Institutional Provider And Beneficiary Summary PUF

The dataset summarizes data from Medicare institutional claims paid to providers during the calendar year as well as summarizes beneficiary demographic data. There are three categories of measures included in the dataset: beneficiary measures, cost and utilization measures and prevention quality indicators (PQI).

Summarized beneficiary measures include beneficiary demographics (e.g., breakdown of beneficiaries number by gender, age, and race), health status information (e.g., breakdown of beneficiaries number by selected chronic conditions) and the top five hospital referral regions (HRRs) where that provider’s beneficiary population resides.

Summarized cost measures include actual and standardized Medicare payments, deductible and coinsurance payments, and pass-through costs.

Utilization measures are summarized in terms of days, stays, visits, episodes, and readmissions.

The PQI measures are based upon hospital inpatient data and include hospital admissions for specific conditions that are considered “ambulatory care sensitive conditions.”