Geographic Indices SNF Wage Index

$179 / year

The dataset has information on the Medicare payment adjustments of Geographic Indices Skilled Nursing Facility (SNF) Wage index for the fiscal years 2010-2018. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.

Complexity

Geographic adjustments are intended to ensure that the Medicare Program does not overpay hospitals and practitioners in certain areas and underpay in other as a result of geographic difference in price for resources such as clinical and administrative staff salaries and benefits, office or hospital space (rent), malpractice insurance (premiums), and other resources that are part of the cost of providing care. As a result, Medicare’s Inpatient Prospective Payment System (IPPS), other Institutional Prospective Payment System (other PPSs), and the Medicare Physician Fee Schedule (PFS, or fee schedule) all employ geographic adjustments factors (GAFs). The two geographic adjustments applied to Medicare payments for care provided by hospitals and practitioners are the hospital wage index (HWI) and three geographic practice cost indexes (GPCI). The index compares difference in price or quantity for a group of goods and services relative to an average value derived from a standard baseline geographic area or time period. The fundamental rationale for geographic adjustment is to create a payment structure that adjusts payments for the input price difference, such as employee compensation, that providers face when they provide care.

GPCIs helps to standardize the differences in resource costs incurred across geographic areas when those costs are compared with the national average costs for the physician work, practice expense and malpractice insurance components of the fee schedule. Specifically, the three adjustments are provided for the following: 1) Physician work reflects the time, skill, effort, judgment, and stress associated with providing one service relative to other services according to the HCPCS codes. On average, as of 2011, work accounted for 52.5 % of the geographic adjustment factor within the fee schedule. 2) Practice expense considers certain price for maintaining a clinical practice, including salaries and benefits for administrative and clinical employees, rent, equipment, and supplies. Practice expense associated with supplies and equipment are not adjusted geographically because they are purchased in a national market in which prices are similar across the country. On average as of 2011, the PE GPCI accounted for 43.7 % of the geographic adjustment. 3) Professional liability insurance PLI represents payment for professional liability malpractice expenses and on average, account for 3.9 % of the geographic adjustment.

Date Created

2016-04-04

Last Modified

2018-02-01

Version

2018-02-01

Update Frequency

Annual

Temporal Coverage

2010-2018

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Geographic Indices SNF Wage Index, Geographic Indices IPPS Wage Index, Geographic Indices IPPS Provider Index, Medicare Payment Adjustments, Medicare Service Payment Rates, Medicare Payment Structure, Medicare Fee for Service, Medicare Spending for Beneficiaries, Fee for Service Reimbursement, Aged Cost Contracts

Other Titles

Geographic Indices SNF Wage Index Data, Geographic Index Repricing of Fee For Service Medicare Claims, Repricing of Medicare Fee For Service Insurance Geographic Index

NameDescriptionTypeConstraints
County_FIPS_CodeThe 5 digits county Federal Information Processing Standard (FIPS) codestring-
State_AbbreviationThe abbreviated name of the statestring-
CountyName of countystring-
Core_Based_Statistical_Area_2018Core Based Statistical Area (CBSA) is a U.S. geographic area defined by the Office of Management and Budget (OMB) that consists of one or more counties (or equivalents) anchored by an urban center of at least 10,000 people plus adjacent counties that are socioeconomically tied to the urban center by commutingintegerlevel : Nominal
SNF_Wage_2010SNF wage index by fiscal year 2010numberlevel : Ratio
SNF_Wage_2011SNF wage index by fiscal year 2011numberlevel : Ratio
SNF_Wage_2012SNF wage index by fiscal year 2012numberlevel : Ratio
SNF_Wage_2013SNF wage index by fiscal year 2013numberlevel : Ratio
SNF_Wage_2014SNF wage index by fiscal year 2014numberlevel : Ratio
SNF_Wage_2015SNF wage index by fiscal year 2015numberlevel : Ratio
SNF_Wage_2016SNF wage index by fiscal year 2016numberlevel : Ratio
SNF_Wage_2017SNF wage index by fiscal year 2017numberlevel : Ratio
SNF_Wage_2018SNF wage index by fiscal year 2018numberlevel : Ratio
County_FIPS_CodeState_AbbreviationCountyCore_Based_Statistical_Area_2018SNF_Wage_2010SNF_Wage_2011SNF_Wage_2012SNF_Wage_2013SNF_Wage_2014SNF_Wage_2015SNF_Wage_2016SNF_Wage_2017SNF_Wage_2018
34830NCStanly167400.93210.92150.81000.79470.90730.9275
36220OHErie0.86860.81670.83470.77880.80660.83070.82510.8053
13380IDPower0.95070.94260.95550.97540.85350.68720.73200.7582
17300KSGeary0.78470.79120.78390.78430.80930.76880.76880.7726
23330MIIonia0.91690.91450.91250.90910.86270.83800.83820.8413
25650MSStone0.88770.85050.85440.85750.78750.74200.75000.7481
34030NCAnson0.94200.93210.92150.94470.85650.79630.79580.7797
45400TXDelta0.98600.98440.98350.98310.87750.77660.77830.7884
49900VASurry0.89610.90010.92080.91210.83890.76090.75930.7689
01310ALGreene0.88430.86640.85330.85000.76510.69100.68730.6828