
.9160
0.9013
0.9253
0.9333
-0.0645
0.0410
0.7740
0.8385
0.7975
.8086
0.7837
0.8215
0.7854
-0.0642
0.0124
0.8601
0.9243
0.9119
.8954
0.9097
0.8918
0.8815
-0.0627
-0.0055
0.7986
0.8613
0.8668
.8670
0.8649
0.7892
0.7966
-0.0605
0.0428
0.8151
0.8756
0.8328
.8154
0.8378
0.8400
0.8474
-0.0583
0.0110
0.9266
0.9849
0.9739
.9585
0.9656
0.9071
0.8824
-0.0582
0.0275
0.8950
0.9532
0.9257
.9134
0.8840
0.9244
0.9052
-0.0572
0.0456
1.1710
1.2282
1.1826
1.1439
1.1394
1.1459
1.1221
-0.0534
0.0290
0.8823
0.9357
0.9067
.8928
0.8986
0.8896
0.8838
-0.0524
0.0399
1.1683
1.2207
1.1808
1.1605
1.1833
1.1774
1.1570
-0.0520
0.0225
0.8382
0.8902
0.8677
.8802
0.8841
0.8350
0.8643
-0.0519
0.0194
0.9171
0.9690
0.9496
.8817
0.9199
0.9170
0.9013
-0.0517
0.0340
0.9736
1.0253
0.9913
.9688
0.9296
0.9236
0.8838
-0.0501
-0.0013
1.3913
1.4414
1.4427
1.4651
1.4517
1.4431
1.3982
-0.0500
-0.0195
0.8865
0.9365
0.9560
.9741
0.9634
0.9809
0.9725
-0.0496
-0.0655
0.8788
0.9284
0.9939
1.0969
1.0834
0.9434
0.9173
-0.0490
0.0157
0.8788
0.9278
0.9121
.8834
0.8809
0.8928
0.9174
-0.0480
-0.0049
0.4689
0.5169
0.5218
.5006
0.4971
0.4799
0.4589
-0.0462
0.0226
0.9212
0.9674
0.9448
.9076
0.8973
0.8811
0.9586
-0.0453
-0.0128
0.9985
1.0438
1.0566
1.0789
1.0573
1.0294
0.9051
MSA’S SPECIFICS
AND PROFILES
Presented by
Healthcare Affiliates, Inc
Florida MSA's AWI Impact
MSA
Location
8/29/1997
7/31/1998
7/30/1999
8/1/2000
8/1/2001
2020
2680
Daytona Beach, FL
0.8838
0.9153
Ft. Lauderdale, FL
1.0487
0.9867
2700
Fort Myers-Cape Coral, FL
0.8838
2710
Fort Pierce-Port St. Lucie, Fl
2750
Fort Walton Beach, FL
2900
8/1/2002
0.8986
.9147
0.8972
0.9062
1.0172
1.0152
1.0784
1.0704
0.8936
0.8986
.9247
0.9374
0.9680
1.0257
1.0263
1.0109
.9622
1.0214
0.9931
0.8838
0.8896
0.8986
.9607
0.9002
0.9693
Gainesville, FL
0.9616
0.9482
1.0102
1.0074
0.9481
0.9871
3600
Jacksonville, FL
0.8969
0.8919
0.8986
.9208
0.9223
0.9381
3980
Lakeland-Winter Haven, FL
0.8838
0.8896
0.8986
.8928
0.9067
0.9357
4900
Melbourne-Titusville-Palm Bay, FL 0.8838
0.9236
0.9296
.9688
0.9913
1.0253
5000
Miami, FL
0.9859
1.0038
1.0233
1.0059
0.9950
0.9815
5345
Naples, FL
1.0109
1.0199
0.9839
.9661
0.9699
0.9754
5790
Ocala, FL
0.9032
0.9172
0.9615
.9243
0.9556
0.9402
5960
Orlando, FL
0.9397
0.9834
0.9806
.9610
0.9642
0.9640
6015
Panama City, FL
0.8838
0.8896
0.9169
.9010
0.9061
0.8865
6080
Pensacola, FL
0.8838
0.8896
0.8986
.8928
0.8794
0.8814
6580
Punta Gorda, FL
0.8838
0.9050
0.9508
.9613
0.9015
0.9218
7510
Sarasota-Bradenton, FL
0.9757
0.9553
0.9905
.9809
1.0090
0.9449
8240
Tallahassee, FL
0.8838
0.8896
0.8986
.8928
0.8794
0.8814
8280
Tampa-St. Petersburg-Clearwater, FL
0.9196
0.9203
0.9119
.9099
0.8925
0.9171
8960
West Palm Beach-Boca Raton, FL 1.0309
1.0203
0.9951
.9615
0.9777
0.9939
8/1/2003
0.9024
1.0436
0.9776
1.0083
0.8930
0.9653
0.9490
0.8823
0.9736
0.9854
0.9750
0.9689
0.9615
0.8819
0.8819
0.9472
0.9931
0.8819
0.9066
0.9759
Var
-0.0038
-0.0268
0.0096
0.0152
-0.0763
-0.0218
0.0109
-0.0534
-0.0517
0.0039
-0.0004
0.0287
-0.0025
-0.0046
0.0005
0.0254
0.0482
0.0005
-0.0105
-0.0180
-0.1269
10
Florida Rurals
0.8896
0.8986
.8928
0.8794
0.8814
0.8819
0.0005
Florida MSAs
Florida MSAs
Sarasota-Bradenton
Fort Pierce-Port St. Lucie
1.0700
Panama City
Ocala
Miami
Ft. Lauderdale
Orlando
1.0200
Wage Index
Pensacola
Tallahassee
Naples
Daytona Beach
0.9700
Jacksonville
West Palm Beach-Boca Raton
Punta Gorda
Tampa-St. Petersburg-Clearwater
Lakeland-Winter Haven
0.9200
Fort Myers-Cape Coral
Melbourne-Titusville-Palm Bay
Gainesville
Fort Walton Beach
0.8700
1998
1999
2000
2001
2002
2003
2004
Daytona Beach
prov num name
