Medicaid, Bureau of Coverage and Reimbursement Policy

Reimbursement Unit

Randy K. Baker, Reimbursement Unit Manager

In-Patient Factors

For questions, contact
John Bromberger
801-538-9189

DOLLAR MULTIPLIER and OUTLIER THRESHOLD FACTORS

Effective Date Dollar
Multiplier Outlier Threshold
07/01/2001 $5,360.05 2.5
07/01/2002 $5,668.79 2.565
07/01/2004 $5,744.18 2.565
07/01/2005 $5,830.34 2.565
01/01/2006 $5,830.34 2.773
07/01/2006 $5,946.95 2.773
07/01/2007 $6,197.32 2.773
07/01/2008 $6,364.65 2.6447
10/01/2008 $6,197.32 2.773
05/27/2009 $6,197.32 4.257
07/01/2009 $6,197.32 3.602

HOSPITAL SPECIFIC OUTLIER FACTORS

01-Jul-01 01-Jul-02 01-Jul-03 01-Jul-05 01-Jan-06 01-Jul-07 01-Jul-08 04-Oct-08 27-May-09 01-Jul-09 01-Oct-09
Alta View 0.9195 0.9135 1.0058 1.0058 0.9958 0.9513 0.9355 0.9104 0.7613 0.8234 0.8179
American Fork 1.0504 0.9771 0.9236 0.9236 0.9498 0.9467 0.9290 0.9040 0.7625 0.8247 0.8060
Cache Valley Specialty Hosp 0.8908 0.7713 0.8924 0.8685 0.6347 0.6865 0.6819
Davis Hospital and Medical Center 0.8775 0.9231 0.8403 0.8403 0.7139 0.7028 0.7065 0.6875 0.5895 0.6376 0.6137
Dixie Regional Medical Center 0.9861 0.9691 0.9831 0.9831 0.9065 0.9226 0.8916 0.8677 0.7561 0.8177 0.7996
Intermountain Medical Center 0.7832 0.7894 0.8010 0.8010 0.7847 0.7870 0.7861 0.7649 0.6306 0.6820 0.6748
Jordan Valley 0.7049 0.7345 0.7040 0.7040 0.6438 0.6402 0.6330 0.6160 0.5112 0.5529 0.5530
Lakeview 0.8070 0.8877 0.8418 0.8418 0.9025 0.8886 0.8301 0.8078 0.6256 0.6766 0.6578
LDS Hospital 0.8551 0.8719 0.9306 0.9306 0.9520 0.9277 0.9551 0.9294 0.7648 0.8272 0.8598
Logan Regional Hospital 1.0411 1.0098 1.0132 1.0132 1.0304 0.9979 1.0069 0.9798 0.8373 0.9056 0.8497
McKay-Dee 0.7982 0.7843 0.7795 0.7795 0.8064 0.8300 0.8257 0.8035 0.6921 0.7486 0.7295
Mountain View 0.7354 0.7704 0.7983 0.7983 0.8175 0.8500 0.8211 0.7990 0.6471 0.6999 0.6741
Ogden Regional 0.8784 0.7966 0.7789 0.7789 0.7916 0.7719 0.7717 0.7509 0.5838 0.6314 0.5984
Orem 0.9573 0.7905 0.8220 0.8220 0.8196 0.8013 0.7918 0.7705 0.6659 0.7202 0.6894
Out of State Hospitals 0.8000 0.3000 0.3000 0.3000 0.3000 0.3000 0.3000 0.3000 0.3000 0.3000 0.3000
Pioneer 0.8121 0.7589 0.7061 0.7061 0.6602 0.6392 0.6237 0.6069 0.5037 0.5448
Primary Children's 0.7691 0.8394 0.8401 0.8401 0.8963 0.8845 0.9020 0.8778 0.6880 0.7442 0.8079
Salt Lake Regional 0.7625 0.7075 0.7079 0.7079 0.6862 0.6414 0.6636 0.6458 0.5273 0.5704 0.5869
St. Mark's 0.7748 0.7457 0.7212 0.7212 0.6842 0.6628 0.6659 0.6481 0.5206 0.5631 0.5873
Timpanogos 0.7264 0.8213 0.7960 0.7960 0.7615 0.6973 0.6828 0.6645 0.5430 0.5873 0.5885
TOSH 0.9547 0.9643 0.9803 1.0518 1.0235 0.7101 0.7681 0.7517
University 0.6414 0.6774 0.6848 0.6848 0.7179 0.7596 0.7754 0.7545 0.6410 0.6933 0.6709
Utah Valley 0.8834 0.8255 0.8531 0.8531 0.8445 0.8598 0.8490 0.8262 0.6904 0.7467 0.7321

HOSPITAL SPECIFIC DSH FACTORS

01-Jul-01 01-Jul-02 01-Jul-03 01-Jan-06 01-Jul-07 01-Jul-08
Alta View 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
American Fork 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058
Cache Valley Specialty Hosp 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
Davis Hospital and Medical Center 0.0000 0.0000 0.0000 0.0058 0.0058 0.0058
Dixie Regional Medical Center 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058
Intermountain Medical Center 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058
Jordan Valley 0.0000 0.0000 0.0000 0.0058 0.0058 0.0058
Lakeview 0.0000 0.0000 0.0000 0.0000 0.0000 0.0058
LDS Hospital 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
Logan Regional Hospital 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058
McKay-Dee 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058
Mountain View 0.0000 0.0000 0.0000 0.0058 0.0058 0.0058
Ogden Regional 0.0000 0.0000 0.0000 0.0058 0.0058 0.0058
Orem 0.0116 0.1160 0.0066 0.0058 0.0058 0.0058
Out of State Hospitals 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
Pioneer 0.0000 0.0000 0.0000 0.0058 0.0058 0.0058
Primary Children's 0.0530 0.0530 0.0240 0.0222 0.0222 0.0222
Salt Lake Regional 0.0000 0.0116 0.0066 0.0058 0.0058 0.0058
St. Mark's 0.0116 0.0000 0.0066 0.0058 0.0058 0.0058
Timpanogos 0.0000 0.0000 0.0000 0.0000 0.0058 0.0058
TOSH 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
University 0.0698 0.0698 0.0558 0.0448 0.0448 0.0448
Utah Valley 0.0116 0.0116 0.0066 0.0058 0.0058 0.0058

Last edited June 03, 2009