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In response to the comments indicating that the calculation of the weighted median for each MS-DRG requires summing the number of inpatient discharges for each MAO for each MS-DRG, and stating that a hospital might get a different result depending on whether inpatient discharges are counted as (1) all inpatient discharges for the MAO's members, (2) those inpatient discharges where the MAO made payment (whether inpatient or otherwise), or (3) those inpatient discharges where the MAO paid for the care at the inpatient rate, the hospital should use (3) those inpatient discharges where the MAO paid for the care at the inpatient rate as the sole purpose of the discharges in the calculation is to weight the rates contained in the MRF

As a result, it can begin a cycle of continued fatigue and lethargy

This is Archimedes' Principle

With that said, I typically expect (and usually see) good improvement with the 1 st round