msa
100014
BERT FISH MEDICAL CENTER 2020
100017
HALIFAX MEDICAL CENTER
100045
MEMORIAL HOSPITAL WEST VOLUSIA
2020
100068
ATLANTIC MED CTR ORMOND2020
100072
FLORIDA HOSPITAL/ FISH MEMORIAL
2020
100118
MEMORIAL HOSPITAL FLAGLER
2020
100169
MEMORIAL HOSPITAL ORMOND
2020
BEACH
100229
ATLANTIC MED. CENTER DAYTONA
2020
MSA 2020
2020
Wage Index
2000
$19.84
$17.77
$20.76
$18.65
$19.22
$19.76
$20.77
$18.21
2001
$19.80
$19.06
$20.92
$19.93
$21.02
$22.87
$20.95
$19.69
2002
$19.58
$19.87
$21.02
$19.83
$20.60
$20.73
$20.30
$18.24
2003
$21.99
$20.14
$22.81
$19.96
$22.03
$21.71
$21.64
$19.73
$21.25
2004 % of MSA Impact
$21.75
0.0859
1.8685
$21.19
0.4289
9.0886
$25.22
0.1025
2.5850
$23.78
0.0310
0.7379
$23.53
0.0913
2.1485
$24.11
0.0468
1.1294
$23.45
0.1613
3.7829
$21.00
0.0522
1.0958
$22.38
1.0000
22.44
0.8986
0.9147
0.8972
0.9062
0.9024
Daytona Beach
Ft. Lauderdale
Ft. Lauderdale
1.0784
1.0704
1.0700
1.0487
1.0436
Wage Index
1.0200
1.0172
1.0152
0.9867
0.9700
0.9200
0.8700
1998
1999
2000
2001
2002
2003
2004
Ft. Lauderdale
prov num name
100038
100039
100056
100073
100086
100167
100189
100200
100210
100224
100225
100228
100230
100237
100276
100281
2000
MEMORIAL REGIONAL HOSPITAL
2680
$24.79
BROWARD GENERAL HOSPITAL
2680
$20.25
CLEVELAND CLINIC HOSPITAL2680
$23.65
HOLY CROSS HOSPITAL
2680
$18.15
NORTH BROWARD MEDICAL CENTER
2680
$21.16
Plantation General
2680
$21.81
NORTHWEST MEDICAL CENTER
2680
$21.01
IMPERIAL POINT MEDICAL CENTER
2680
$22.26
FLORIDA MEDICAL CENTER 2680
$19.18
UNIVERSITY HOSPITAL
2680
$24.70
HOLLYWOOD MEDICAL CENTER
2680
$20.65
COLUMBIA WESTSIDE REGIONAL
2680MED CTR $23.70
MEMORIAL HOSPITAL PEMBROKE
2680
$20.60
NORTH RIDGE MEDICAL CENTER
2680
$22.93
CORAL SPRINGS MEDICAL CENTER
2680
$21.98
MEMORIAL HOSPITAL WEST 2680
$22.02
2001
$23.36
$21.53
$25.79
$21.19
$21.70
$23.41
$21.31
$22.46
$21.36
$20.03
$20.68
$21.32
$20.51
$22.09
$22.36
$22.44
2002
$24.59
$21.79
$21.85
$22.28
$23.37
$23.30
$26.60
$23.87
$21.85
$21.86
$21.51
$20.88
$22.57
$23.24
$24.10
$23.01
2003
$24.95
$23.31
$23.17
$22.24
$24.31
$25.77
$27.13
$24.89
$23.04
$22.36
$22.46
$24.97
$23.42
$23.27
$24.83
$23.47
$23.97
2004 % of MSA Impact
$25.79
0.2135
5.5068
$23.80
0.1191
2.8343
$25.92
0.0277
0.7191
$23.58
0.1362
3.2127
$25.23
0.0700
1.7651
$26.45
0.0386
1.0211
$26.68
0.0318
0.8486
$24.81
0.0332
0.8246
$26.09
0.0578
1.5085
$23.08
0.0373
0.8615
$23.99
0.0216
0.5174
$26.25
0.0327
0.8584
$25.05
0.0261
0.6542
$26.76
0.0430
1.1513
$25.45
0.0426
1.0847
$25.33
0.0686
1.7382
$25.11
1.0000
25.11
1.0172
1.0152
1.0784
1.0704
1.0436
MSA 2680
msa
Wage Index
Ft. Myers – Cape Coral
Fort Myers-Cape Coral
1.0300
1.0100
0.9900
0.9776
Wage Index
0.9700
0.9680
0.9500
0.9374
0.9300
0.9247
0.9100
0.8986
0.8936
0.8900
0.8838
0.8700
1998
1999
2000
2001
2002
2003
2004
Fort Myers – Cape Coral
prov num name
msa
100012
LEE MEMORIAL HOSPITAL
2700
MSA 2700
Wage Index
100107
100220
100244
100279
2000
$18.52
EAST POINTE HOSPITAL
2700
$18.01
REGIONAL MEDICAL CENTER 2700
SOUTHWEST FL
$19.91
CAPE CORAL HOSPITAL
2700
$17.41
GULF COAST HOSPITAL
2700
$23.02
2001
$19.62
$20.13
$21.28
$18.62
$22.91
2002
$20.47
$20.07
$21.82
$20.54
$22.59
2003
$22.02
$21.76
$24.62
$21.44
$23.18
$22.60
2004 % of MSA Impact
$24.26
0.5290 12.8344
$23.37
0.0514
1.2018
$24.97
0.2023
5.0507
$23.48
0.1614
3.7894
$24.84
0.0559
1.3881
$24.25
1.0000
24.26
0.8986
0.9247
0.9374
0.9680
0.9776
Fort Pierce-Port St. Lucie
Fort Pierce-Port St. Lucie
prov num name
100044
100246
100260
2000
MARTIN MEMORIAL MEDICAL 2710
CENTER
$21.14
LAWNWOOD REGIONAL MEDICAL
2710CENTER $21.22
COLUMBIA MED. CTR. PORT ST.
