Inpatient Utilization and Payment Data 2013

$199 / year

The dataset includes hospital-specific charges for U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for 2013 for discharges paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG).

Complexity

Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills for an item or service. The Total Payment amount includes the MS-DRG amount, bill total per diem, beneficiary primary payer claim payment amount, beneficiary Part A coinsurance amount, beneficiary deductible amount, beneficiary blood deducible amount and DRG outlier amount. Average charges, average total payments, and average Medicare payments are calculated at the individual hospital level. The amount charged by individual hospitals within local markets, and nationwide, for services that might be furnished in connection with a particular inpatient stay can be compared.

Date Created

2016-06-23

Last Modified

2016-06-23

Version

2016-06-23

Update Frequency

Annual

Temporal Coverage

2013

Spatial Coverage

United States

Source

John Snow Labs => Centers For Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Inpatient Utilization Payment, Medicare Reimbursement, Medicare Payment List, Inpatient CMS Medicare Prospective Payment, Inpatient Data, DRG Charges, Medicare Payment, Inpatient Payment Data

Other Titles

Medicare Inpatient Utilization and Payment Data 2013, Medicare Inpatient Charges Data 2013

NameDescriptionTypeConstraints
DRG_DefinitionDiagnosis related group definition, The code and description identifying the MS-DRG. MS-DRGs are a classification system that groups similar clinical conditions (diagnoses) and the procedures furnished by the hospital during the stay.string-
Provider_IdProvider identification, The CMS Certification Number (CCN) assigned to the Medicare certified hospital facilityintegerlevel : Nominal
Provider_NameName of providerstring-
Provider_Street_AddressStreet address of the providerstring-
CityCity of the providerstring-
State_AbbreviationState of the providerstring-
Zip_CodeZipcode of the provider regionintegerlevel : Nominal
Hospital_Referral_Region_DescriptionHospital referral region location of the providerstring-
Total_DischargesNumber of total discharges billed by the provider for inpatient hospital servicesnumberlevel : Ratio
Average_Covered_ChargesThe provider's average charge for services covered by Medicare for all discharges in the MS-DRG. These will vary from hospital to hospital because of differences in hospital charge structures.number-
Average_Total_PaymentsThe average total payments to all providers for the MS-DRG including the MSDRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Also included in average total payments are co-payment and deductible amounts that the patient is responsible for and any additional payments by third parties for coordination of benefits.number-
Average_Medicare_PaymentsThe average amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Average Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co-payments and deductible amounts nor any additional payments from third parties for coordination of benefits.number-
DRG_DefinitionProvider_IdProvider_NameProvider_Street_AddressCityState_AbbreviationZip_CodeHospital_Referral_Region_DescriptionTotal_DischargesAverage_Covered_ChargesAverage_Total_PaymentsAverage_Medicare_Payments
638 - DIABETES W CC390063UPMC HAMOT201 STATE STREETERIEPA16550PA - Erie2029136.54942.253787.95
100 - SEIZURES W MCC390063UPMC HAMOT201 STATE STREETERIEPA16550PA - Erie1573331.610069.666678242.8
100 - SEIZURES W MCC520045THEDA CLARK MED CTR130 2ND STNEENAHWI54956WI - Neenah15185239465.28305.2
313 - CHEST PAIN70031GRIFFIN HOSPITAL130 DIVISION STDERBYCT6418CT - New Haven2013028.64397.053470.3
638 - DIABETES W CC70029BRISTOL HOSPITALBREWSTER RDBRISTOLCT6010CT - Hartford2021791.75667.554900.75
637 - DIABETES W MCC390063UPMC HAMOT201 STATE STREETERIEPA16550PA - Erie1361701.30769100568131.230769
100 - SEIZURES W MCC140011HERRIN HOSPITAL201 S 14TH STHERRINIL62948MO - St. Louis1434902.4285789148176
101 - SEIZURES W/O MCC350006TRINITY HOSPITALS407 3RD ST SEMINOTND58701ND - Minot1218738.754800.53788.5
313 - CHEST PAIN50039ENLOE MEDICAL CENTER1531 ESPLANADECHICOCA95926CA - Chico2437104.754263.9166673240
389 - G.I. OBSTRUCTION W CC390063UPMC HAMOT201 STATE STREETERIEPA16550PA - Erie2526465.765457.44282.76