A detailed financial report submitted annually by healthcare providers participating in the Medicare program. It outlines the costs incurred by providers in delivering services to Medicare beneficiaries and is used to determine reimbursement rates.
The amount of money that Medicare pays to healthcare providers for services rendered to Medicare beneficiaries. It is calculated based on the information provided in the Medicare Cost Report.
The process of assigning costs to specific activities, departments, or services within a healthcare organization. Proper cost allocation is essential for accurately determining reimbursement rates and assessing the financial performance of different areas.
Expenses that cannot be directly attributed to a specific service or department within a healthcare organization. These costs are allocated based on predetermined methods outlined in the Medicare Cost Report instructions.
Expenses that can be directly attributed to a specific service or department within a healthcare organization. Examples include salaries of healthcare personnel, medical supplies, and equipment costs.
Additional payments made to hospitals that serve a large number of low-income patients. The DSH adjustment is calculated based on data reported in the Medicare Cost Report and aims to offset the financial burden of treating uninsured and underinsured individuals.
A factor used to adjust Medicare reimbursement rates based on regional variations in labor costs. The wage index is calculated using wage data reported in the Medicare Cost Report and helps ensure equitable payments across different geographic areas.
Uncollected revenue resulting from services provided to patients who are unable or unwilling to pay. Hospitals can claim a portion of their bad debt expenses on the Medicare Cost Report for reimbursement.
Additional payments made to healthcare providers for unusually costly cases that exceed a predetermined threshold. Outlier payments are calculated based on data reported in the Medicare Cost Report and aim to compensate providers for the high costs associated with complex medical conditions.
A ratio used to convert a hospital’s reported costs to charges for Medicare reimbursement purposes. The CCR is calculated by dividing the total allowable costs reported in the Medicare Cost Report by the total charges for services provided during the same period.