2710
LUCIE
$21.22
2001
$21.48
$19.64
$21.05
2002
$22.72
$21.92
$24.92
2003
$22.95
$23.56
$21.24
$22.58
2004 % of MSA Impact
$23.99
0.5537 13.2831
$26.76
0.2914
7.7967
$23.51
0.1550
3.6429
$24.72
1.0000
24.72
1.0109
0.9622
1.0214
0.9931
1.0083
MSA 2710
msa
Wage Index
Fort Walton Beach
Fort Walton Beach
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9693
0.9607
0.9500
0.9300
0.9100
0.9002
0.8986
0.8930
0.8900
0.8896
0.8838
0.8700
1998
1999
2000
2001
2002
2003
2004
Fort Walton Beach
prov num name
msa
FT WALTON BEACH MEDICAL 2750
CENTER
2000
$18.19
$18.06
$18.76
2001
$23.55
$19.88
$20.63
2002
$21.15
$19.26
$20.22
2003
$20.96
$24.98
$21.90
$22.61
2004 % of MSA Impact
$22.03
0.1529
3.3677
$24.18
0.2885
6.9749
$21.24
0.5587 11.8662
$22.15
1.0000
22.21
100054
TWIN CITIES HOSPITAL
2750
100122
NORTH OKALOOSA MEDICAL CENTER
2750
100223
MSA 2750
0.8986
0.9607
0.9002
0.9693
0.8930
Wage Index
Gainesville
Gainesville
1.0300
1.0100
1.0102
1.0074
0.9900
0.9871
Wage Index
0.9700
0.9653
0.9616
0.9500
0.9482
0.9481
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Gainesville
prov num name
100113
100204
2000
SHANDS TEACHING HOSPITAL2900
AND CLINICS$22.26
NORTH FLORIDA REGIONAL MED
2900CNTR
$20.20
2001
$23.20
$20.90
2002
$21.35
$20.22
2003
$23.34
$21.19
$22.27
2004 % of MSA Impact
$24.36 0.8203 19.9818
$22.26 0.1797 4.0007
$23.94
1.0000
23.98
1.0102
1.0074
0.9481
0.9871
0.9653
MSA 2900
msa
Wage Index
Jacksonville
Jacksonville
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9500
0.9490
0.9381
0.9300
0.9208
0.9223
0.9100
0.8986
0.8969
0.8919
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Jacksonville
prov num name
msa
ORANGE PARK MEDICAL CENTER
3600
2000
$17.69
$18.64
$20.06
$17.88
$18.86
$17.35
$19.40
$15.12
$20.91
$24.86
2001
$19.58
$19.04
$20.37
$19.15
$20.76
$17.14
$21.61
$18.51
$22.30
$20.69
2002
$20.22
$18.63
$20.56
$19.77
$20.70
$19.06
$23.85
$19.30
$23.08
$21.88
2003
$22.01
$19.52
$20.67
$21.04
$21.31
$20.23
$26.61
$21.25
$23.96
$22.73
$21.93
2004 % of MSA Impact
$22.61
0.1113
2.1400
$22.46
0.2060
4.6274
$23.62
0.2256
5.3275
$22.58
0.0884
1.9956
$23.91
0.0390
0.9328
$22.51
0.0203
0.4575
$26.64
0.1401
3.7312
$0.00
0.0000
0.0000
$24.18
0.1171
2.8307
$23.87
0.0623
1.4865
$23.54
1.0000
23.54
MSA 3600
0.8986
0.9208
0.9223
0.9381
0.9490
100001
UNIVERSITY MEDICAL CENTER,
3600
INC.
100040
ST. VINCENT'S MEDICAL CENTER
3600
100088
BAPTIST MEDICAL CENTER
3600
100090
FLAGLER HOSPITAL, INC.
