Decision tool · included
Should this hospital reclassify?
A four-step model for the Medicare Geographic Classification Review Board decision. Check eligibility, compare target wage areas, and see the payment effect of each, with the working shown.
| Target | Wage index | Screens | Net effect / yr |
|---|---|---|---|
| Target area A | 0.9412 | Pass | +1,840,000 |
| Target area B | 0.9087 | Pass | +620,000 |
| Target area C | 0.8764 | Review | −95,000 |
How it works
From a CCN to a ranked decision.
01
Hospital profile
Enter a CMS Certification Number. The model fills the hospital's current wage area, wage index, three-year average hourly wage, and special-status flags from the public files, and shows where each value came from.
02
Target areas
Add up to eight areas you are considering. The model suggests nearby candidates and checks each one against the geographic and wage tests.
03
Results & decision
Eligibility and payment effect for every target, side by side: the estimated change from swapping the current wage index for the target's, net of cost, weighted for the chance of approval, over the three-year term.
04
Rules
The thresholds and regulatory text behind every check, by application year, so you can see why a target passed or didn't.
Where the numbers come from
Public files, with the rule behind every check.
This is a decision aid, not a filing system. It does not submit anything to the Board and it is not legal advice. A passing check means the model's tests are met, not that an application will be approved.
- Wage data
- CMS wage index tables and the three-year average hourly wage data, kept by year so a new cycle never overwrites an old one.
- Hospital history
- Provider-specific file status and HCRIS cost report values for the hospital's own wages and payments.
- Geography
- Census boundaries for adjacency and distance, with driving distance where a test calls for it.
- Rules
- 42 CFR Part 412, Subpart L, held as data by application year rather than as constants in the code.
Included
Part of the portal subscription.
No separate price. If the question is bigger than the model, our analysts can work it with you.