The Weighted Average for Medicare Payments 1. Compute the weighted average for Medicare payments for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY all discharges around the country. Use the number of discharges as the weight.

Compute the 90%, 95%, and 99% confidence intervals for this average.

2. Compute the weighted average for TOTAL payments for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY all discharges around the country. Use the number of discharges as the weight. Compute the 90%, 95%, and 99% confidence intervals for this average.

# Computing The Weighted Average for Medicare Payments

3. Compute the weighted average for percentage of Total payments that is paid by the Medicare for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY all discharges around the country. Use the number of discharges as the weight. Compute the 90%, 95%, and 99% confidence intervals for this average.

4. Compute the weighted average for Medicare payments for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY all discharges for each of the states. Use the number of discharges as the weight. Compute the 90%, 95%, and 99% confidence intervals for this average. (Hint: A smart application of pivot table feature of Microsoft Excel can be really helpful here)

5. Compute the weighted average for Medicare payments for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY all discharges for each of the hospital referral regions in the country. Use the number of discharges as the weight. Compute the 90%, 95%, and 99% confidence intervals for this average. (Hint: A smart application of pivot table feature of Microsoft Excel can be really helpful here)

6. Focus on the State of Tennessee and various Hospital Referral Regions (HRR) of the state. Are there statistically meaningful differences in the weighted averages for Medicare payments for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY? Provide careful argument citing the correct formula, if necessary.

## Arguments Results and Conclusion for The Weighted Average for Medicare Payments

7. Looking at the results, would you conclude that larger hospitals charge more than the smaller hospitals? Carefully state your answer and provide robust argument.

8. Looking at the results, would you conclude that Medicare reimbursement rates are higher for bigger city hospitals compared to the smaller city hospitals? Carefully state your answer and provide robust argument.

9. What would have been the savings to the Medicare if all MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY were performed in the lowest cost hospital for each Hospital Referral Region? Can you compute the 90%, 95%, and 99% confidence interval for this savings?

10. Write a short essay (NOT exceeding 3 pages) providing an overview local, regional, and national distribution of hospital charges, total payments, and Medicare reimbursements for MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY. You may do that by carefully reviewing all the results that you have derived so far. Provide an idea as to how these differences may lead to inefficiencies and excess expenditure and how that be reduced or eliminated by innovative solutions. You can also reflect on the systematic differences between states, and cities/hospital referral regions.