3600
100117
BAPTIST MEDICAL CTR. BEACHES
3600
100140
BAPTIST MEDICAL CTR. NASSAU
3600
100151
ST. LUKE'S HOSPITAL ASSOCIATION
3600
100170
METHODIST MEDICAL CENTER
3600
100179
MEMORIAL HOSPITAL OF JACKSONVILLE
3600
100226
Wage Index
Lakeland-Winter Haven
Lakeland-Winter Haven
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9500
0.9357
0.9300
0.9100
0.9067
0.8986
0.8900
0.8928
0.8896
0.8838
0.8823
0.8700
1998
1999
2000
2001
2002
2003
2004
Lakeland-Winter Haven
prov num name
msa
2001
$17.95
$15.78
LAKELAND REGIONAL MEDICAL
3980
CENTER
2000
$16.19
$15.30
$19.34
$19.05
$21.03
100052
WINTER HAVEN HOSPITAL
3980
100099
LAKE WALES MEDICAL CENTER
3980
100121
BARTOW
100137
HEART OF FLORIDA REG'L MEDICAL
3980 CTR.
100157
MSA 3980
0.8986
3980
Wage Index
$18.70
$22.67
2002
$18.18
$15.76
$18.58
$19.56
$22.62
2003
$19.66
$16.53
$19.90
$20.90
$24.22
$20.24
2004 % of MSA Impact
$20.59
0.3687
7.5912
$18.52
0.0436
0.8080
$23.11
0.0314
0.7263
$20.40
0.0641
1.3075
$23.10
0.4922 11.3690
$21.76
1.0000
21.80
0.8928
0.9067
0.9357
0.8823
Melbourne-Titusville Palm Bay
Melbourne-Titusville-Palm Bay
1.0300
1.0253
1.0100
0.9913
0.9900
0.9736
Wage Index
0.9700
0.9688
0.9500
0.9300
0.9296
0.9236
0.9100
0.8900
0.8838
0.8700
1998
1999
2000
2001
2002
2003
2004
Melbourne-Titusville Palm Bay
prov num name
msa
100019
HOLMES REG'L MEDICAL CENTER
4900
100028
PARRISH MEDICAL CENTER 4900
100092
WUESTHOFF MEMORIAL HOSPITAL
4900
100177
CAPE CANAVERAL HOSPITAL,4900
INC.
2000
$19.81
$19.75
$18.20
$22.00
MSA 4900
0.9296
Wage Index
2001
$22.62
$19.38
$17.92
$24.43
2002
$23.55
$19.34
$20.18
$24.43
2003
$25.83
$20.38
$21.46
$25.10
$23.19
2004 % of MSA Impact
$24.28
0.4859 11.7978
$21.88
0.1386
3.0327
$25.46
0.2224
5.6633
$24.50
0.1530
3.7497
$24.15
1.0000
24.24
0.9688
0.9913
1.0253
0.9736
Miami
Miam i
1.0233
1.0300
1.0059
1.0038
1.0100
0.9950
0.9859
0.9815
Wage Index
0.9900
0.9854
0.9700
0.9500
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Miami
prov num name
msa
100008
BAPTIST HOSPITAL
5000
100277
2000
$20.72
COLUMBIA CEDARS MEDICAL 5000
CENTER
$24.29
HEALTHSOUTH DOCTOR'S HOSPITAL
5000
$26.17
JACKSON MEMORIAL
5000
$25.89
NORTH SHORE MEDICAL CENTER
5000
$19.18
MOUNT SINAI MEDICAL CENTER
5000
$18.23
PALMS SPRINGS GENERAL HOSPITAL
5000
$16.61
HIALEAH HOSPITAL
5000
$18.71
MERCY HOSPITAL, INC.
5000
$21.79
PAN AMERICAN HOSPITAL
5000
$16.25
PARKWAY REGIONAL MEDICAL
5000
CENTER
$23.45
HOMESTEAD HOSPITAL
5000
$17.33
AVENTURA HOSPITAL AND MED.
5000CENTER $22.17
SOUTH MIAMI HOSPITAL
5000
$19.85
SOUTH SHORE HOSPITAL
5000
$15.18
LARKIN COMMUNITY HOSPITAL
5000
$24.58
CORAL GABLES HOSPITAL
5000
$20.86
PALMETTO GENERAL HOSPITAL
5000
$20.69
DEERING HOSPITAL
5000
$15.91
KENDALL MEDICAL CENTER 5000
$19.74
ANNE BATES LEACH EYE HOSPITAL
5000
$17.94
MIAMI JEWISH HM & HOSPT./ AGED,
5000 INC.
$16.14
100284
Westchester General
5000
MSA 5000
Wage Index
100009
100020
100022
100029
100034
100050
100053
100061
100076
100114
100125
100131
100154
100172
100181
100183
100187
100208
100209
100240
1.0233
2001
$20.50
$22.64
$21.38
$24.41
$20.87
$17.87
$17.24
$20.17
$22.11
$17.87
$21.63
$18.95
$23.44
$20.00
$14.34
$23.08
$24.61
$20.25
$21.21
$22.46
$20.43
$16.63
2002
$20.84
$22.17
$20.78
$26.57
$20.89
$19.53
$17.90
$19.68
$22.92
$17.86
$22.82
$19.61
$23.16
$20.41
$14.88
$18.95
$23.07
$20.85
$20.70
$23.39
$21.06
$19.72
$18.94
2003
$21.64
$22.64
$21.74
$27.42
$22.26
$20.01
$17.90
$21.66
$24.53
$18.48
$22.53
$20.32
$24.62
$21.67
$15.78
$17.90
$22.21
$21.50
$20.47
$22.82
$21.35
$14.92
$18.57
$21.00
2004 % of MSA Impact
$22.77
0.0883
2.0106
$24.78
0.0469
1.1625
$23.53
0.0223
0.5236
$27.90
0.3173
8.8537
$24.68
0.0287
0.7075
$23.11
0.1100
2.5422
$20.04
0.0170
0.3403
$23.78
0.0241
0.5740
$26.12
0.0164
0.4296
$19.64
0.0286
0.5620
$25.36
0.0356
0.9032
$22.41
0.0128
0.2869
$25.48
0.0262
0.6686
$23.08
0.0550
1.2694
$17.60
0.0156
0.2751
$18.13
0.0095
0.1714
$24.45
0.0147
0.3587
$23.47
0.0389
0.9138
$24.14
0.0205
0.4954
$23.85
0.0293
0.6991
$23.06
0.0144
0.3316
$25.29
0.0163
0.4115
$22.30
0.0115
0.2566
$24.44
1.0000
24.75
1.0059
0.9950
0.9815
0.9854
Naples
Naples
1.0300
1.0199
1.0100
1.0109
0.9900
0.9839
Wage Index
0.9700
0.9661
0.9754
0.9750
2003
2004
0.9699
0.9500
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
Naples
prov num name
100018
NAPLES COMMUNITY HOSPITAL,
5345INC.
