Figure 2

Wide variation in payments from Medicare for ST-elevation myocardial infarction despite prospective payment system. It is widely assumed that payments from Medicare are "fixed" due to prospective payment system. However, a patient presenting with ST-elevation myocardial infarction can have a wide variety of clinical events, which ultimately determine the assigned DRG, and can lead to a nearly 20-fold variation in payment from Medicare. Addition of payments from the outlier payment system can lead to even larger variations in hospital revenue. (Fiscal 2007 Medicare DRG Relative Weights and 2007 St. Francis Heart Center base rate of $5,238)