msa
2000
$20.84
2001
$21.03
2002
$21.64
2003
$22.66
MSA 5345
0.9839
0.9661
0.9699
0.9754
Wage Index
2004 % of MSA Impact
$24.18
1.0000
24.18
0.9750
Ocala
Ocala
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9689
0.9615
0.9556
0.9500
0.9402
0.9300
0.9243
0.9172
0.9100
0.9032
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Ocala
prov num name
msa
100062
MUNROE REGIONAL MEDICAL5790
CENTER
100212
MARION COMMUNITY HOSPITAL
5790
2000
$17.95
$25.34
MSA 5790
0.9615
Wage Index
2001
$19.44
$21.12
2002
$21.44
$21.13
2003
$21.91
$21.72
$21.81
2004 % of MSA Impact
$24.98
0.6841 17.0900
$22.65
0.3159
7.1541
$24.03
1.0000
24.24
0.9243
0.9556
0.9402
0.9689
Orlando
Orlando
1.0300
1.0100
0.9900
0.9834
0.9806
Wage Index
0.9700
0.9610
0.9642
0.9640
0.9615
0.9500
0.9397
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Orlando
prov num name
msa
2000
$21.72
HEALTH CENTRAL
5960
$18.82
SOUTH LAKE HOSPITAL
5960
$18.84
FLORIDA HOSPITAL WATERMAN
5960
$18.75
LEESBURG REGIONAL MEDICAL
5960
CENTER $20.40
COLUMBIA MED CTR OSCEOLA
5960
AS FILED CR $19.64
CENTRAL FLORIDA REGIONAL5960
HOSPITAL $21.50
WINTER PARK MEMORIAL HOSPITAL
5960
$19.87
LUCERNE MEDICAL CENTER 5960
$22.25
2001
$20.11
$21.72
$22.82
$23.13
$19.97
$22.37
$20.90
$22.30
$20.14
$17.40
2002
$21.23
$22.16
$20.60
$17.95
$19.53
$22.70
$20.19
$22.31
$20.31
$21.23
2003
$21.69
$22.53
$19.56
$19.33
$22.34
$24.57
$22.81
$23.36
$24.30
$23.23
$22.37
2004 % of MSA Impact
$23.37
0.3047
7.1204
$24.33
0.4177 10.1618
$21.85
0.0273
0.5956
$20.02
0.0129
0.2582
$24.64
0.0526
1.2971
$24.11
0.0697
1.6815
$24.45
0.0300
0.7332
$24.62
0.0329
0.8097
$23.80
0.0415
0.9882
$0.00
0.0107
0.0000
$23.85
1.0000
23.65
0.9806
0.9610
0.9642
0.9640
0.9615
100006
ORLANDO REGIONAL HEALTHCARE
5960 SYSTEM
$20.63
100007
FLORIDA HOSPITAL MEDICAL 5960
CENTER
100030
100051
100057
100084
100110
100161
100162
100221
MSA 5960
Wage Index
Panama City
Panama City
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9500
0.9300
0.9169
0.9100
0.9061
0.9010
0.8900
0.8896
0.8865
0.8838
0.8819
0.8700
1998
1999
2000
2001
2002
2003
2004
Panama City
prov num name
msa
GULF COAST MEDICAL CENTER
6015
2000
$20.76
$17.12
2001
$20.56
$17.93
2002
$20.95
$18.69
2003
$21.37
$19.11
$20.24
2004 % of MSA Impact
$20.16
0.7244 14.6044
$20.46
0.2756
5.6383
$20.26
1.0000
20.24
100026
BAY MEDICAL CENTER
6015
100242
MSA 6015
0.9169
0.9010
0.9061
0.8865
0.8819
Wage Index
Pensacola
Pensacola
1.0300
1.0100
Wage Index
0.9900
0.9700
0.9500
0.9300
0.9100
0.8986
0.8900
0.8838
0.8928
0.8896
0.8794
0.8814
0.8819
0.8700
1998
1999
2000
2001
2002
2003
2004
Pensacola
prov num name
msa
100025
SACRED HEART HOSPITAL
6080
MSA 6080
Wage Index
100048
100093
100124
100231
100266
2000
$19.12
JAY HOSPITAL
6080
$13.50
BAPTIST HOSPITAL
6080
$16.63
SANTA ROSA MEDICAL CENTER
6080
$19.05
WEST FLORIDA REGIONAL MEDICAL
6080 CENTER
$17.40
GULF BREEZE HOSPITAL
6080
$17.73
2001
$18.78
$15.06
$16.51
$17.07
$17.92
$18.30
2002
$19.45
$15.78
$16.84
$20.40
$18.75
$19.36
2003
$20.14
$17.37
$18.72
$20.09
$21.57
$20.28
$19.69
2004 % of MSA Impact
$21.25
0.3436
7.3009
$17.55
0.0203
0.3569
$20.29
0.2883
5.8495
$24.30
0.0590
1.4332
$23.54
0.2458
5.7867
$21.52
0.0430
0.9252
$21.62
1.0000
21.65
0.8986
0.8928
0.8794
0.8814
0.8819
Punta Gorda
Punta Gorda
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9613
0.9508
0.9500
0.9472
0.9300
0.9218
0.9100
0.9050
0.9015
0.8900
0.8838
0.8700
1998
1999
2000
2001
2002
2003
2004
Punta Gorda
prov num name
msa
100047
CHARLOTTE REG'L MEDICAL CENTER
6580
100236
FAWCETT MEMORIAL HOSPITAL
6580
100077
St Joseph Port Char
6580
2000
$18.87
$21.81
$19.62
MSA 6580
Wage Index
0.9508
2001
$20.01
$20.38
$22.34
2002
$20.61
$20.69
$19.06
2003
$21.50
$21.79
$20.95
$21.41
2004 % of MSA Impact
$24.35
0.2879
7.0101
$23.97
0.2993
7.1745
$22.37
0.4128
9.2344
$23.49
1.0000
23.42
0.9613
0.9015
0.9218
0.9472
Sarasota Bradenton
Sarasota-Bradenton
1.0300
1.0100
1.0090
0.9931
0.9900
0.9905
0.9809
0.9757
Wage Index
0.9700
0.9553
0.9500
0.9449
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Sarasota Bradenton
prov num name
msa
ENGLEWOOD COMMUNITY HOSPITAL
7510
2000
$19.58
$20.34
$23.11
$20.42
$19.12
$17.10
2001
$20.15
$18.74
$23.61
$20.03
$20.66
$20.11
2002
$23.81
$20.04
$23.66
$21.23
$21.18
$21.74
2003
$21.35
$20.96
$22.18
$22.24
$22.02
$22.81
$21.93
2004 % of MSA Impact
$22.63
0.1729
3.9133
$23.55
0.1595
3.7557
$26.59
0.3881 10.3187
$23.74
0.0963
2.2853
$24.44
0.1405
3.4347
$23.37
0.0427
0.9985
$24.61
1.0000
24.71
MSA 7510
0.9905
0.9809
1.0090
0.9449
0.9931
100035
MANATEE MEMORIAL HOSPITAL
7510
100070
Bon Secours-Venice Hospital
100087
SARASOTA MEMORIAL HOSPITAL
7510
100166
DOCTORS HOSPITAL OF SARASOTA
7510
100213
BLAKE MEDICAL CENTER
100267
7510
7510
Wage Index
Tallahassee
Tallahassee
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9500
0.9300
0.9100
0.8986
0.8900
0.8928
0.8896
0.8838
0.8794
0.8814
0.8819
0.8700
1998
1999
2000
2001
2002
2003
2004
Tallahassee
prov num name
msa
100135
TALLAHASSEE MEMORIAL HOSPITAL
8240
100159
GADSDEN COMMUNITY HOSPITAL
8240
100254
TALLAHASSEE COMMUNITY HOSPITAL
8240
2000
$17.48
$16.37
$20.91
MSA 8240
0.8986
Wage Index
2001
$18.83
$10.28
$19.66
2002
$19.19
$10.78
$19.55
2003
$19.77
$15.06
$20.44
$18.42
2004 % of MSA Impact
$20.49
0.8571 17.5614
$0.00
0.0094
0.0000
$23.27
0.1335
3.1064
$21.04
1.0000
20.67
0.8928
0.8794
0.8814
0.8819
Tampa St. Petersburg Clearwater
Tampa-St. Petersburg-Clearwater
1.0300
1.0100
0.9900
Wage Index
0.9700
0.9500
0.9300
0.9196
0.9203
0.9171
0.9119
0.9100
0.9099
0.9066
0.8925
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
Tampa-St. Petersburg-Clearwater
prov num name
msa
100015
SUN COAST HOSPITAL
8280
MSA 8280
Wage Index
100032
100043
100046
100055
100063
100067
100069
100071
100075
100126
100127
100128
100132
100173
100180
100191
100206
100211
100238
100239
100243
100248
100255
100256
100259
100264
100265
100271
100280
2000
$18.24
BAYFRONT MEDICAL CENTER,8280
INC.
$19.32
MEASE HOSPITAL & CLINIC 8280
$17.52
EAST PASCO MEDICAL CENTER
8280
$21.21
HELEN ELLIS MEMORIAL HOSPITAL
8280
$17.62
NORTH BAY MEDICAL CENTER
8280
$16.23
ST. ANTHONY'S HOSPITAL 8280
$17.39
UCH - CARROLLWOOD
8280
$16.14
BROOKSVILLE REGIONAL HOSPITAL
8280
$16.47
ST. JOSEPH'S HOSPITAL
8280
$18.05
PALMS OF PASADENA HOSPITAL
8280
$18.09
MORTON PLANT HOSPITAL 8280
$19.87
TAMPA GENERAL HOSPITAL 8280
$21.36
SOUTH FLORIDA BAPTIST HOSPTIAL
8280
$16.90
UNIVERSITY COMMUNITY HOSPITAL
8280
$17.34
ST. PETERSBURG GENERAL 8280
$18.48
NEW PORT RICHEY COMMUNITY
8280HOSPITAL $18.47
MEMORIAL HOSPITAL OF TAMPA
8280
$20.35
PASCO COMMUNITY HOSPITAL
8280
$25.53
NORTHSIDE HOSPITAL & HEART
8280
INSTITUTE$17.63
EDWARD WHITE HOSPITAL 8280
$19.76
COLUMBIA BRANDON REGIONAL
8280MED CTR $20.38
LARGO REGIONAL MEDICAL CENTER
8280
$21.54
TOWN & COUNTRY HOSPITAL8280
$21.02
COLUMBIA REG MED CTR AT BAYONET
8280
PT $23.56
SOUTH BAY HOSPITAL
8280
$19.86
OAK HILL HOSPITAL
8280
$17.61
MEASE HOSPITAL COUNTRYSIDE
8280
$19.86
H. LEE MOFFITT CANCER CENTER
8280
$19.92
SPRING HILL REGIONAL HOSPITAL
8280
$16.59
2001
$18.48
$19.81
$18.80
$21.62
$18.05
$19.26
$18.09
$16.83
$17.55
$18.37
$19.54
$19.99
$20.15
$18.12
$18.57
$20.21
$19.99
$19.57
$20.64
$19.64
$21.32
$21.26
$20.70
$25.21
$20.94
$20.38
$19.16
$18.83
$20.48
$17.37
2002
$18.07
$19.75
$18.82
$21.30
$18.88
$18.46
$18.49
$17.37
$17.72
$19.45
$19.31
$19.21
$22.88
$18.79
$17.13
$21.54
$21.06
$20.12
$20.75
$20.83
$19.45
$20.80
$21.30
$21.03
$21.28
$21.12
$19.95
$18.23
$20.87
$18.20
2003
$18.94
$20.65
$20.77
$23.20
$19.13
$19.25
$19.22
$18.88
$20.75
$20.46
$21.43
$20.52
$23.58
$19.53
$18.38
$22.78
$22.05
$20.34
$21.64
$23.37
$23.22
$22.45
$22.16
$20.72
$22.48
$21.50
$21.74
$20.27
$21.98
$19.02
$21.01
2004 % of MSA Impact
$22.12
0.0238
0.5273
$21.64
0.0272
0.5886
$21.77
0.0285
0.6197
$24.27
0.0328
0.7962
$19.63
0.0273
0.5369
$21.56
0.0095
0.2038
$23.88
0.0338
0.8072
$19.60
0.0149
0.2916
$21.76
0.0113
0.2449
$22.38
0.1254
2.8064
$21.79
0.0086
0.1871
$21.01
0.0832
1.7486
$24.41
0.1119
2.7313
$21.15
0.0203
0.4291
$19.71
0.0806
1.5879
$24.94
0.0181
0.4505
$24.19
0.0349
0.8447
$22.87
0.0144
0.3300
$24.32
0.0106
0.2578
$24.65
0.0235
0.5795
$25.05
0.0107
0.2674
$23.28
0.0429
0.9992
$23.87
0.0287
0.6849
$22.97
0.0112
0.2564
$24.19
0.0386
0.9337
$24.11
0.0151
0.3648
$22.48
0.0247
0.5543
$21.06
0.0237
0.4984
$0.00
0.0536
0.0000
$0.00
0.0104
0.0000
$22.49
1.0000
21.13
0.9119
0.9099
0.8925
0.9171
0.9066
West Palm Beach-Boca Raton
West Palm Beach-Boca Raton
1.0300
1.0309
1.0203
1.0100
0.9951
0.9939
0.9900
0.9777
0.9759
Wage Index
0.9700
0.9615
0.9500
0.9300
0.9100
0.8900
0.8700
1998
1999
2000
2001
2002
2003
2004
West Palm Beach-Boca Raton
prov num name
100002
100010
100080
100130
100168
100176
100234
100253
100258
100262
100268
100269
100275
2000
BETHESDA MEMORIAL HOSPITAL
8960
$21.32
ST. MARY'S HOSPITAL
8960
$21.91
JFK MEDICAL CENTER
8960
$21.16
GLADES GENERAL HOSPITAL 8960
$19.11
BOCA RATON COMMUNITY HOSPITAL,
8960
INC. $20.13
PALM BEACH GARDENS
8960
$24.70
COLUMBIA HOSPITAL PALM BEACH
8960 AS FILE $21.58
JUPITER MEDICAL CENTER 8960
$20.60
DELRAY MEDICAL CENTER 8960
$21.88
GOOD SAMARITAN HOSPT. 8960
$19.59
WEST BOCA MEDICAL CENTER
8960
$23.59
PALMS WEST HOSPITAL
8960
$21.20
WELLINGTON REGIONAL MEDICAL
8960 CENTER $21.33
2001
$20.71
$21.91
$22.20
$18.68
$20.20
$22.86
$20.91
$21.32
$21.35
$20.04
$23.92
$21.67
$20.92
2002
$21.02
$23.06
$22.72
$20.09
$20.32
$24.61
$21.64
$22.48
$20.03
$21.09
$24.05
$22.51
$21.49
2003
$21.58
$23.96
$22.97
$21.00
$23.01
$24.66
$24.34
$22.65
$22.08
$22.71
$23.54
$26.03
$23.29
$23.22
0.9951
0.9615
0.9777
0.9939
MSA 8960
msa
Wage Index
2004 % of MSA Impact
$22.59
0.1033
2.3334
$25.56
0.1228
3.1380
$22.87
0.1255
2.8698
$20.24
0.0204
0.4124
$24.62
0.1515
3.7293
$26.87
0.0635
1.7052
$24.91
0.0464
1.1555
$23.69
0.0766
1.8139
$24.56
0.0986
2.4224
$23.80
0.0646
1.5382
$26.02
0.0536
1.3958
$24.90
0.0431
1.0725
$23.14
0.0302
0.6992
$24.20
1.0000
24.29
0.9759
Tomorrow
Changes on the Horizon
Occupational Mix Survey
MSA Changes
Congressional Interference
Interns and Residents et al
Sample S-3 Review Exercises
Behind the Sheet Adjustments
Part II - Wage Data
S ALARIES
1 Total S al ary
$
2 Non-physi ci an ane sthe ti st Part A
$
3 Non-physi ci an ane sthe ti st Part B
$
4 Physi ci an -Part A
$
4.01 Te achi ng Physi ci ans
$
5 Physi ci an-Part B
$
6 Inte rns & Re si de nts (approve d program) $
7 Home offi ce pe rsonne l
$
8 S NF
$
8.01 Excl ude d are a sal ari e s
$
Adjuste d
S al ari e s
-
-
O THER WAGES & RELATED CO S TS
Contract l abor:
$
Pharmacy Contract
$
Laboratory Contract
$
Contract l abor: physi ci an-Part A
$
Te achi ng Physi ci ans Contract
$
Home offi ce sal ari e s & wage -re l ate d costs
$
Home O ffi ce Phys Pt A
$
Te achi ng Physi ci ans
$
-
13
14
15
16
17
18
18.01
19
20
WAGE-RELATED CO S TS
Wage -re l ate d costs (core )
$
Wage -re l ate d costs (othe r)
$
Excl ude d are as
$
Non-physi ci an ane sthe ti st Part A
$
Non-physi ci an ane sthe ti st Part B
$
Physi ci an Part A
$
Physi ci an Part A
$
Physi ci an Part B
$
Inte rns & Re si de nts (approve d program) $
-
O VERHEAD CO S TS
Emp Be nfi ts
Admi n & Ge nl
Mai nt & Re pai rs
O pe rati on of Pl ant
Laundry & Li ne n
House ke e pi ng
Di e tary
Cafe te ri a
Mai nt of Pe rsonne l
Nursi ng Admi n
Ce ntral S e r & S uppl y
Pharmacy
Me di cal Re cords
S oci al S e rv
O the r Ge nl S e rv
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
-
Part III - Hospi tal Wage Inde x S ummary
1 Ne t S al ari e s
2 Excl ude d are a sal ari e s
3 S ubtotal sal ari e s (l i ne 1 mi nus l i ne 2)
4 S ubtotal othe r wage s & re l ate d costs
5 S ubtotal wage -re l ate d costs
6 Total (sum of l i ne s 3 thru 5)
13 Total O ve rhe ad Costs
0
Avg Hrl y
Wage
-
9
9.01
9.02
10
10.01
11
12
12.01
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Pai d
Hours
-
$
$
-
Average Hourly Wage Calculation for the Fiscal Year 2004 Wage Index (Using Cost Reporting Periods Beginning 10/1/99-9/30/00)
*Fields in bold are calculated fields
Work Sheet S - 3, Part II
Total Salaries
line1/col. 3
0
Other Wages & Related Costs
line2/col. 3
line3/col. 3
line4.01/col. 3
line5/col. 3
line5.01/col. 3
line6/col. 3
line7/col. 3
line8/col. 3
line8.01/col. 3
sub-tot-a
line9/col. 3
line9.01/col. 3
line9.02/col. 3
line10/col. 3
line11/col. 3
line12/col. 3
line13/col. 3
line14/col. 3
line18/col. 3
sub-tot-b
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
adjusted salaries
0
sub-tot-a=line2+line3+line4.01+line5+line5.01+line6+line7+line8+line8.01
sub-tot-b=line9+line9.01+line9.02+line10+line11+line12+line13+line14+line18
adjusted salaries=line1/col3 - sub-tot-a + sub-tot-b
Total Paid Hours
line1/col. 4
0
Other Paid Hours
line2/col. 4
line3/col. 4
line4.01/col. 4
line5/col. 4
line5.01/col.4
line6/col. 4
line7/col. 4
line8/col. 4
line8.01/col. 4
sub-tot-c
line9/col. 4
line9.01/col. 4
line9.02/col. 4
line10/col. 4
line11/col. 4
line12/col. 4
sub-tot-d
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
adjusted hours
0
adjusted hours=line1/col4 -sub-tot-c + sub-tot-d
Work Sheet S - 3, Part III
Overhead Allocation
line13/col. 3
0
refers to work sheet S-3, Part III
line13/col. 4
0
refers to work sheet S-3, Part III
sub-tot-c=line2+line3+line4.01+line5+line5.01+line6+line7+line8+line8.01
Overhead Allocation
sub-tot-d=line9+line9.01+line9.02+line10+line11+line12
Occupational Mix Survey
Presented by
Healthcare Affiliates, Inc
Occupational Mix Data
Benefit Improvement and Projection Act of 2000 (BIPA) states:


CMS must collect data every three years
CMS must make and OM adjustment to the wage index for FFY 2005 and
thereafter.
CMS announced in the August 1 Federal Register that CMS plans
(after an initial data collection scheduled for late Spring 2003) to
include OM data in the cost report forms in future years.
Apparently it will be collected annually.
GOA computed impacts using data accumulation from California
occupational mix data
Occupational Mix Data
Why use OM Data to adjust wage indexes? CMS adjusts resource consumption
through the weighing factor of the DRG. Theoretically the difference in
weighting reflects the relative occupational mix of various hospitals. Using a
standard occupational mix eliminated the “double scoring” of occupational mix
difference that are accounted for in the DRG weighting. This is expected to
improve payment to rural hospital and reduced payment to large tertiary care
MSAs.
Contrary argument – OM will reduce wage indexes to urban areas with
sophisticated teaching hospitals. There is no corresponding higher DRG
weighting for the sicker patients treated in the tertiary care hospitals, OM
adjustments should be delayed.
Occupational Mix Adjustment
Conceptual Overview
Assume two types of employees
National Average
Professional
Non Professional
Total
Occupational Mix Index
Percent Of
50%
50%
100%
1.000
Occupational Mix Adjustment
Metropolis MSA
Tertiary Care and Teaching Hospitals
Computed
Metropolis MSA (Tertiary Care and Teaching Hospitals)
Professional
Non-Professional
Total
Occupational Mix Index (56e50)
Wage Index
55%
45%
100%
1.1000
Average Hourly Wage & Wage Index
$25.00/Hour
Occupational Mix Adjustment Factor
+ 1.10
Occupational Mix Adjustment AHW & Wage Index
$22.72
1.0762
.9780
.0982
Occupational Mix Adjustment
Conceptual Overview
Statewide Rural Area
Professional Employee
Non-Professional
Total
Occupational Mix Index (45e50)
Average Hourly Wage
Occupational Mix Adjustment Fact
Occupational Mix Adjusted AHW
45%
55%
100%
.90
$19.00
+ .90
$21.11
Occupational Mix Adjustment
Computed Wage Indexes
Current AHW
National AHW
Current Wage Index
Occupational Mix AHW $
National AHW
Occupational Mix Adj. WI
Metropolis
$
25.00
+ 22.3096
1.1206
22.72
+ 22.3096
1.0184
Increase (Decrease)
The above example is hypothetical
(.1022)
$
Statewide Rural
$
19.00
+ 22.3096
.8517
21.11
+ 22.3096
.9457
+.0094